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Brain cancer – a dangerous disease that is difficult to treat and can lead to the death of the patient. The greatest threat lies in its asymptomatic course – the fourth stage of brain cancer, in which the patient has severe symptoms of the disease, is difficult to treat, and the prognosis for such patients is disappointing.
At the same time, the symptoms with which the patient can consult a doctor are easily confused with manifestations of other diseases. So, headaches, vomiting and dizziness in combination with visual impairment are characteristic of migraine, hypertensive crisis. Pain in the head can also be triggered by osteochondrosis. Therefore, in the treatment of brain cancer, much depends on the qualifications of the doctor who is consulted for diagnosis – whether he will be able to detect dangerous signs in time and conduct the necessary examination, which will help identify the oncological process.
Tumors are classified according to the tissues in which they began to grow. So, tumors that develop from the lining of the brain are called menangiomas. Tumors that arise in the tissues of the brain are gangliomas or astrocytomas, the common name is neuroepithelial tumors. Neurinoma is a malignant neoplasm that affects the sheath of cranial nerves.
Gliomas account for 80% of malignant neoplasms of the brain, meningiomas are also common tumors, occurring in 35% of cases of primary brain cancer.
Causes of brain cancer
The causes of brain tumors are not well understood – in 5-10% of cancers are provoked by hereditary pathologies of genes, secondary tumors occur when metastases spread from cancer of other organs.
The following causes of brain cancer can be distinguished:
Genetic diseases such as Gorlin’s syndrome, Bourneville’s disease, Li-Fraumeni syndrome, tuberculous sclerosis, and APC gene disorders can cause brain cancer.
The weakened state of immunity that can occur after organ transplantation in AIDS patients increases the likelihood of cancerous tumors in the brain and other organs.
Brain cancer is more common in women than in men. The exception is meningiomas – neoplasms of the arachnoid membrane of the brain. Race also plays an important role – white people are more likely to suffer from the disease than members of other races.
Exposure to radiation and carcinogens also carries an oncogenic hazard and is a risk factor for the development of brain cancer. The risk group includes people involved in hazardous industries, for example, in the industrial production of plastics.
Brain cancer is more common in adults, with age the risk of malignant neoplasms increases, and the disease is more difficult to treat. Children also have a risk of developing cancer, but the typical sites of tumor localization are different: for example, in adults, cancer often affects the membranes of the brain, while in younger patients, the cerebellum or brainstem is affected. In 10% of adult brain cancers, the tumor affects the pineal gland and pituitary gland.
Secondary tumors are the result of other oncological processes in the body – metastases enter the skull through the circulatory system and give rise to a malignant neoplasm in the brain. Such tumors are often found in breast cancer and other cancers.
The first signs of brain cancer
With tumor formations of the brain, the symptoms are of two types: focal and cerebral. Cerebral are characteristic of all cases of brain cancer, while focal depend on the location of the tumor.
Focal symptoms can be very diverse, their type and severity depend on the part of the brain that has affected the disease and the functions for which it is responsible – memory, oral and written speech, counting, etc.
Among the focal symptoms of brain cancer, there are:
Partial or complete impairment of the mobility of some parts of the body, impaired sensitivity of the limbs, distorted perception of temperature and other external factors;
Changes associated with the personality – the character of the patient changes, the person may become quick-tempered and irritable, or, on the contrary, too calm and indifferent to everything that previously worried him. Lethargy, apathy, frivolity in making important decisions that affect life, impulsive actions – all this can be a sign of mental disorders that occur with brain cancer.
Loss of bladder control, difficulty urinating.
All brain tumors are characterized by common symptoms associated with an increase in intracranial pressure, as well as the mechanical effect of the neoplasm on various centers of the brain:
Dizziness, loss of balance, feeling that the ground is slipping from under your feet – occur spontaneously, are an important symptom that requires a diagnostic study;
Pain in the head – often dull and bursting, but can have a different character; usually occur in the morning before the first meal, as well as in the evenings or after psycho-emotional stress, aggravated by physical exertion;
Vomiting – appears in the morning or uncontrollably occurs with a sharp change in the position of the head. May appear without nausea, not associated with meals. With intense vomiting, there is a risk of dehydration of the body, which is why the patient is forced to take drugs that block the stimulation of the corresponding receptors.
Other symptoms of brain cancer
Symptoms of brain cancer that appear already in the later stages:
Partial or complete loss of vision, “flies” before the eyes – a symptom provoked by the pressure of the tumor on the optic nerve, which, in the absence of timely treatment, can lead to its death. It will be impossible to restore vision in this case.
Squeezing by a tumor of the auditory nerve causes hearing loss in the patient.
Epileptic seizures that occur suddenly in young people are a dangerous sign that you should immediately consult a doctor. Characteristic of the second and later stages of brain cancer.
Hormonal disorders are often observed in adenomatous neoplasms of glandular tissue that are capable of producing hormones. Symptoms in this case can be very diverse, as in other diseases associated with hormonal imbalance.
Lesions of the brain stem are characterized by a violation of the function of breathing, swallowing, distorted sense of smell, taste, vision. Despite the severity of the symptoms, which can significantly reduce the quality of life and make a person incapacitated and dependent, brain damage can be minor and benign. But even small tumors in this area can lead to serious consequences, displacement of brain structures, which necessitates surgical intervention.
Tumors in the temporal zone of the brain manifest themselves as visual and auditory hallucinations, neoplasms in the occipital region are characterized by impaired color perception.
Diagnosis of brain cancer
Types of brain cancer diagnostics include:
Personal examination by a doctor. During the initial examination, the doctor asks the patient to perform a series of tasks that allow you to determine violations of coordination, tactile and motor functions: touch your fingers to your nose with your eyes closed, take a few steps right after rotating around yourself. The neurologist checks the tendon reflex.
MRI with contrast prescribed in the presence of deviations from the norm, which allows you to detect brain cancer at an early stage, determine the localization of the tumor and develop an optimal treatment plan.
Puncture of brain tissue allows you to determine the presence of abnormal cells, the degree of tissue change, determine the stage of the oncological process. However, tissue biopsy is not always possible due to the inaccessible location of the tumor, so such an analysis is most often performed when a malignant neoplasm is removed.
X-ray – allows you to determine the presence and localization of the tumor on the blood vessels displayed in the picture, for which the patient is first injected with a contrast agent. Craniography allows you to determine changes in the bone structure of the skull, abnormal layers of calcium, provoked by the oncological process.
After a diagnostic examination, the doctor draws up an individual treatment plan.
Stages of brain cancer
Due to the almost asymptomatic course of the disease, it is difficult to accurately determine the stage of cancer, especially since the transition from one stage to another occurs quickly and unexpectedly. This is especially true for cancers in the brain stem. The stage of the disease is accurately determined only after a post-mortem autopsy, therefore, the slightest manifestations of pathology should be treated carefully from the first days – in the last stages, cancer does not respond to surgical treatment, it reacts poorly to drugs and other types of therapy.
stage 1 brain cancer
In the first stage of cancer, a small number of cells are affected, surgical treatment is most often successful with a minimal chance of recurrence. However, it is very difficult to detect oncology at this stage – the symptoms are characteristic of a number of other diseases, so cancer can only be detected with special diagnostics. The first stage of cancer is characterized by weakness and drowsiness, periodic pain in the head and dizziness. With such symptoms, they rarely go to the doctor, as they attribute these manifestations to weakened immunity due to climate change or to chronic diseases.
stage 2 brain cancer
The transition of the cancer process to the second stage is accompanied by the growth of a tumor that captures nearby tissues and begins to compress the brain centers. Dangerous symptoms are convulsions and epileptic seizures. In addition, the patient may experience digestive disorders – problems with bowel movements and occasional vomiting. At this stage, the tumor is still operable, but the chances of a complete cure are reduced.
stage 3 brain cancer
The third stage of brain cancer is characterized by the rapid growth of the tumor, the malignant degeneration of cells affects healthy tissues, which makes it almost impossible to surgically remove the neoplasm. However, surgical treatment can give good results if the tumor is located in the temporal lobe.
Symptoms of the third stage of brain cancer – the symptoms of the second stage intensify, hearing, vision and speech impairments become more pronounced, the patient has problems with the selection, “remembering” words, it is difficult for him to concentrate, attention is scattered and memory is disturbed. The limbs become numb, tingling is felt in them, the mobility of the arms and legs is disturbed. In an upright position and when walking, it becomes almost impossible to maintain balance due to dysfunction of the vestibular apparatus. A characteristic symptom for the third stage is horizontal nystagmus – the patient has running pupils, even if the head remains motionless, the patient himself does not notice this.
stage 4 brain cancer
At the fourth stage of cancer, surgical treatment is not performed, since the tumor affects the vital parts of the brain. Palliative techniques, radiation therapy, drug treatment are used to reduce the patient’s suffering with the help of strong painkillers. The prognosis is disappointing, but much depends on the state of the patient’s immune system and his emotional state. Symptoms of brain cancer at this stage are associated with the loss of basic vital functions when the malignant process spreads to the corresponding parts of the brain. With low effectiveness of treatment, the patient falls into a coma, from which he no longer comes out.
How long do people live with brain cancer?
To predict the development of the disease and assess the health status of patients with brain cancer, the concept of “five-year survival rate” is used. People who have been diagnosed with a disease are evaluated, regardless of the course of treatment they are undergoing. Some patients after successful therapy live longer than five years, others are forced to constantly undergo medical procedures.
The average survival rate for patients with brain tumors is 35%. For malignant brain tumors, most of which are gliomas, the survival rate is about 5%.
Treatment for Brain Cancer
The treatment of brain cancer requires the interaction of specialists of different profiles – an oncologist, a therapist, a neuropathologist, a neurosurgeon, a radiologist and a rehabilitation specialist. Diagnosis of the disease usually begins with a visit to a general practitioner or neurologist, from where the patient is referred to other specialists for additional examination.
The further treatment plan depends on the age of the patient (cancer therapy in the younger age group 0-19 years old, middle and older is different). In addition, when drawing up a course of treatment, the general health of the patient, the type of tumor and its location are taken into account.
In the treatment of oncogenic neoplasms of the brain, radiation therapy, radiotherapy, and surgical intervention are used. The most reliable method is an operation to remove the tumor, but its implementation is not always possible due to the inaccessible location of the tumor formation. Surgical intervention is rarely performed at the third and fourth stages of cancer, as this entails great risks and does not give the desired result – at this stage of the development of the disease, the tumor affects the vital parts of the brain, deeply penetrates into healthy tissues and its complete removal is impossible.
Surgery
Surgical removal of a neoplasm is an effective method of treating brain cancer in the early stages, especially when it comes to benign tumors. Surgical intervention in this case differs from abdominal operations, in which the surgeon can capture some of the surrounding tissues in order to prevent the spread of the oncological process.
During surgery on the brain, maximum accuracy must be observed – an extra millimeter of tissue damaged during surgical procedures can cost a person a vital function. That is why in the terminal stages of cancer, surgical treatment is ineffective – it is completely impossible to remove the tumor, the pathological process spreads further. Palliative techniques can reduce the pressure that the tumor exerts on neighboring areas, and drug treatment, radiotherapy and chemotherapy slow down the growth of the neoplasm.
At the first and second stages of cancer, when a benign tumor is removed, the symptoms of the disease are completely eliminated. Therefore, with timely diagnosis, the prognosis for the patient is favorable. When the location of the tumor is difficult to access, surgical intervention requires additional studies to accurately determine the localization of the neoplasm. To classify the tumor and determine the stage of the cancer, the doctor takes a tissue biopsy.
To reduce tissue damage that may occur during the operation, modern techniques are used – stereostatic radiosurgery. This is a surgical operation, during which high-dose gamma-ray radiation or X-ray radiation is delivered in high precision in order to destroy the tumor. At the same time, healthy tissues are affected minimally or remain intact. The possibility of using the technique depends on the location and size of the tumor. Such treatment is the least traumatic for the patient, reduces the rehabilitation period and minimizes the risk of complications after surgery.
Conservative or drug therapy is carried out before surgery and includes:
Anticonvulsants – reduce the symptoms of the second and later stages of cancer, reduce the likelihood of an epileptic seizure;
Steroid anti-inflammatory drugs – drugs of this group relieve swelling of tumor tissues, which reduces mechanical pressure on healthy areas; a common remedy is dexamethasone;
To reduce intracranial pressure, shunt surgery may be necessary, the purpose of which is to remove excess cerebrospinal fluid, the removal of which is difficult due to compression of the CSF tract by the tumor. Fluid is withdrawn through a catheter in the process of ventriculo-peritoneal shunting – through a plastic tube, the lateral ventricle is connected to the abdominal cavity.
Radiation therapy
Radiation therapy of cancerous tumors is used in two cases: if the patient for health reasons is contraindicated in surgery or after removal of the tumor to prevent recurrence. Surgical removal of the neoplasm is ineffective in the late stages of brain cancer, then radiation therapy is used as the main method of treatment. The presence of concomitant chronic diseases, pathologies of the cardiovascular system may be a contraindication for surgical intervention. In other cases, radiation therapy may be used to kill abnormal cells that can cause cancer after the tumor has been surgically removed.
The specialist prescribes the radiation dose individually, the exposure is carried out locally in order to minimize damage to the tissues adjacent to the tumor. For radiation therapy, it is important to take into account the type of tumor, its location and size of the neoplasm. Two methods of radiation therapy are used:
Brachytherapy – performed during inpatient treatment; a radioactive substance is injected into the tissue of the tumor formation, which destroys it from the inside. The dose of the introduced grain is calculated in such a way that the tumor is destroyed, but healthy tissues remain intact.
External radiation therapy is carried out in a course of several weeks, during which the patient is irradiated with high doses of radiation for several minutes. Sessions are held five days a week, you can visit the hospital only at the appointed time, then the patient goes home.
Chemotherapy
Chemotherapy is not used as the main method of cancer treatment due to the fact that its effect concerns not only tumor tissues, but also affects the body as a whole. The treatment regimen is compiled by a doctor, including drugs of a certain group – antimetabolites, drugs of the alkylating group, synthetic antibiotics, etc. Treatment is carried out in a course of several cycles, between which it is necessary to pause. The drugs are taken orally or administered by injection or through a liquor shunt. After three or four cycles, a break is taken to evaluate the effectiveness of therapy.
The danger of chemotherapy lies in its negative impact on the hematopoietic organs and the epithelium of the digestive tract.
Endoscopic treatment
Endoscopic surgery is less traumatic than traditional neurosurgical methods, as it is performed using special equipment without wide incisions. In the course of conventional brain surgery, access is carried out by trepanation, during which the skull is opened, which additionally injures the patient, prolonging the rehabilitation period. Endoscopic methods minimize damage to nerves and tiny blood vessels, which is especially important when working with brain tissues. So, endoscopic operations are used to treat hydrocephalus in children caused by fluid stagnation in the ventricles of the brain, such an operation is called ventruloscopy. A pituitary adenoma can also be removed by endoscopic methods, by inserting endoscopic instruments through the nose – transnasal endoscopy.
Endoscopic surgery is also used for traumatic brain injuries, removal of cysts and hematomas.
The latest methods of non-surgical treatment of brain cancer
Oncology of the brain is the most difficult to treat, since the quality of processing incoming, as well as outgoing information from a person, depends on the nerve cells of the cerebral hemispheres and the connections between them. Simply put, when trying to destroy cancer cells, it is easy to hurt healthy ones, and when localized in the brain, this means a great risk of losing memory, intelligence, and communication between various organs and muscles.
In this regard, neurosurgeons are innovating, developing new methods of microscopic intervention to reduce this risk, and in the meantime, Japanese scientists have found an alternative means of fighting cancer and other diseases.
Gamma Knife – point radiosurgery
The creation and implementation of the gamma knife into practice provided doctors with the opportunity to remove brain tumors of various origins without trepanation. Also, this innovative technology is used to treat formations in the soft tissues of the head and neck.
The Gamma Knife has a whole range of advantages, the main of which are: no need to immerse the patient in general anesthesia, rehabilitation and lengthy preparation. Complications are kept to a minimum. The prognosis when using this method is the most favorable. After the procedure, in patients with benign neoplasms, the survival rate remains at the level of about 95%, and with malignant tumors – 89%.
The cost of therapy is high, it starts from 250 and can reach 000 rubles per procedure – this is the cost in Russia, prices abroad are much higher. Patients can apply for a quota, but it will not be granted as soon as possible.
In the center of radio wave microsurgery, up to 8000 procedures are performed annually using a gamma knife. The use of modern equipment makes this method effective and safe, and makes it possible to treat patients with complex diagnoses.
The benefits of therapy:
The doctor does not open the patient’s skull. It is no secret that trepanation is associated with a high risk of developing severe complications.
The patient does not need anesthesia. The procedure is painless, doctors limit local anesthesia to the area on which the frame is installed in order to fix the head in the desired position.
The person is in the ward, in the open space, and not in the cell. We can implement the method even for the treatment of children. However, they do not need to take sedatives.
The impact is targeted, only cancer cells are destroyed. Healthy tissues are not affected.
Gamma Knife is a method of treating tumors located in areas that are simply impossible to reach with a scalpel.
The process is under the control of artificial intelligence, which reduces the probability of error to zero.
Disadvantages:
During the procedure, the patient will have to be motionless for a long time. To do this, his head is fixed with a special frame. It puts a serious load on the skull, which is accompanied not only by discomfort, but also by pain. Local anesthesia is used to minimize discomfort.
The method is available for implementation only if the tumor does not exceed 35 mm in diameter.
The price of the course is high, and it takes only a few months, and sometimes even years, to get a quota. Cancer patients cannot afford such a long waiting period. During this time, the neoplasm may increase in size, due to which the operation will become inaccessible.
Limited application of the method. It is used only for the treatment of neoplasms in the brain, neck and head.
Less widely used is another innovative method of cancer treatment – this is a cyber-knife. Its disadvantages: even higher cost and little practical experience.
If treatment using the gamma knife was started at an early stage of the development of the disease, then the prognosis is favorable in 89% of cases.
Even the gamma knife cannot be considered a panacea. This method is not suitable for every patient. Often, relief is temporary, and full recovery is never achieved. However, with the help of a gamma knife, you can get rid of brain metastases and prolong the life of the patient.
Radiosurgery centers in Russia
The main radiosurgery centers in Russia are located in Moscow and St. Petersburg:
Research Institute. Burdenko;
“Gamma Clinic”;
branch in Obninsk (nearest Moscow region);
Radiosurgery Center “Gamma Knife” in St. Petersburg;
Oncological clinic MIBS in St. Petersburg;
Berezin Institute (St. Petersburg);
first aid to them. Sklifosovsky (Moscow).
In addition, similar equipment is located in Tyumen, Kazan, Khanty-Mansiysk, Saratov, Krasnoyarsk and Ufa. There are gamma knives in some private clinics.
[Video] What is Gamma Knife and how it works:
Men o’zimdagi belgilar sababini bilib oldim.Malumotlar uchun raxmat.