Brain tumor develops from two sources. The first is the uncontrolled growth of the brain's own cells (primary brain tumors), and the second is the involvement of the brain tissue of cancers developing in other organ systems in the body, especially lung and prostate (metastasis; secondary brain tumors). In both cases, tumor masses developing in a limited area of the skull compress the brain tissue and increase intracranial pressure. Neurological and epileptic problems can be seen in individuals with brain tumors. Brain tumors occur more often in children than adults. Brain tumors in children take the second place among childhood tumors.
What are the Types of Brain Tumors?
Brain tumors are primary (primary) developing from the brain tissue or developing due to the spread of another organ cancer to the brain. They are divided into two as secondary (secondary) tumors.
They are also classified as benign (benign) or malignant (malignant) according to the character of the tumor. Classification of brain tumors can also be made according to the cell type they originate from (histological). The most common type of tumor in the brain is called 'glioma' and develops from brain glial cells.
Why Does Brain Tumor Occur? What are the Causes?
The following risk factors play a role in the development of brain tumors:
- Increasing age: They are most common between the ages of 40 and 70. The incidence increases with increasing age. However, they are in the first place in tumors seen in children under 8 years old. Among the childhood brain tumors, medulloblastoma is the most common malignant brain tumor.
- The risk of development increases if exposed to radiation.
- Family history: Although it cannot be said with certainty that brain tumors are genetically inherited, the risk is high in those whose first-degree relative has a brain tumor.
- Smoking and alcohol consumption increase the risk.
What are the Symptoms of a Brain Tumor?
It acts as a helmet on the brain and other sensitive tissues in the skull bone. For this reason, it does not have an anatomical structure suitable for expansion when the skull bones fully unite (2 years old). they start doing it. The mass in the brain grows slowly and the tumor develops insidiously. Following an asymptomatic period, symptoms begin to appear according to the characteristics of the structures that the growing mass compresses.
The first sign of a brain tumor is usually severe headaches due to increased intracranial pressure. Headaches are unresponsive to painkillers and tend to increase in severity as the disease progresses.
The most common symptoms in brain tumors:
- Headache: Waking up in the morning with a headache, new onset severe headache (especially at night)
- Complaints such as nausea and vomiting accompanying headache,
- double vision with visual disturbances, blurred vision or shifting of shapes may occur. In such complaints, an ophthalmologist should be consulted and it should be investigated whether the complaints originate from the eye or the brain.
- Seizures can affect the whole body, or there may be spasms or contractions in the muscles we call twitching in the arms and legs.
- Mobility and balance problems can cause problems especially when standing, depending on the area where the tumor is.
- Changes in speech and personality may cause problems depending on the area where the tumor is.
How to Identify a Brain Tumor?
A series of physical and neurological examinations are performed to make the diagnosis. Diagnosis is made with MR (Magnetic Resonance) and CT (Computerized Tomography), and biopsy and pathological evaluation are performed to confirm the diagnosis. As a result, the type and stage of the cancer are learned precisely and a treatment plan is prepared.
How to Treat a Brain Tumor?
Treatment method; It varies according to the type of tumor, its size, the affected areas, its location, stage and general health status of the patient. Methods such as surgery, radiotherapy (radiation therapy), radiosurgery and chemotherapy can be used in the treatment.
Treatment of "glioma", which is the most common type, according to its stages:
- If the tumor location is not risky in stages 1 and 2, the tumor is completely removed. Afterwards, radiotherapy is applied to prevent recurrence. The life expectancy of patients after treatment is 6-8 years.
- Although the onset age is late in stage 3, progress is saved. Since the intracranial pressure is too high, the effect of edema is very pronounced and the treatment is generally not very good. The survival time of these patients is approximately 1.5 years and is around 60%.
- In stage 4, intense distribution is seen in the surrounding tissues. It is most common in adults. It progresses rapidly and the course of the disease is poor. 1-year survival rate 20%; The 2-year survival rate is predicted to be 10%. At this stage, the tumor cannot be surgically removed. For this reason, patients are given radiotherapy and chemotherapy.
Latest Developing Technological Methods and Brain Tumor Treatment
Today, brain and spinal cord tumors that can be diagnosed earlier can be operated with special devices. Before surgery, neuroradiology is evaluated and treatments are determined accordingly. The 5-ALA method is used for the safe and precise removal of the tumor site in the surgery. In addition, "neuronavigation" is used in all surgeries. Thus, the location of brain tumors can be determined more easily. In addition, brain surgery is performed with "motor-sensorial stimuli" in brain tumor surgeries located in special regions. In all spinal cord tumor surgeries, spinal cord functions are recorded instantly with neuromonitoring. Follow-up treatment processes after the surgeries are decided by the "neurooncology council".
- Surgical: The patient's health status, medical history, and tumor stage - if the location is appropriate- the complete removal of the tumor found by surgery is used as the first option. With the prolongation of the life expectancy after surgery, the quality of life also increases.
- Radiotherapy (Radiotherapy): It is based on the destruction of cancerous cells with high-energy rays. It is aimed to shrink and spread the tumor by giving it to both the tumor and the tissues near the tumor.
- Radiosurgery: It is aimed to neutralize tumors that are not suitable for open surgery with high-dose radioactive rays. It has been used in the treatment of tumors that are not suitable for surgery in Group Florence Nightingale Hospitals since 2012.
- Chemotherapy: It is applied before or after radiotherapy. Chemotherapy aims to kill cancer cells with drugs. But since it has an effect on healthy cells as well. may cause side effects such as nausea, vomiting, hair loss in patients. Chemotherapy drugs are usually given to the patient through a vein, but they are also available in capsule form.
How to Follow-up and Rehabilitation After Brain Tumor Treatment?
Follow-up is very important in terms of early detection of recurrence after treatment. For this reason, controls including physical and neurological examinations are made at regular intervals. In addition, CT or MRI should be performed at certain intervals. After treatment, the patient should be more careful. Rehabilitation may vary according to the patient's complaints. If the patient has arm and leg weakness in his daily life, while receiving appropriate physical therapy support, patients who have difficulty in swallowing and speaking should receive treatment accordingly. These treatment programs are determined by the physician.
How Does a Brain Tumor in Children Occur?
Brain tumor is the second most common type of cancer seen in children. Treatment is more difficult in children because of their younger age. Radiotherapy, which is a type of tumor treatment, cannot be applied to children, especially until the age of two. Until the age of two, children's bones are not completely fused, and even their fontanels do not close. Therefore, when the tumor occurs, it can expand and neurological findings become difficult to show. It is observed that behavioral disorders and head circumference are larger than normal in these children.
Tumors are examined in two groups according to the age of the children. (As tumors detected under 2 years of age and up to 16 years of age) Tumors that occur up to 2 years of age are generally congenital. These tumors are more common in childhood and are caused by "glial" cells in the central nervous system. The cause of brain tumors in children is mostly due to radiation. According to the stage of the disease in children with brain tumor, personality changes, not participating in games, introversion, lack of attention, memory problems, speech disorders are observed. Children over the age of two may also have problems such as seizures, headaches, vomiting, and failure in school.
MRI is performed for diagnosis in children as well as in adults. After the diagnosis is made, planning for treatment begins. But it appeared before As we have seen, treatments such as radiotherapy in children can be applied in a limited way because the child's brain development and bone development are not completed. For this reason, it is aimed to increase the expected life expectancy by performing radical surgery in children. Brain tumors can occur after birth or be congenital. Some tumors can be detected even in the womb. Ultrasonography (USG) and Magnetic Resonance (MR) methods can be used to detect it in the womb.
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