Brain Tumor is a Tissue That Arise
A brain tumor is a tissue that arise from the nerve supporting tissue (glioma / astrocytoma) or in the territory of the meninges (Meningeom) or the pituitary gland (Hypophysenadenom) develops in the brain and its function impaired.
Brain tumors are rare malignant tumors that arise from different cells can form. This leads to an uncontrolled proliferation and growth of cells in the brain tissue. Depending on the cell from which the tumor has formed, a distinction is made between different tumor types such as Gliomas, Meningeome, Hypophysenadenom and neurinomas.
There are 2 types of brain tumors:
1. primary brain tumors, are formed from different cell types of the brain, eg Neuroepithel and meninges (the primary tumor is located in the brain)
2. Secondary brain tumors are Tochtergeschwülste (metastasis) of cancers of other organs to migrate into the brain or metastases.
The WHO (World Health Organization) distinguishes between benign (benign) and malignant (malignant) brain tumors. Classification of grade 1 (benign) to grade 4 (malignant). This corresponds to a grade 1 benign, slow growing tumor with favorable prognosis and grade 4 a malignant, rapidly growing tumor with poor prognosis. This division plays later in the treatment planning is important.
Benign brain tumors do not grow into the surrounding tissue and into metastasieren (spread) is not. Due to the unbridled growth, they can, inter alia, the crowd surrounding tissue, the flow of brain fluid (Liquorabfluss) more difficult and lead to increased intracranial pressure, which is fatal for the patient can be. “Benign” in the sense only in relation to the infiltration, because the surrounding tissue of the tumor cells are not infected. The prospect of a cure are at complete removal of benign tumor is very large.
Malignant brain tumors grow on the other hand, infiltrative, and have no sharp boundary. After surgery, it is often to a relapse (recurrence), because individual cells in the surrounding tissues may always remain.
Among the most common brain tumors include:
* Gliomas: come most frequently before and 50% of all primary tumors. Gliomas are similar to glial cells and glia are derived from precursor cells in the central nervous system from.
* Medulloblastoma: malignant and most frequent tumor in childhood. The tumor has its origin in the cerebellum and is spreading rapidly into the surrounding tissue from metastatic preferred Liquorraum and in the brainstem.
* Meningeome: these are mostly benign, slow-growing tumors that arise from the hides brain (meninges) or skin form of the spinal cord. They are due to the slow growth until late or randomly detected when the tumor adjacent brain structures already has shifted and their function impaired. Meningeome rarely form metastases.
* Neurinomas: come mostly in the posterior fossa and are among the most benign, slow-growing tumors. They differentiate themselves from the Schwann cells, the nerves surrounding the brain. The eighth Hirnnerv which the auditory and balance sense gives (N. vestibulocochlearis) is most commonly affected. Neurinomas are no metastases.
* Lymphoma: evolving from lymphocytes (cells necessary for the body’s own defenses are responsible). They belong to the malignant tumors that originate from the lymphoid tissue. Although the brain has no lymphatic organs, lymphomas can also emerge, with the cause of this process is still unclear. This tumor frequently occurs particularly in patients with AIDS and immunosuppressed patients.
* Hypophysenadenom: belong to the benign brain tumors (with a good prognosis) and grow in the pituitary gland and the brain base.
Some of these tumors can form their own hormones, for example, Growth disorders or menstrual disorders may cause.
Brain tumors represent approximately 7-9% of all cancers. In Germany, each year approximately 8,000 people newly out, according to estimates by the Robert Koch Institute in Berlin. It is a disease incidence between the 3-12 Year of life before, and the 65th – 85 Year of life, with a brain tumor at any age can occur. Men are from this disease more often affected than women. When children are often diagnosed with primary brain tumors in adults and are often metastatic, ie secondary brain tumors, before.
Typical symptoms are frequent headaches, vomiting, neurologic symptoms and paralysis, depending on where the tumor is localized. The chance of cure is dependent on localization of the tumor and the tumor in the brain.
Causes
Despite intensive research has been the exact causes for the emergence of brain tumors has not yet been clarified. Risks and living habits, such as smoking and alcohol consumption, in other cancers are always in the foreground, obviously play in the emergence of a Gehirntumorm not essential. As risk factors are discussed ionizing radiation, genetic and hormonal factors, carcinogenic substances, and oncogenic viruses (tumor viruses), and certain chemicals (pesticides, herbicides). Enabling factors include certain diseases and their treatments, such as it was in some HIV-infected patients, with progression of the disease also increases the risk that a brain tumor develops.
Symptoms
A brain tumor is often a long time hidden in the beginning because it causes little discomfort. The tumor is usually diagnosed late, because the symptoms are not specific and may be ambiguous, including the first and most common symptom, headache.
Typical symptoms of the existence of a brain tumor may be indicative are:
* Headache, new onset and often, especially at night and early morning, which also increasingly are lying, but will spontaneously improve
* Dizziness voice and visual disturbances
* Stauungspapille (rare)
* Nausea and vomiting, slug-like, usually early in the morning, when the patient is sober and no gastro-intestinal disease, often signs of increased intracranial pressure
* Seizures, involuntary twitching of a limb or a body half
* Neurological failure, paralysis
* Coordination disorder, clumsiness, and forgetfulness
* Personality changes
Headaches, which caused by a brain tumor, are with the course of the disease within a few days to weeks and are always heavy with conventional painkillers hardly be alleviated. But there are always cases where the parties do not have a headache.
Diagnosis
It consists of a suspected brain tumor, various diagnostic methods. The earlier the diagnosis is made, the better the chances of a cure. In addition to questioning (medical history) and physical examination, imaging techniques are used.
The diagnosis is primarily on computer tomography (CT) or magnetic resonance imaging (MRI) asked. In CT X-rays are used to penetrate the brain and cut pictures represent, so you can tumors, hemorrhage and calcifications clearly. In contrast, MRI is working with radio waves and magnetic fields, the irregularities in the brain in more detail visible.
As a further diagnostic procedures are available:
* EEG (electroencephalogram) measures electrical potentials of the nerve, but may also be inconspicuous PET (positron emission tomography)
* Rötgennativaufnahmen of the skull (excluding cranial osteolysis)
Angiography * (presentation of the cerebral vessels with contrast media)
Lumbar puncture * / Liquorpunktion, investigation of the nerve water
* Biopsy tissue from the tumor (rare)
If the suspicion of a malignant tumor, the biopsy with complete tumor removal, because otherwise when sampling the tumor cells in the healthy brain tissue can diversify. Therefore, biopsies before surgery and only rarely carried out in strict indication.
Differential Diagnosis
As a differential diagnosis mainly diseases with intracranial space exposures and neurodegenerative diseases in question, this can be:
- Subduralhämatom (Einblutung into a gap space of the skull)
- Brain haemorrhage
- Multiple sclerosis (inflammatory demyelinating disease of the nervous system)
- Meningitis (inflammation of the meninges)
- Hirnabszess
Therapy
The treatment of brain tumors is difficult and needs the patient and the tumor will be individually adapted.
Basically, the following options:
* Surgical removal
* Irradiation
* Chemotherapy
In brain tumors is the first therapy of choice, the operation, with a partial or complete removal of the tumor. Indicates that an operation is not possible / sensible, because the tumor to vital areas of the brain as Respiratory center adjacent to alternative methods. The operation is performed on the patient monitor to brain areas important to maintain.
The procedure is not painful and will almost always be under local anesthesia durchgeführt.Da the tumor by surgery is often not adequately treated, it is in many cases post-treatment is required. These include the radiation and chemotherapy.
The main effect of the irradiation damage is on a fast-growing tumor cells by ionizing radiation with sparing of surrounding tissue. The sole radiotherapy leads even among Keimzelltumoren of the pineal gland (Germinomen) to a complete cure. The planning of the fixed dose is not administered with a meeting, but in daily small doses over several weeks or several times a day as a small individual doses delivered. In doing so, the radiation directly to the tumor, only in exceptional cases, the surrounding area mitbestrahlt, eg in certain lymphomas. Some tumor cells are very strahlenempfindlich. The radiation sensitivity is due to the rapid cell division. As a frequent side effects of radiotherapy occur tiredness, fatigue, limited hair loss, headaches, and local skin irritation, but after the therapy are reversible.
In addition to conventional radiotherapy, there is the stereotactic radiosurgery, here is the tumor by an energy blast destroyed. In Radiosurgery is particularly the procedure of the Gamma Knife (cobalt unit) performed. These are measured simultaneously from 200 sources of gamma rays emitted radiation in the tumor tissue at a predetermined point, and thus meet the targeted tumor and damage the surrounding tissue largely unharmed.
Chemotherapy for brain tumors has, in contrast to other cancers a subordinate role. It is only a few tumor types successfully used, eg with lymphoma.
Depending on the tumor growth and localization, the chemotherapy is given intravenously, ie as an infusion or i.v. Injection, tablet or as infrequently as an injection into the Liquorraum administered. But still, a combination of chemotherapy, surgery and radiation therapy is preferred.
Forecast
The more a brain tumor is malignant, the worse the prognosis. That means the prognosis is dependent on the tumor and the localization in the brain.
After the degree of the WHO classification can also derive the forecast.
* WHO grade I: benign, slow growing tumor with good prognosis (Hypophysenadenom)
* WHO grade II or benign tumor, with a tendency to relapse education, can convert to malignant tumors, a relatively good prognosis
* WHO grade III malignant tumor, after surgery, a radiation and / or chemotherapy is necessary, poor prognosis
* WHO Grade IV: very malignant tumor, rapid growth, after an operation is a radiation and / or chemotherapy is necessary, very poor prognosis (glioblastomas)
Again, the earlier a tumor is detected, the higher the chances of cure and the average life expectancy, as obtained by a targeted therapy in some cancers, and expression of growth delay and may alleviate the symptoms. If a tumor from a different region demonstrated brain metastases, so the forecast is again poor. Brain metastases limit survival much stronger than the primary tumor.
Information for patients
There are no specific measures to prevent a brain tumor. It should be generally against unnecessary radiation exposure to protect, especially from children should be preserved. The handling and contact with chemicals should also be avoided. Moreover, one can assume that a healthy lifestyle, the disease risk is limited.
In particular, family members should be attentive and sudden personality disorders, and abnormal symptoms (slug-like vomiting, headache becoming increasingly heated) by the patients themselves are not perceived to be serious, and possibly observe the patient to the doctor post. If the diagnosis, you can help with brain tumor or cancer support groups in touch and experience with other patients that are in the same situation. The German aid brain tumor has two telephone counseling services. First, the worries Phone (03437,999 68 67), which is always on Tuesdays 10:00 to 15:00 clock is occupied and in which the caller emotional support in coping with disease-related problems receive burdensome thoughts and feelings as well as address their own strengths and identify could mobilize.
The other offer is the information (03437.702 702), from Monday to Friday 9:00 to 16:00 clock can be contacted. It is superficial to the mediation of current, scientifically sound, understandable information. In order to provide a competent guide is independent and confidential to the individual concerns of the callers received.
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