Brain Tumours

About Brain Tumours

The brain is the centre of thought, memory, emotion, speech, sensation and motor function. The spinal cord and special nerves in the head called cranial nerves carry and receive messages between the brain and the rest of the body.

• There are two types of brain tumours:
• Primary — a tumour that starts in the brain. Primary brain tumours can be benign (non-cancerous) or malignant.
• Metastatic — a tumour caused by cancer elsewhere in the body that spreads to the brain. Metastatic brain tumours are always cancerous.
• Primary tumours in the brain or spinal cord rarely spread to distant organs.
• Brain tumours cause damage because as they grow they can interfere with surrounding cells that serve vital roles in our everyday life.

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General Risk Factors for Brain Tumours

Most brain and spinal cord tumours have no known risk factors and occur for no apparent reason. There are no known proven ways to prevent these tumours.

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Signs of Brain Tumours

No blood test or other screening exam can detect brain tumours, but there are often some outward signs. While tumours in different parts of the central nervous system disrupt different functions, some symptoms include:

•     * Headaches.
•     * Nausea/vomiting.
•     * Seizures.
•     * Weakness or numbness on one side of the body.
•     * Changes in vision, hearing or sensation.
•     * Difficulty with speech.
•     * Lack of coordination.
•     * A change in mood or personality.
•     * Memory loss.

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Diagnosing Brain Tumours

If you suffer from any of the initial signs of a brain tumours, your doctor will likely conduct some or all of the following tests:

  

• A physical exam to determine your overall health.
• A neurological exam to evaluate brain and spinal cord function.
• Imaging studies, such as CT, MRI or PET scans, to look for signs of a brain tumour.
• If studies or scans indicate you might have a brain tumour, some tissue may be taken from the tumour to make an exact diagnosis. This test is called a biopsy.
• A spinal tap may also be performed to look for tumour cells. During this test, a needle is placed in the lower back to obtain a sample of cerebrospinal fluid. This fluid is then examined to see if tumour cells are present.

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Treating Brain Tumours

If doctors determine that you have a tumour, the treatment options and prognosis are based on the following factors:

• Tumour type.
• Location and size of tumour.
• Tumour grade (how abnormal the cells are).
• Your age, medical history and general health.

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Understanding Radiation Therapy

Radiation therapy, sometimes called radiotherapy, is the careful use of radiation to safely and effectively treat many different kinds of tumours.

• Doctors called radiation oncologists use radiation therapy to aim to kill tumours, to control tumour growth or to relieve symptoms.
• Radiation therapy works within tumour cells by damaging their ability to multiply. When these cells die, the body naturally eliminates them.
• Healthy cells near the tumour may be affected by radiation, but they are able to repair themselves in a way tumour cells cannot.

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Radiation Therapy Options for Brain Tumours

People with brain tumours should discuss treatment options with several cancer specialists, including a radiation oncologist. A radiation oncologist is a doctor who will help you understand the types of radiation therapy available to treat your tumour. Conventional radiation therapy treatment options for brain tumours include:

• External beam radiation therapy.
• Brachytherapy or internal radiation therapy.

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External Beam Radiation Therapy

External beam radiation therapy involves a series of daily outpatient treatments over several weeks to accurately deliver radiation to the brain. Radiation is often given after surgery, and sometimes it is used instead of surgery.

• 3-dimensional conformal radiotherapy (3D-CRT) combines multiple radiation treatment fields to deliver precise doses of radiation to the brain. Tailoring each of the radiation beams to the patient's tumour allows coverage of the brain tumour while keeping radiation away from nearby organs, such as the eyes.
• Intensity modulated radiation therapy (IMRT) is the most recent advance in the delivery of radiation. IMRT differs from 3D-CRT by modifying the intensity of the radiation within each of the radiation beams.
• Stereotactic radiotherapy, sometimes called radiosurgery, is a type of external beam radiation therapy that pinpoints high doses directly on the tumour, in some cases in only one treatment.

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Internal Radiation Therapy

Internal radiation therapy, or brachytherapy, works by placing radioactive sources in or just next to a tumour.

• During brachytherapy, a tube or balloon called a catheter will be inserted into the brain. The radiation will then be carried to the tumour using this catheter.
• The radioactive source will then be left in place from several hours to several days to kill the tumour cells.
• In some cases, the radiation is permanently placed directly into the tumour or the area where the tumour was before surgery.

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Newer Techniques

Doctors are constantly exploring new and better ways to treat primary brain tumours.

• Drugs that make tumour cells more sensitive to radiation are called radiosensitisers. Combining radiation with radiosensitisers may allow doctors to kill more tumour cells.
• Chemotherapy is used with radiation to treat some brain tumours. Your doctor may recommend that you consult with a medical oncologist (chemotherapy doctor) before starting radiation.

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Potential Side Effects

The effects of brain radiation can vary depending on your tumour and the technique used to treat it.

• Before treatment, your radiation oncologist will discuss any side effects — however rare — you may experience.
• Possible side effects can include fatigue, change in appetite, headaches, visual changes, hair loss, skin irritation, nausea, vomiting and/or unsteadiness.

Some side effects can be treated with steroids or other medications. Talk to your doctor about any problems you experience.

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