Various types of tumors in the brain account for approximately 6% of all tumor formations in the human body. They occur in approximately 10 - 15 cases per 100 thousand population.
ALENA PARETSKAYA
Pathophysiologist, immunologist, member of the St. Petersburg Society of Pathophysiologists ALEXANDER SERYAKOV MD, professor, oncologist, hematologist, radiologist (radiation therapist) of the highest category, leading oncologist of the SM-Clinic holding »
What is a brain tumor
“Brain tumors,” says oncologist Alexander Seryakov, “are intracranial neoplasms, including both tumor lesions of the brain tissue itself, as well as nerves, membranes, blood vessels, and endocrine structures of the brain.
Such formations can be benign or malignant in nature. Benign tumors put pressure on certain areas of the brain directly adjacent to the tumor and can lead to disruption of the functioning of individual structures in the brain itself.
A malignant tumor is distinguished by very rapid growth and the ability to grow into the surrounding tissues. Glioma is one of the most common types of malignant brain tumor. Its most aggressive type is glioblastoma. It grows quickly and has no clear edges. It is difficult to treat, with a high relapse rate.
Other malignant brain tumors include:
- meningiomas – tumors of the meninges;
- neuroepithelial tumors (gangliomas and astrocytomas);
- Neuromas are special tumors from the membranes of nerve cells.
Causes
The causes of brain cancer have not been established. Only a few risk factors have been identified, and most of them are uncontrollable. These are radiation exposure, heredity, and some congenital syndromes. It is also known that the risk of primary lymphomas of the central nervous system increases with immunodeficiency, but the proportion of these tumors in the structure of brain tumors is low.
Causes of brain tumors in adults
Scientists have not yet determined the exact cause of tumors, but there are assumptions about the connection of their growth with the effects of radioactive radiation, toxins penetrating the body, and environmental pollution.
Children may develop congenital neoplasms - one of the reasons is considered to be intrauterine development disorders. A possible factor may be traumatic brain injury, which can also intensify an already existing process.
There is evidence that some brain tumors can develop after radiation therapy prescribed for the treatment of other pathologies, immunosuppressive treatment, and HIV infection. There is a hereditary predisposition to certain types of brain cancer. But for many people the cause remains unknown.
About 10 - 30% of brain tumors are of metastatic origin - these are cells that are carried by the blood flow (less often lymph) into the brain vessels, tissues, and membranes. About 60% of such tumors are multiple.
Most often it metastasizes to the brain:
- in men – lung damage, colorectal cancer, kidney damage;
- in women - breast cancer, melanoma, colorectal and lung cancer.
Intracerebral metastases occur with cancer of the uterus, digestive tract or prostate.
Why is it worth coming to Germany for brain cancer treatment?
In addition to the general reasons and advantages of treatment in Germany, which we described in this section of the site, in Germany doctors never refuse to treat patients who have already come to their clinic for treatment. If the doctors agreed to accept you for treatment, then they will not send anyone home to die, but will fight to the end. When making decisions about the need to use a particular technique, German doctors proceed from the patient’s condition and the appropriateness of treatment, but they never refuse further treatment simply because of the patient’s age, as is often the case in other countries. If it becomes obvious that it is no longer possible to stop the progression of the disease, the patient is offered a well-thought-out palliative program to alleviate suffering and relieve pain as much as possible.
Signs of a brain tumor in adults
Focal symptoms are often among the first to appear.
They arise due to the pressure of the tumor on the surrounding tissues and chemical reactions to foreign cells, hemorrhages, blockage of blood vessels with a tumor embolus, compression of tissues and nerves. As the tumor grows, symptoms from neighboring areas appear, then general brain symptoms. If the tumor is large, a so-called mass effect may occur (the main structures of the brain are displaced, causing the cerebellar region to become wedged into the opening of the skull). One of the early signs is headache. It is usually local and occurs due to irritation of blood vessels, nerves, and meninges. There may be diffuse pain throughout the head, which is typical of meningeal lesions. The nature of the pain is paroxysmal, deep, intense or bursting.
Another sign is vomiting, which is not associated with food intake. It may or may not be at the peak of the headache.
Dizziness occurs in the form of dips, rotation of the body or objects around.
Possible muscle weakness, muscle hypertonicity, uneven on one and the other side of the body, changes in tendon reflexes. Muscle-joint sensations may also suffer - sensations during movement, pressure, vibration.
For many tumors, convulsive syndrome is typical - sometimes it becomes the first sign of brain damage. There may be absence seizures or tonic-clonic seizures, Jacksonian epilepsy. Some people also experience an aura before attacks. As the tumor grows, there may be partial seizures or decreased activity of the lesions.
Some people may have mental disorders. Sloppiness, lack of initiative, aggression, euphoria or causeless gaiety, apathy, complacency can also be signs of brain damage. Tumor growth increases the severity of symptoms. Visual hallucinations, severe memory disturbances, attention problems and thinking problems may occur.
Possible problems with vision, congestion in the area of the optic nerve - these are floaters before the eyes, blurred vision, fog, blurred vision. Fields of vision may be lost.
Additionally possible:
- hearing loss;
- aphasia;
- ataxia;
- eye movement disorders;
- hallucinations (auditory, gustatory);
- autonomic dysfunctions.
If the hypothalamic-pituitary region is affected, hormonal metabolism suffers.
How can cancer be cured?
At the moment, medicine has three large groups of treatment methods. They can be used individually or in various combinations:
1. Surgical intervention. The most radical, but also the most effective method of treatment. The surgeon’s task is to remove the detected malignant tissue as completely as possible.
Unfortunately, surgery is not always possible. For example, if the tumor has spread to too large a part of a vital organ or distant metastases have already appeared. In this case, surgical intervention may be considered inappropriate. Is it possible to cure cancer without surgery? Theoretically, yes. But if doctors see that with the help of drugs it was possible to destroy the metastases, they will still recommend surgical removal of the main malignant focus. Let us repeat: surgery is the most effective way to get rid of a tumor.
2. Treatment with drugs. This includes both traditional chemotherapy and all new developments in the field of pharmacological treatment of tumors - immunotherapy, targeted treatment, etc.
3. Exposure to ionizing radiation. Due to their rapid metabolism, tumor cells absorb radiation more actively. And therefore, they die much faster under its influence. This is precisely the basis for the treatment of malignant tumors with radiation therapy.
Stages of brain tumor in adults
A typical stage for a cancerous lesion determines treatment options, prognosis, and typical signs and symptoms.
There are 4 stages in total - from the mildest to the extremely severe. The first stage is when one of the parts of the brain is affected by a small neoplasm, a nodule, there is no penetration into neighboring tissues, there is no pressure on the surrounding areas of the brain.
The second stage - the tumor grows slowly, but there is penetration into neighboring areas;
The third stage - the tumor changes its structure, cells divide faster, neighboring sections and tissues grow;
Stage four – the tumor is large, grows into neighboring brain structures, and distant metastases are possible.
Stages
Doctors distinguish 4 main degrees of brain cancer:
- The neoplasm is small in size, does not affect or compress nearby structures, and does not metastasize.
- The tumor noticeably increases in volume, can disrupt the activity of nearby healthy areas, and also germinate into them; there are no metastases.
- The neoplasm is moderately aggressive, often inoperable, and can produce single metastases.
- The neoplasm reaches a significant size, affects other parts of the organ and gives distant metastases.
The rate of tumor progression depends on the type of cancer. Sometimes cancer develops very slowly, while other tumors are extremely aggressive.
Diagnostics
The first examination is carried out by a neurologist.
The doctor evaluates general complaints, conducts an examination, examines muscle tone, reflexes, communication, emotions and cognitive functions. EEG and echo-encephalography are also performed. A visit to an ophthalmologist is indicated to assess the condition of the fundus, acuity, and visual fields. Suspicion of a tumor formation is an indication for a CT or MRI of the brain. Angiography of cerebral vessels, PET scan and other complementary examinations may be prescribed. In some cases, a biopsy can help determine the type of cancer, but it is not possible in all cases.
Modern methods of treatment
“The volume of treatment is selected depending on the course of the brain tumor,” says oncologist Alexander Seryakov.
– The most effective is surgical removal of the tumor. The use of surgical microscopy and navigation allows for radical removal of the tumor and minimizes injury to healthy tissue. If the tumor cannot be completely removed, after its partial removal, the patient is prescribed radiation, as well as chemotherapy, targeted (“targeted”) or immunotherapy. For small malignant tumors (up to 3 cm), stereotactic radiosurgery is possible (using Cyber-Knife linear accelerators or Gamma-Knife gamma machines). To remove tumor tissue, many beams of radiation are used at once, which are directed at one point or collected into one beam. Its direction will constantly change during the irradiation session, but the beam necessarily passes through the tumor tissue.
For large tumors, and especially in cases where it is impossible to surgically remove the tumor, classical external beam radiation therapy is used. In some cases, it is used after surgery to reduce the risk of relapse (regrowth).
Chemotherapy is carried out with cytostatic drugs, taking into account the type of tumor. The effectiveness of chemotherapy increases significantly if it is combined with radiation therapy.
Targeted therapy in combination with radiotherapy and chemotherapy improves survival of patients with aggressive brain tumors. Most often used in the treatment of glioblastomas.
Currently, methods of using immunotherapy for malignant tumors (antitumor vaccines, immunotherapy drugs) and its integration into existing standards of treatment are being considered.
How is the operation performed?
Neurosurgical operations to remove malignant tumors are complex and high-tech. It is important for the doctor to remove the tumor completely, without damaging functionally significant areas of the brain.
The procedures that determine the success of the operation often begin before it even begins. Doctors conduct a thorough examination of the patient, especially if the tumor is deep. They determine the boundaries of the tumor using PET or functional MRI. Then it is necessary to identify functionally significant areas in order to bypass them by dissecting the brain tissue. For this purpose, functional mapping and electrophysiological studies are used. If necessary, studies can be performed directly during surgery.
The operation is performed under stereotactic control. Stereotaxis allows the doctor to perfectly navigate inside the patient's skull. The classic version involves the use of a rigid frame, which is fixed with screws to the periosteum. In recent years, frameless stereotaxis systems have become widespread.
The most important task of the neurosurgeon, which determines the success of the operation, is to completely remove the tumor. But to do this, it must be distinguished from healthy tissue. They look almost the same. To find the boundaries of the tumor, fluorescent diagnostics and laser spectroscopy are used. The doctor uses a substance that is absorbed by abnormal cells and causes them to glow.
A German study involving 350 patients showed that without fluorescent diagnostics, glioblastoma can be completely removed in only 1 out of 3 patients, and in 2/3 of cases with its use. The probability of no tumor recurrence within 6 months after surgery increases by 2 times.
Our expert in this field:
Malakhov Igor Yurievich
Neurosurgeon
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Prevention of brain tumors in adults at home
Prevention of brain tumors, according to oncologist Alexander Seryakov, generally includes:
- healthy lifestyle;
- optimal physical activity (preferably in the fresh air);
- complete rest;
- giving up bad habits (for smokers and alcohol abusers, the likelihood of developing brain tumors increases by almost 30%);
- a diet rich in fruits and vegetables;
- limiting stressful situations (or changing your attitude towards negative circumstances).
What are the survival prognoses at different stages?
It is impossible to give numbers here that would have at least some universal meaning. The scatter, depending on the type of tumor, its molecular genetic characteristics and other individual characteristics, is too great. To the question “can stage IV cancer with metastases be cured,” the answer will be positive. But taking into account that for each patient the probability of cure is very different.
Only one thing can be said for sure: the higher the stage of tumor development, the worse the prognosis. And if at stage “0” or “I” for almost all types of cancer the survival rate is 90-100%, then at stage IV it usually does not exceed 5-7%. Although these values may vary greatly. According to the American Cancer Society, the five-year survival rate for stage IV cancer is:
- prostate - 30%;
- breast - 25-28%;
- uterus - 8-12%;
- stomach - 6%;
- lung - 3-7%.
So, the main conclusion of this article is the fact that cancer is curable, and there are chances to defeat it at any stage of development. The specific answer to the question “can stage III or IV cancer be cured” depends on many parameters of the clinical case. But the sooner a tumor is detected, the higher the chance of getting rid of it. This means that the most effective way to increase this probability is to undergo periodic preventive screening examinations.
