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Brain Tumours and Brain Cancer

Brain tumors are abnormal growths of cells within the brain or its surrounding tissues. These growths can be benign (non-cancerous) or malignant (cancerous). A brain tumor can originate in the brain itself (primary brain tumor) or spread to the brain from another part of the body (secondary or metastatic brain tumor).

Brain cancer specifically refers to malignant brain tumors, which are aggressive and can invade surrounding brain tissue.

Types

1. Acoustic Neuroma:
A non-cancerous tumour on the nerve connecting the ear to the brain, causing hearing loss and balance problems.
2. Astrocytoma:
A tumour originating in star-shaped glial cells (astrocytes). It can range from low-grade to high-grade (glioblastoma).
3. Chordoma:
A rare, slow-growing tumour that forms at the base of the skull or spine, often affecting nearby nerves.
4. Choroid Plexus Tumor:
A rare tumour that arises in the ventricles of the brain, typically affecting cerebrospinal fluid flow.
5. CNS Lymphoma:
A malignant tumour affecting the lymphatic system in the brain, often linked to immunosuppressive conditions.
6. Craniopharyngioma:
A benign tumour near the pituitary gland, leading to hormone imbalance and vision issues.
7. Embryonal Tumor:
Aggressive childhood tumours that develop from embryonic tissue, often located in the cerebellum.
8. Ependymoma:
A tumour that forms in the lining of the brain's ventricles or spinal canal, leading to fluid buildup.
9. Glioblastoma:
A fast-growing, aggressive brain cancer with poor prognosis, known for rapid spread.
10. Glioma:
A broad category of tumours that arise from glial cells, including astrocytomas, oligodendrogliomas, and ependymomas.
11. Medulloblastoma:
Often forming near joints, such as the wrist, ganglion cysts may press on nerves, causing discomfort or limiting movement. These cysts sometimes disappear without treatment, but those that cause significant symptoms may require removal.
12. Meningitis and Meningioma:

Meningitis: Inflammation of the brain’s protective membranes, typically caused by infection.

Meningioma: A mostly benign tumour arising from the brain's outer membranes

13. Oligodendroglioma:
A slow-growing tumour from oligodendrocytes, cells responsible for producing myelin in the CNS.
14. Pineoblastoma:
A rare, malignant tumour that forms in the pineal gland, disrupting sleep patterns and hormone production.

Symptoms of Brain Tumors and Brain Cancer:

Symptoms depend on the tumor's size, location, and growth rate but can include:

Headaches (often worse in the morning or with activity)

Seizures

Nausea and vomiting

Cognitive or personality changes

Weakness or numbness in limbs

Difficulty with balance and coordination

Vision, speech, or hearing problems

Diagnosis of Brain Tumours and Brain Cancer

Early detection is essential for effective treatment. Diagnostic methods include:

Neurological Exams:

Evaluate motor skills, coordination, and sensory functions.

Imaging Tests

MRI (Magnetic Resonance Imaging): Provides detailed images of the brain to detect abnormalities.

CT Scans (Computed Tomography): Useful for spotting tumour size and location.

Biopsy:

Tissue sample analysis to determine whether the tumour is malignant or benign.

Molecular and Genetic Testing:

Identifies specific mutations for targeted treatments.

Lumbar Puncture:

Collects cerebrospinal fluid to detect cancer cells or infections if CNS lymphoma is suspected.

Treatment

Surgery:

Surgery is often the first line of treatment to remove as much of the tumour as possible.

  • Craniotomy: A portion of the skull is removed to access the tumour.

  • Minimally Invasive Surgery: Small incisions with the use of endoscopes or robotic systems for hard-to-reach tumours.

  • Awake Brain Surgery: Performed while the patient is conscious to ensure no critical functions (e.g., speech) are impacted during tumour removal.

  • Challenges: Tumours near critical brain regions may not be fully removable, requiring additional treatments.

Radiation Therapy:

Radiation therapy uses high-energy rays to destroy tumour cells or shrink them.

  • External Beam Radiation Therapy (EBRT): Directs radiation from outside the body over multiple sessions.

  • Stereotactic Radiosurgery (SRS): Delivers highly focused radiation in a single or few sessions (e.g., Gamma Knife, Cyber Knife). Ideal for small, inoperable tumours.

  • Proton Therapy: Uses protons as conventional radiation therapy to minimize damage to surrounding healthy tissue.

  • Side Effects: Fatigue, hair loss, and brain swelling can occur, requiring supportive care.

Chemotherapy

Chemotherapy drugs stop tumour growth or kill cancer cells directly.

  • Administration Methods: Directs radiation from outside the body over multiple sessions.

    1. Oral: Pills taken at home

    2. Intravenous (IV): Delivered directly into the bloodstream.

    3. Intrathecal: Injected into the cerebrospinal fluid for central nervous system cancers.

  • Common Drugs: Temozolomide (for glioblastoma) and Carmustine.

  • Challenges: Chemotherapy can lead to side effects like nausea, hair loss, and lowered immunity.

Targeted Therapy:

This approach blocks specific molecules or mutations that drive tumour growth.

  • EGFR Inhibitors: Effective for tumours with EGFR mutations (common in glioblastoma).

  • VEGF Inhibitors: Prevent tumour blood vessel formation.

  • mTOR Inhibitors: Blocks proteins involved in cell growth and survival.

  • Advantages: Fewer side effects than chemotherapy since healthy cells are less affected.

Immunotherapy:

Immunotherapy enhances the body’s natural defences to fight cancer cells.

  • Checkpoint Inhibitors: Blocks proteins that prevent immune cells from attacking the tumour.

  • Vaccine Therapies: Trains the immune system to target tumour-specific antigens.

  • CAR-T Cell Therapy: Immune cells are modified to recognize and destroy brain cancer cells.

  • Limitations: Brain tumours can evade immune detection, so immunotherapy may not always be effective alone.

Rehabilitation and Supportive Care:

Since brain tumours affect critical functions, patients may need rehabilitation during or after treatment.

  • Physical Therapy: Restores strength and mobility affected by surgery or radiation.

  • Occupational Therapy: Helps patients adapt to changes in cognitive or motor functions.

  • Speech Therapy: Addresses communication challenges if speech areas are impacted.

  • Counselling and Mental Health Support: Supports patients and families in coping with emotional stress and life adjustments.

Clinical Trials:

Patients can access cutting-edge treatments not widely available through clinical trials.

  • Emerging Therapies: New drug combinations, gene therapies, and advanced surgical techniques are tested.

  • Eligibility: Trials may have specific criteria, such as tumour type and previous treatments.

Conclusion

Brain tumours and brain cancers are challenging to treat, but advances in neurosurgery, radiation, and targeted therapies provide hope for better outcomes. Early diagnosis and comprehensive care tailored to the tumour type are key to improving quality of life.
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