- 1 What is brain tumor?
- 2 The brain
- 3 Types
- 4 Causes
- 5 Risk factors
- 6 What is the difference between a benign and a malignant tumor?
- 7 Symptoms
- 7.1 Syncope
- 7.2 Convulsions
- 7.3 Motor incoordination
- 7.4 Numbness
- 7.5 Changes in memory and cognition
- 7.6 Nausea
- 7.7 Mudanças na visão
- 7.8 Dores de cabeça
- 7.9 Mudanças de personalidade e comportamento
- 7.10 Delírio
- 7.11 Frequent symptoms of some brain tumors
- 8 How is the diagnosis made?
- 9 The care of the swelling of the cerebral tem?
- 10 What is the treatment?
- 10.1 Palliative treatment
- 10.2 Relieving intracranial pressure
- 10.3 Surgery
- 10.4 Radiotherapy
- 10.5 Chemotherapy
- 10.6 Target therapy
- 10.7 What if the treatment fails?
- 11 Medicines
- 12 Prognosis
- 13 Living together
- 14 Complications
- 15 How to prevent brain tumor?
- 16 Common questions
What is brain tumor?
A brain tumor is characterized when abnormal cells are formed in the brain. They divide very quickly and uncontrollably, bringing with them a series of complications. When they originate from cells of the Central Nervous System, they are classified as primary. When they come from other tumors, they are secondary.
The National Cancer Institute (INCA) estimated that approximately 9,090 (4,960 in men and 4,130 in women) would appear new cases of brain tumor in the years 2014 and 2015. It is also estimated that, in general numbers, this means that the likelihood of a person who develops a malignant brain tumor in his lifetime is less than 1%.
The causes of brain tumors are still unknown, however, among its risk factors, heredity is one of the main factors in conjunction with exposure to carcinogenic materials.
Among its complications, sensory changes (vision, hearing), changes in cognition, nausea, headaches and changes in personality and behavior can occur, although the latter is the least common.
It is very difficult to treat a brain tumor, since its location, which is very sensitive, requires thorough treatment and, in the case of surgery, a lot of precision.
It is not possible to state that the brain tumor can be cured, as each case has its particular characteristics. Despite this, many people are able to heal and return to live a normal life.
The brain tumor can be found in the International Classification of Diseases, or ICD-10, using codes D71 and D33.
Learn more about brain tumor in the following text:
The brain is part of the Central Nervous System (CNS) and is located in the skull, where it floats in a transparent liquid called cerebrospinal fluid, or cerebrospinal fluid, which protects it both physically and immunologically.
As it is considered the main organ of the SNC, we can say that it is the “director” who controls the vast majority of brain and body functions.
Everything that happens in our lives, even while we are sleeping, is to breathe, swallow, see, hear, touch, read, write, sing or dance; everything goes through the brain. Thus, it is possible to state that this body is responsible for the following functions:
- Control vital functions: functions such as the control of body temperature, blood pressure, heart rate, breathing, sleep, appetite, thirst, etc .;
- Receive, process and integrate all sensory information: vision, hearing, touch, taste and smell;
- Control movements: walking, running, talking, standing, etc .;
- Control of emotions and behavior: joy, anger, sadness, disgust, fear, surprise, etc .;
- Control cognitive functions: reasoning, thinking, memory, learning, perception, executive functions, etc.
The human brain contains about 86 million neurons and represents only 2% of body mass. Despite this, it receives approximately 25% of all the blood that is pumped through the heart.
To further facilitate the understanding and understanding of the complexity of brain tumors and why they are difficult to treat, it is also necessary to understand the role of certain anatomical structures of this organ, as each one plays a role. Check out!
The brain is considered the most complex organ in the body – the human. It has an ovoid shape and weighs just under 1.5 kg. It is symmetrically divided into 2 hemispheres, the right and the left, one of which is dominant.
Each hemisphere is divided into two ends, posterior and anterior, and three faces, the outer, the lower and the inner. Below the two hemispheres is the cerebellum. The union of these and other structures together is called the brain.
Seeking to facilitate understanding and quickly expose the functions of each part of the brain, we will not go into details about structures such as the brain stem, the ventricles and the spinal bulb, for example.
Check now the main brain regions and their functions:
It occupies the anterior part of the hemispheres. It is of great importance to perform functions such as mental flexibility, problem solving, but it is also responsible for several characteristics that define our personality.
To get an idea of how important the frontal lobe is in this regard, we can mention the famous case of Phineas Gage, one of the most famous in the field of neuropsychology.
After suffering an accident in which a 1 meter long iron rod passed through his skull, Gage recovered completely physically, but with some very peculiar side effects.
For the people around him, his personality changed a lot after the accident. They say that the man has ceased to be a responsible and peaceful man and has become irregular, blasphemous, aggressive and impatient.
This severely damaged his relationships, as well as his performance at work, causing him to jump from job to job until he found a job where he displayed his scars at the circus.
It was thanks to the case of Phineas Gage that science began to consider the possibility of the frontal lobe playing a fundamental role in maintaining our personality.
It is for this reason that tumors in the frontal lobe region can bring about several problems of cognition, memory and even bring about personality changes, as we will see later in the section “Psychiatric changes” of the topic “Complications”.
It is the middle part of the brain, located between the frontal and occipital lobes. It has the function of enabling the perception of sensations such as touch, pain and heat. It is the most sensitive area of the brain and represents all areas of the human body.
For these reasons, when tumors are present in this region of the brain, symptoms that affect perception, such as numbness, are present.
It is located at the back of the hemispheres. It works by processing visual stimuli, which are, for this reason, also known as the visual cortex. In addition, this region of the brain interprets visual signals, making it possible to recognize that the cat we see is a cat, not an unknown object.
Tumors and injuries in this region can cause vision problems, such as partial loss, or the inability to recognize objects, words and even the faces of family members.
The famous neurologist Oliver Sacks, in his short story that gives name to the book “The Man who mistook his wife for a hat”, tells the story of one of his patients, whom he calls Dr. P, who had some occipital lobe dysfunction and other regions and, therefore, did not recognize people or objects.
The problem was such that Dr. P mistook his wife for a hat and tried to put it on his head at the end of an appointment. The case is so peculiar that, although Dr. P managed to get his life back to normal, there was in fact no cure or 100% reliable explanation to explain this problem.
It is located at the bottom, in the region of the temples, above the ears, from where it receives the name “temporal”. Its main function is to process auditory stimuli. As with occipital lobes, it not only detects the sound signals but also interprets them.
Tumors in this location can cause hearing problems.
It is at the back of the skull, just below the brain. It is responsible for maintaining balance, controlling muscle tone, voluntary movements and motor learning.
It is through the functioning of the cerebellum that we are able to walk, run, jump, swim and develop other physical activities. Therefore, tumors in this region can bring symptoms related to motor difficulties.
There are, in general, 2 types of brain tumor: the primary and the secondary .
When tumors originate in other organs, such as the breasts or lungs, and only then reach the brain, they are called secondary tumors, while those that originate directly in the brain are called primary tumors.
In adults, most tumors in the brain come from some other region of the body and have reached the brain through metastasis. Primary brain tumors, on the other hand, can originate anywhere in the brain or spinal cord and some contain a combination of cell types.
It is very important to know what type of tumor it is, as primary and secondary tumors require different treatments.
Unlike other cancers, a brain tumor is unlikely to metastasize and spread to distant organs. On the other hand, they cause serious damage and can have very serious consequences, as we will see in the article in the future.
Very rarely, a brain or spinal tumor is benign, with only a few rare exceptions. If they are not completely removed, they will continue to grow until leading to the eventual death of the patient.
Still, we must remember that the brain is a very plastic organ, very complex and divided into several regions. Therefore, it is possible to affirm that there are different classifications of tumors, referring to both the location they affect and the cell type of origin. Check out:
Pituitary tumors usually show neurological and hormonal symptoms together.
Neurological symptoms happen, most of the time, due to the compression that the tumor causes in the adjacent structures, and can present as a constant headache in the frontal and lateral regions, without relief after the use of common analgesics.
Another very common neurological symptom is the decrease in visual acuity, mainly due to the loss of the lateral visual field, which occurs due to compression of the optic chiasm (an X-shaped structure formed by the meeting of two optic nerves) by the tumor.
Hormonal symptoms, on the other hand, are a reflection of overproduction or lack of hormone production.
The lack of hormones causes symptoms that include lack of energy, drop in pressure, drowsiness, discouragement, lack of vitality, drop in blood glucose and others. The hormonal excess is a little more complex and we can divide the symptoms according to the type of hormone that is being produced in excess.
Hormonal excess can occur, for example, in growth hormones (GH and IGF-1), which can cause acromegaly, a disorder that causes the appearance of changes in the body such as the growth of the extremities (hands and feet), change in the facial aspect and alterations in the metabolism (hypertension and diabetes ).
Another hormone that can be found in excess in the body is prolactin. A small excess of this hormone can occur for causes other than a tumor, such as stress or the use of contraceptives.
However, when prolactin levels are very high, the possibility of having a tumor as the responsible one must be considered. In women, there is a drop in libido , irregular menstrual cycle and milk out of the breast (galactorrhea). In men, there is a loss of sexual potency, erectile dysfunction and an increase in the size of the mammary glands ( gynecomastia ).
There is still another hormone that can increase its production because of a tumor. This is cortisol.
Cortisol is a hormone related to the body’s stress reactions and is produced by the adrenal gland when stimulated by the pituitary hormone ACTH. This causes the patient to develop Cushing’s syndrome, a rare condition, characterized by the presence of a nodule in the pituitary gland that produces high ACTH levels.
The high production of ACTH results in the high production of cortisol, which ends up having very negative effects on the body.
When there is a high amount of cortisol in the body, symptoms such as weight gain, resulting from increased fat in the abdomen, loss of muscle mass with thinning of the arms and legs, appearance of large stretch marks , roundness of the face, thinner skin and subject to bruising, in addition to metabolic changes such as diabetes and hypertension.
It is a very rare and severe disease that must be treated by a neuroendocrinologist experienced in referral centers.
There is yet another situation, which is when the pituitary tumor appears during adolescence. In such cases, an exaggerated increase in the patient’s height may occur, leading to gigantism.
The main symptoms of this condition are changes in physical appearance, enlargement of the forehead region, prominent chin, spacing between teeth with tooth loss, increased volume of the nose and lips, thickening of the skin (becoming oily and more prone to acne) ), profuse sweating and respiratory, cardiovascular and metabolic disorders.
It is the appearance of benign tumors that normally occur at the base of the brain, close to the ophthalmic nerves and hormonal centers. They most often affect children, adolescents and individuals over 50 years of age.
They are classified by the World Health Organization (WHO) as grade I tumors, that is, tumors with low or uncertain potential for malignancy.
Your symptoms will depend a lot on where the tumor grew. When it is, for example, compressed in the pituitary stalk or surrounding the pituitary gland, it can lead to partial or complete deficiency in the production of growth hormones, causing delayed puberty.
They are tumors of the central nervous system (CNS) that originated from the vascular system. They usually occur in middle age and can affect other regions such as the spine, brain stem or retina.
They are usually associated with other diseases, such as polyglobulia (an exaggerated increase in the amount of red blood cells), pancreatic cysts and Von Hippel-Lindau syndrome (a rare and genetic disease that involves the abnormal growth of tumors).
It is a type of tumor located on the auditory nerve. It constitutes approximately 6% of all brain tumors, occurs equally in all races and has a slight predilection for women.
They are benign tumors that can be located deep in the skull and close to the vital centers of the brain. Its first symptoms are usually related to hearing loss, noises in the ear (tinnitus) or lack of balance.
Most of the times they are slow to grow and, in most patients, the symptoms are mild and almost imperceptible, and many of them have not evolved for years.
It can come in two forms:
- Associated with neurofibromatosis.
Patients who have a sporadic acoustic neuroma usually begin to show symptoms between 40 and 60 years of age, and the tumors usually affect only one side of the brain, that is, they are unilateral.
Acoustic neuromas associated with neurofibromatosis, on the other hand, usually present symptoms when the patient is between 20 and 30 years old (phase known as “young adult”). Unlike sporadic ones, these types of tumor are bilateral, that is, they affect both sides of the brain.
While the sporadic acoustic neuroma represents about 95% of the cases of acoustic neuroma, the one associated with neurofibromatosis represents the other 5%.
Tumors of the pineal region
Tumors of the pineal region tend to happen during childhood, but they can appear at any time in life. They happen in the pineal gland, a small structure located near the center of the brain and responsible for regulating the so-called circadian cycles, responsible for regulating the biological cycle.
These tumors can increase intracranial pressure by compressing the Sylvius aqueduct, a channel that allows cerebrospinal fluid to pass through. It can also cause ptosis (drooping eyelids) and loss of pupil reflexes to light and accommodation.
It is not exactly a brain tumor, as it happens in the meninges, which are the layers of tissue that cover the brain and spinal cord. They cause similar symptoms, however, as they increase the size of the meninges, putting pressure on the brain or spinal cord.
They are quite common and represent about 25% of primary brain tumors and most spinal cord tumors. In adults, it is the most common type of brain tumor and its incidence rate increases with age, being higher in people between 70 and 80 years old.
Unlike other types of brain tumors, most meningiomas (about 85%) are benign and can be cured by surgery. Some, however, appear in places very close to vital structures and cannot be cured with surgery alone.
The other, malignant portion, is more difficult to cure and may reappear after removal surgery.
Most brain tumors themselves arise from a type of cell called an astrocyte – hence the name astrocytoma. They represent about 35% of all brain tumors.
It is very difficult to cure this type of tumor because it spreads widely over nearby normal brain tissue. Often, even astrocytomas are disseminated throughout the tissues bathed in the cerebrospinal fluid.
It is very rare for astrocytomas to spread beyond the spinal cord.
In general, they are classified into astrocytomas of high or low degree of malignancy. This classification is done through microscopic analysis, where the pathologist evaluates the following characteristics:
- The proximity of cells within the tumor;
- The degree of abnormality of the cells;
- The number of cells that are in the process of dividing;
- The presence of blood vessels inside the tumor;
- The reaction of tumor cells to treatment.
Low-grade astrocytomas develop slowly, while high-grade astrocytomas are especially malignant, developing rapidly and representing 60% of all astrocytomas.
Even so, there are some astrocytomas that have a particularly good prognosis and, in these cases, are called non-infiltrating astrocytomas.
Oligodendrogliomas receive this name because it has its origin in oligodendrocytes. Thus, like astrocytomas, they spread easily to surrounding tissues and, in most cases, cannot be removed completely by surgery.
Sometimes they spread along tissues bathed in cerebrospinal fluid, but they rarely spread beyond the brain and spinal cord. They represent only 4% of brain tumors.
Ependymomas arise from ependymal cells, which line the ventricles and can block the circulation of cerebrospinal fluid, causing it to accumulate in the ventricles, dilating them, in a condition called hydrocephalus .
They represent about 2% of all brain tumors and, unlike astrocytomas and oligodendrogliomas, they do not spread or infiltrate normal brain tissue.
Therefore, many of the ependymomas can be removed surgically successfully. Especially those who reach the spinal cord are more likely to be surgically cured.
Despite this, they can still spread through the tissues bathed in the cerebrospinal fluid, but they do not spread beyond the brain and spinal cord.
It is very unlikely that a tumor will have a neuron as its point of origin, not least because these are cells that do not divide. However, medulloblastomas are tumors that originate in the neurons of the cerebellum, part of the CNS located just below the brain and responsible for maintaining balance and other functions.
Although their growth is rapid, they can still be cured with surgery or radiation.
Medulloblastomas are more common in children and usually spread along the flow of cerebrospinal fluid.
They are a type of tumor that contains both neurons and glial cells (the part of the brain that provides support and nutrition for the neuron). They are very rare and have a high cure rate with surgery alone, or with surgery combined with radiotherapy.
Neurilemoma ou Schwannoma
These are tumors that originate in Schwann cells, which produce myelin, which lines the cranial nerves and other nerves. These tumors are usually benign and arise near the cerebellum and cranial nerves responsible for hearing and balance.
They correspond to approximately 7% of all tumors of the central nervous system.
These are tumors that start at the back of the skull or at the lower end of the spine, and are not properly considered tumors of the central nervous system, but, as they can affect regions of the brain, they should also be mentioned.
They do not usually spread to other organs, but they tend to reappear several times over the course of 10 or 20 years, progressively compromising the nervous system of the patient who suffers from this problem.
Lymphomas have their origin in lymphocytes, the main type of cell in the immune system, also popularly known as a type of white blood cell. Many of the cases of lymphoma happen in people with HIV , because of the immune system, which can be compromised.
Most lymphomas begin elsewhere in the body. Occasionally, however, lymphomas start in the brain and are called brain lymphomas.
Like most lymphomas, these are also more common in people with immune system problems, such as HIV. However, over the years, improvements in antiretroviral treatment techniques have helped this type of tumor to become increasingly rare.
Until recently, it was believed that lymphomas were highly malignant tumors, leading to the patient’s death in just 1 year. However, advances in chemotherapy have radically altered the prognosis of people with this type of tumor.
It is not yet known exactly what causes a brain tumor and most of them appear without us being able to know why. Some injuries were related to the appearance of tumors, but this relationship is still not fully understood and there is still doubt as to whether these are determining factors or not.
For some years now, brain tumors have been associated with some type of predisposition or genetic mutation. It has been discovered, for example, that changes in chromosomes 1, 10, 13, 17, 19 and 22 may be related to the appearance of brain tumors.
Another hypothesis is the influence of radiation therapy anywhere on the body, including the brain, for people who have already undergone treatment for tumors.
In addition, some variations of oncoviruses, a type of virus that have the ability to alter the cell cycle inducing the development of a tumor, are known to potentially cause tumors in the brain.
The good news is that at the same time that radiotherapies are becoming increasingly safer to prevent the appearance of other tumors, many oncoviruses are being studied and even have a vaccine for their prevention.
However, there is still no complete list of what causes the disease. All that is known so far are the risk factors involved in its development.
As stated in the previous topic, it is not yet known exactly what causes a brain tumor, especially because of the variety of types that exist. However, some diseases, behaviors and external factors are closely associated with the development of tumors in the brain. Check out:
Exposure to radio frequency
This is a controversial topic. It has not yet been fully discovered that radio frequency, emitted mainly by cell phones, would be a risk factor for the development of brain tumors.
In 2011, the World Health Organization (WHO) issued an opinion stating that the use of mobile phones could be related to brain cancer.
The WHO reached this conclusion after a panel made up of 31 scientists that make up the International Agency for Research on Cancer (IARC, in English International Agency for Research on Cancer ).
The researchers looked at a diverse range of epidemiological studies (analyzes of the incidence of the disease in populations with varying cell phone use or other exposure to radio frequency fields) to reach this conclusion.
It is worth remembering, however, that what the organization said, is that there is a possibility that cell phones are responsible or partially responsible for the appearance of brain tumors. She does not contraindicate the use of cell phones and points out that there is no new data to prove that cell phones cause cancer.
In spite of this, countless researches with varied results appear, with some that show their carcinogenic potential and others that deny it. It is for this reason that the WHO classifies cell phones and radio frequency as a possible , and not probable , carcinogen.
An example of a study that talks about the possibility of cell phones being responsible for the appearance of brain tumors, more especially gliomas, came from France in 2015, in a review article.
The researchers followed approximately 400 patients diagnosed with glioma or meningioma and their habits.
The study showed that the excessive use of cell phones can considerably increase the chances of a brain tumor, especially in the temporal lobe, the area of the brain closest to the ears, where we coincidentally use the cell phone.
On the other hand, research in Australia shows the opposite. The researchers analyzed data on the incidence of cancer between the years 1982 to 2012 to check the incidence of tumors in the population.
The data showed that, although the use of cell phones in the country, which started in 1987, has increased by more than 90% since that year, the incidence of brain tumors has not followed the same growth pattern. It didn’t even come close.
In general, since the introduction of cell phones in Australian society, the average number of diagnosed brain tumors has grown 0.05%. However, a significant increase in the number of brain tumors in the elderly has been found.
Scientists dismiss the hypothesis that it is cell phones and radio frequency that caused this increase, because since 1982, the date before the introduction of cell phones to society, diagnostic methods for brain tumors have become increasingly efficient, which would explain the increase in the incidence of registered cases.
Therefore, up to the present moment it is not possible to state categorically that the cell phone is directly responsible or at least plays a role in the appearance of brain tumors.
Since the excess, for both sides, can be harmful, the best thing to do is to keep the opinion aligned with the WHO and consider the cell phone as a possible carcinogen.
Brain tumor is much more common in men than in women. However, meningiomas occur mainly in women.
Although the brain tumor can develop at any age, it is much more common in the elderly (over 65 years old).
Neurofibromatosis is a hereditary disease that manifests itself at around 15 years of age. It increases the chances of a brain tumor because it causes abnormal growth of nervous tissue and the appearance of small neurofibromas, also a kind of tumor, in the outer parts of the brain.
Tuberous sclerosis is a rare, multi-systemic genetic disease, that is, it affects several tissues and organs, and causes the appearance of benign tumors in the brain and other vital organs, such as heart, kidneys, eyes, lungs and skin.
Li-Fraumeni syndrome is a rare autosomal dominant syndrome that is characterized by the appearance of several types of cancer with a genetic correlation with each other, that is, they are inheritable and not caused exclusively by pressure from the environment.
As the pattern of inheritance is autosomal dominant, there are no differences between inheritance between men and women, as long as the individual inherits an allele that is already predisposed to develop the syndrome.
Von Hippel-Lindau syndrome
Von Hippel-Lindau syndrome is a rare autosomal dominant genetic disease that causes abnormal growth of tumors in different parts of the body, especially those that are highly irrigated by blood, which is the case of the brain.
The onset of this disease occurs approximately in the 2nd and 3rd decade of life, that is, at 20 or 30 years old.
Remember high school biology classes? Then, in them, the teacher spoke of various syndromes on the X chromosome, or sex chromosome. Turner’s syndrome is one of them.
To refresh your memory a little, Turner’s syndrome is a chromosome anomaly of the X chromosome whose origin is total from one X chromosome or partial from the other X chromosome, creating a defective Y that is not necessarily related to the male sex, since syndrome affects only women.
It is already identified at birth, or before puberty, because it has phenotypic characteristics, that is, expression, very clear and evident.
All people who are born with turner syndrome have short stature, sexual organs and secondary characteristics (breasts) that are poorly developed, a broad chest, a winged neck, a higher frequency of cardiovascular problems and are almost always sterile, that is, they cannot have children.
Especially in carriers who have an XY cell line, that is, who have a normal X gene and a defective Y gene, the risk of tumorigenesis, that is, of developing tumors in different areas of the body, is greater. This ends up applying to the brain.
Turcot’s syndrome is a rare genetic disease that is characterized by the association of the appearance of polyps in the intestine and primary tumors in the central nervous system. Its main symptoms include diarrhea, rectal bleeding, abdominal pain, weight loss and tiredness .
Gorlin’s syndrome is a rare genetically inherited disease that causes multiple defects to appear in the body, especially affecting the skin, the nervous system, the eyes, the endocrine system and the bones.
These people are more likely to develop some types of cancer, such as skin and brain cancer.
People with HIV are more likely to develop lymphomas (lymphocyte tumor), especially when their immune system is weakened and weakened for some reason.
However, with advances in antiretroviral therapies, lymphomas in the brain have become increasingly rare.
According to a 2015 publication in the journal Neurology , obese people are more likely to develop a type of brain cancer called meningioma.
A meta-analysis of 13 previous studies on the correlation between obesity and the onset of meningioma concluded that patients with obesity are 54% more likely to develop brain tumors than the others.
As it is not yet known exactly everything that can cause the appearance of a brain tumor, family history is something to be considered.
As we saw earlier, a variety of genetic factors increase the propensity of the disease to develop, so completely dismissing the hypothesis that family history is an important factor is not a reasonable thing to assume.
First of all, it is necessary to understand that the word “tumor” means an abnormal increase in the volume of cells in any part of the body. This increase in volume happens because there was a genetic mutation that caused the cells to start dividing more than they should and in an uncontrolled way.
In the case of benign tumors, this genetic mutation was small, which makes it, in a way, more “mild” than the malignant one. But we’re getting ahead of ourselves. Let’s take it easy.
The main difference between benign and malignant tumors can already be seen in the name itself. It is not that a benign tumor is good, but that it poses less risk to the state of health as a whole than a malignant tumor.
Benign tumors are still tumors and are dangerous. However, they are not as risky as the malignant ones, as their growth occurs in an organized and, in general, slow manner. This makes them less aggressive and the risk of metastasis, which is when the cancer “spreads”, is much less.
In the case of malignant tumors, things change a little. They are aggressive, perform uncontrolled cell multiplication, causing the tumor to grow more and more, and are more likely to invade other organs and cause metastasis.
It is worth mentioning that another difference between malignant and benign tumors is that, while benign tumors do not differ much from the cells of their original tissue, malignant ones, over time, become quite differentiated.
Still, it is important to note that brain tumors, whether cancerous or not, can cause serious problems. As the skull is very rigid and has a stable volume, there is no room for the tumor to expand, and this is exactly what can cause serious complications and even lead to death.
It is very difficult to specify which symptoms clearly indicate a tumor in the brain and which do not, because the brain is a very complex organ divided into many parts, responsible for different functions.
As a brain tumor can affect any part of this organ, the symptoms will vary according to the affected region, and it is not possible to be completely categorical when making a diagnosis.
Even so, despite all the difficulties involved in the diagnosis of tumors, there are some signs. They will depend and vary a lot according to the region of the brain affected.
For example, when there is a tumor in the parts of the brain that control the eyes, for example, symptoms can include blurred vision.
It is very important that you pay attention to the main symptoms if you suspect that you may have a brain tumor. There are some that are more common than others, and that is what we will see next. Check out:
Syncope can be described as a sudden and transient loss of consciousness and postural tone, followed by subsequent spontaneous and complete recovery. In other words, a syncope is nothing more than a fainting episode .
It is usually associated with premonitory symptoms such as dizziness , sweating, nausea, palpitations or blurred vision. However, these symptoms are not always present.
It happens because there is a significant increase in intracranial pressure, which can temporarily cut off the cerebral blood perfusion, leading to loss of consciousness. This increase in intracranial pressure can be caused by exertion, coughing, sneezing or vomiting.
Still, it is worth noting that there are several causes for syncope that are not brain tumors and that whenever it happens it must necessarily be investigated by a doctor, as it is not a normal event.
Regardless of the type of tumor that affects a patient, seizures are quite common and are usually the first indication that something is wrong. That’s because the tumor causes an irritation in the brain that causes neurons to fire in an uncontrolled and disordered manner.
However, like tumors, seizures come in many forms. They can be acute crises in which the whole body convulses or a simple contraction and relaxation of a member of the body or the face.
It is very important to keep an eye out for these involuntary reflexes from the body, especially those contractions and light relaxation, as they are a strong indication of the initial stages of the disease. In cases of generalized seizure, it goes without saying that you should go to the doctor immediately.
The sooner the disease is diagnosed, the more likely the treatment will be successful.
Often, a brain tumor causes the patient to become more clumsy, making daily tasks difficult. People have difficulty with balance, walking or, for example, difficulty in handling the keys.
Problems can still occur when speaking, when swallowing food or with facial expressions. Those around you most notice these symptoms. So keep your head open for other people’s comments.
Like awkwardness, numbness can appear anywhere on the body. Suddenly, the person begins to no longer feel certain regions of the body, presenting symptoms similar to those of paresthesia .
Changes in memory and cognition
People with brain tumors usually have difficulty remembering things, are easily confused and can have problems solving simple problems.
Ter mal estar e sensação de enjoo de forma frequente, persistente e sem explicação, sendo que a maioria dos tratamentos não funciona por muito tempo, pode ser um indicativo de tumor cerebral.
Mudanças na visão
Visão embaçada, dobrada e perda de visão são bastante associadas à tumores no cérebro. É possível também ter alucinações visuais, como ver formas ou pontos flutuantes, o que é chamado clinicamente de “aura”.
Dores de cabeça
As dores de cabeça normalmente são um dos primeiros sintomas a aparecer em quem sofre de tumor cerebral. Elas normalmente não vão responder bem ao uso de medicações. Mas se atente ao fato de que a grande maioria das dores de cabeça não está relacionada a tumores cerebrais.
Além disso, as dores de cabeça causadas pelos tumores são diferentes de uma simples dor de cabeça normal. Elas são causadas, tipicamente, pelo aumento da pressão intracraniana. Confira as peculiaridades da dor de cabeça causada por tumores:
- Torna-se progressivamente mais forte ao longo das semanas, às vezes chegando a se assemelhar à enxaquecas;
- Se agrava ou melhora depois de mudanças de posição, como se curvar ou abaixar a cabeça, ou então depois de realizar ações que aumentam a pressão intratorácica, como tossir e espirrar.
- É acompanhada de sintomas não usuais;
- É mais intensa durante as manhã e desaparece após vômitos;
- Faz o indivíduo acordar durante o sono por causa de dor de cabeça.
Mudanças de personalidade e comportamento
Podem acontecer algumas mudanças no comportamento e na personalidade da pessoa que sofre com um tumor no cérebro.
A pessoa que sofre de tumor cerebral pode começar a ficar mais irritadiça, dormir menos ou mais, sentir-se muito mais disposta ou cansada do que o normal. Tudo vai depender da área do cérebro afetada.
Como dito anteriormente, essas mudanças são normalmente leves e muitas vezes passam despercebidas, tanto pelo próprio paciente, quanto pela família. Por isso, é muito importante se conhecer bem e ter uma noção interessante de como você reage às situações do seu dia a dia.
O delírio é um sintoma bastante comum, especialmente nos estágios avançados da doença, ocorrendo em cerca de 15% a 30% dos pacientes internados e até 85% das pessoas nas últimas semanas de vida.
Trata-se de um sintoma que pode ser extremamente estressante tanto para o paciente, quanto para sua família, podendo interferir, inclusive, com outros sintomas em tratamento, incluindo a manutenção da dor.
É importante manter em mente que delírio e demência são duas coisas diferentes, apesar de possuírem suas similaridades. Enquanto os pacientes com delírio se tornam agitados e podem ter perda da consciência por um determinado período de tempo, a demência se desenvolve de forma gradual e seus efeitos sobre a memória e a consciência são permanentes.
Por isso, podemos dizer, de modo geral, que existem 3 tipos de delírio: o hipoativo, em que a pessoa permanece a maior parte do tempo dormindo ou fechada em si, o hiperativo, em que a pessoa fica agitada, apresentando delírios e alucinações, e o misto, em que a pessoa alterna entre os dois tipos.
Some signs that can help you better identify delusions are:
- Reduced awareness of the surroundings;
- Inability to follow a conversation and speak clearly;
- Auditory hallucination;
- Visual hallucination;
- Sleep during the day, but wake during the night;
- Vivid, frightening dreams, which sometimes continue once the patient is awake;
- Sudden mood swings ranging from anxiety, depression, irritability, fear, etc.
Identifying a delusion and what exactly is causing it is very important for proper treatment. Other causes include:
- Medicines, such as pain relievers and chemotherapeutic drugs;
- Medication withdrawal;
- Imbalance of mineral liquids;
- Organ failure;
- Lack of oxygen in the blood;
- Other brain disorders.
The best thing to do, in cases of delirium, is to try to manage it. The best way to do this is to make the patient comfortable and safe.
Therefore, providing a safe and reassuring environment for the patient, such as a quiet, well-lit room with people and objects close by, is one of the options.
For family members and friends who follow the patient closely, it is also a good tip to talk to the doctor or nurse in cases of hallucinations and agitated behavior. In addition to providing information, these professionals know what precautions to take in the most extreme situations.
In many cases, the use of antipsychotics and medications can help the patient to better cope with these symptoms. It is worth remembering, however, that these drugs have significant side effects.
Frequent symptoms of some brain tumors
There are also more characteristic symptoms for different classes of tumors. That’s because each class of tumor affects a specific area or cell type, causing symptoms to vary according to these factors. Check out:
Gliomas include astrocytomas, oligodendrogliomas, medulloblastomas and ependymomas, with astrocytomas being the most common gliomas.
Symptoms, in general, will vary depending on their location in the brain:
- Frontal lobes : tumors located in the frontal lobes, region behind the forehead, can cause weakness and personality changes. When they develop in the dominant frontal lobe (the left one, for most people) they can cause language changes. People may find it difficult to express themselves, even if they know what they mean;
- Parietal lobes: located behind the frontal lobes, these tumors can cause change or loss of sensation. They often cause partial loss of vision in one eye;
- Temporal lobes: located above the ears, these tumors can cause seizures and, if they develop on the dominant side, the patient may lose the ability to understand and use language;
- Occipital lobes: located on the back of the head, these tumors can cause partial loss of vision in both eyes;
- In or near the cerebellum: tumors in that location can cause changes in eye movements, lack of coordination, gait instability, and sometimes hearing loss and vertigo. In addition, they can obstruct the drainage of the cerebrospinal fluid, causing an accumulation of fluids in the cavities inside the brain. As a result, intracranial pressure increases and symptoms such as headache, nausea, vomiting, problems with vision and lethargy can happen. If the intracranial pressure is too high, herniation of the brain can occur, which can result in death.
These tumors, as mentioned earlier, do not invade the brain directly, but they can compress it together with the cranial nerves, in addition to blocking the absorption of cerebrospinal fluid.
Symptoms depend on where this tumor develops, but in general, they can cause weakness, numbness, seizures, changes in smell, impaired vision and impaired mental function. In older people, meningiomas can still cause dementia.
Tumors of the pineal gland
When they develop during childhood, they often cause precocious puberty. In addition, they can obstruct the drainage of cerebrospinal fluid around the brain, which causes hydrocephalus.
The most common type of pineal tumor affects germ cells and can cause symptoms such as an inability to look up and drooping eyelids.
The pituitary gland controls much of the body’s endocrine system. Therefore, when tumors reach this region, the gland stops functioning properly and starts to produce too many hormones, or less.
When large amounts of hormones are secreted, the effects vary depending on which hormone is involved.
For example, if growth hormone is secreted in excess or to a lesser extent, gigantism can occur, a disproportionate increase in the size of the head, face, hands, feet and chest.
If the adrenocorticotrophin is unbalanced, the patient may develop Cushing’s syndrome, a set of signs and symptoms caused by an endocrine disorder caused by high levels of cortisol in the blood.
In the case of prolactin, menstrual cycles are interrupted (amenorrhea), milk production in women who are not breastfeeding (galactorrhea) and, in men, loss of libido, erectile dysfunction and increase in the size of the mammary glands (gynecomastia).
In addition, tumors in the pituitary gland can also destroy the tissues of the hormonal gland, which, over time, leads to insufficient levels of these hormones in the body.
Headaches often occur, and if the tumor increases in size, there is a loss of peripheral vision in both eyes.
There are some ways to diagnose brain tumor. They differ from each other by the method and some of them are indicated especially for a specific type of patient. Check out:
Often, one of the options used to diagnose the presence of brain tumors is lumbar puncture. Through it, doctors obtain cerebrospinal fluid to perform a further microscopic examination.
In this examination, the patient usually lies on his side on a bed and bends his knees until he touches his chest. The doctor uses local anesthesia to numb the examination site, and then a needle is inserted between two vertebrae, at the bottom of the spine, where the spinal cord ends.
The exam takes about 15 minutes and can be a little uncomfortable. After the lumbar puncture, around 1 in 10 people suffer from headache when they get up. It usually disappears within a few days or weeks.
In cases where the headache becomes very uncomfortable, doctors may inject a small amount of the person’s blood into the area around where the lumbar puncture was performed. This procedure, called a blood plug, reduces the leakage of cerebrospinal fluid and helps to relieve headache.
This type of procedure is only done when doctors suspect that the tumor has invaded the layers of tissue that line the brain (the meninges), as these types of tumors can block the absorption of cerebrospinal fluid.
Lumbar puncture can also help when it is not possible to have a clear diagnosis of the problem or the type of tumor. This is because the cerebrospinal fluid can often contain cancer cells, which would indicate the presence of the tumor.
Despite this, people who have a very large tumor and who increase the pressure inside the skull cannot perform the test. This is because the extraction of fluid during lumbar puncture can cause the tumor to move, resulting in herniation of the brain.
Nuclear magnetic resonance imaging of the skull
It is the best way to visualize a brain tumor. Through this exam, it is possible to tell whether a tumor is present or not and calculate its size. However, to measure the degree of aggressiveness of the tumor, more invasive exams, such as a biopsy, are necessary.
Magnetic resonance imaging is done through a huge donut-shaped device that works like a giant magnet that aligns the nucleus of the hydrogen atoms, making them become small magnets.
In this way, the device is able to map the different positions of water molecules in our body and create an image of what our interior would be like.
Computed tomography, as well as magnetic resonance imaging, is a non-invasive exam that combines x-ray equipment with computers programmed to produce images of internal organs.
In this way, it is possible to see the organism from the inside and identify the presence of a tumor and its size. However, it is only possible to have an idea of the shape, region of the brain affected and the size of the tumor. To find out more details, such as severity, whether it is benign or malignant, more invasive tests are needed.
A biopsy is when a sample of tissue or cells is taken for further analysis through a surgical procedure. Therefore, a biopsy will almost always be an invasive procedure.
In the case of a brain tumor, a biopsy must be performed to analyze the severity of the cancer. It is also critical, because many inflammatory, infectious and vascular diseases can pass for a brain tumor.
Stereotactic biopsy, unlike the others, is indicated only in special cases, in which the patient cannot, for some reason, undergo a surgical procedure because of the risks.
To perform this procedure, it is necessary to fix the patient’s head in a structure similar to a helmet, so as not to allow it to move.
Then, a small cut is made on the patient’s head, usually with local anesthesia and sedation, through which a needle is inserted to perform the biopsy.
This procedure is usually done with the aid of nuclear magnetic resonance or computed tomography.
Conventional surgical biopsy
Conventional surgical biopsy is indicated when the surgical risk is low. It occurs in the same way as stereotaxics, that is, with the patient’s head attached to a kind of helmet that immobilizes it. The difference between the two, however, is that the cut made on the patient’s head is larger.
During the operation, the pathologist may opt for an examination using the freezing technique, which allows the diagnosis to be confirmed within the operating room. In this technique, a microscopic analysis is done during surgery and it is possible to detect the presence of the tumor.
In such cases, the surgeon may choose to remove the tumor at the time of biopsy, depending on the location and estimated size.
The freezing technique, however, is not as accurate as the normal anatomopathological exam, in which the cellular and tissue samples will be studied thoroughly within the laboratories.
The truth is that it depends on the type of brain tumor that is diagnosed, the type of cells affected, the size and region where the tumor is located and a number of other factors.
Therefore, although most of them can, in fact, be cured through surgery, or surgery with radiotherapy, it is not possible to say that all of them are curable.
If you suspect you have a brain tumor, talk to a doctor, get tested and discuss treatment options with him. Not much is known about how to cure cancer in general.
The good news, however, is that techniques for treating this disease have come a long way, which can serve as emotional support and provide hope for many people who find themselves in complicated situations.
Many of the tumors that affect the central nervous system can be treated by surgery, radiation and / or chemotherapy. In most cases, a combination of the 3 is the treatment of choice.
During the treatment of a brain tumor, a variety of doctors are involved in the process and they work together to create an effective plan of action.
It is a multidisciplinary team , with doctors of different specialties, such as neurologists, neurosurgeons, oncologists, and other professionals, such as nurses, pharmacists, psychologists and many others.
The treatment used will depend on a number of factors, such as:
- The size, type and location of the tumor;
- If the tumor is pressing on any vital part of the brain;
- If the tumor has spread to other parts of the CNS or the body;
- Possible side effects;
- The patient’s preferences.
In addition, there is the growth factor. Some tumors grow faster than others, increasing or decreasing the urgency of treatment.
Often, especially if the tumor is less aggressive, it may be indicated to have surgery only, without the need for another type of more specific treatment. For more severe tumors, the most common treatment is surgery followed by radiotherapy and chemotherapy.
Treating brain tumors successfully can be a very difficult task, but the past 20 years of medical research have helped to significantly increase the life expectancy and quality of life of people who suffer from this problem.
More refined surgical techniques and a better understanding of how the disease works has helped doctors and researchers to seek new ways to help patients live better lives.
Here are the different types of treatment for brain tumors and treatment progressions:
As we saw earlier, in the topic “Symptoms”, a brain tumor can bring a multitude of very undesirable and bothersome side effects. Therefore, in most cases, treatment for tumor removal is accompanied by treatments to cure or at least alleviate side effects.
This type of treatment, which seeks to relieve symptoms and bring a better quality of life for the patient, is called palliative treatment and basically consists of offering support to the patient, be it physical, emotional, psychological or social.
Anyone, regardless of the stage of the cancer, can receive palliative treatment and, in fact, it often begins long before the treatment of the tumor itself. Consultations with psychologists and other health professionals are often essential to make treatment more effective and as uncomfortable as possible.
Patients who receive treatment for the tumor and its side effects have less severe symptoms, have a better quality of life and say they are more satisfied with their treatment;
Palliative treatments vary significantly and may also include the use of prescription medications, nutritional changes, relaxation techniques and other therapies.
Although the symptoms caused by the tumors and even the treatment of the tumor can be quite severe, they can be controlled and alleviated by the use of certain medications, such as:
- Corticosteroids , which are used to reduce swelling in the brain, which reduces the pain of inflammation, preventing the use of specific pain medications, such as some opioids, which can be addictive;
- Anticonvulsant medications , which help to control seizures, if they are frequent, and improve the quality of life.
Before starting any type of treatment, talk to your doctor about possible side effects and all palliative options. And talking to a psychologist and seeking emotional support never hurts. It will do you good for both your treatment, your health and your quality of life.
Relieving intracranial pressure
Often the tumor ends up obstructing the flow of cerebrospinal fluid through the spaces within the brain. In such cases, a device is used to drain the liquid and thus reduce the risk of herniation.
This device is nothing more than a small tube (catheter) connected to a manometer, which measures the pressure inside the skull. The tube is introduced through a tiny hole in the skull and drains the cerebrospinal fluid.
In this procedure, local anesthesia (usually together with a sedative) or general anesthesia is used. After a few days, the tube is removed or maintained as a form of permanent drainage.
During this time, the doctor removes the tumor surgically and uses radiation and chemotherapy to fight it.
Surgery consists of removing the tumor from the affected region. Often, to ensure the effectiveness of the operation, even parts of healthy tissue are removed together with the tumor. This decreases the chance of regression and guarantees a higher success rate.
Usually, it is the first treatment option adopted by the medical staff, since the removal of the tumor, by itself, can help a lot in the relief of symptoms, in addition to providing the possibility of diagnosing the tissues and measuring the degree of aggressiveness of the tumor.
This helps the multidisciplinary team to think about the next stages of treatment and come up with a more effective approach, improving the prognosis of the disease.
For this, it will be necessary to have a qualified neurosurgeon . He is a specialist in brain and spinal surgery.
Brain tumor removal surgery requires the removal of a part of the skull, a procedure called craniotomy. After that, the neurosurgeon removes the tumor and the patient’s own bone will be used to cover the opening in the skull.
In recent years, advances in neurosurgery techniques have enabled more accurate and effective surgeries.
One of the techniques employed is the use of cortical mapping , which allows the neurosurgeon to identify areas of the brain and their functions during surgery and can perform the tumor removal procedure so as not to compromise areas with functions, motor, sensory or logical -linguistics.
There are also techniques based on the use of computers, such as image-guided intervention, which helps surgeons to map the location of the tumor in a very precise way. This technique, however, requires a high degree of specialization and may not be widely available.
Interestingly, there are surgical techniques that are done with the patient awake. This has a very simple and logical explanation: it serves so that the surgeon does not err and damage some function of the patient.
When the tumor to be removed is, for example, very close to the center responsible for speech, this technique is used. The awake patient is immobilized with the surface of the brain exposed and the specialist uses small electrical stimuli to locate the areas of the brain responsible for speech.
In addition to removing and decreasing the size of tumors in the brain, surgery can also serve simply to remove tissue samples for subsequent biopsy, as we saw in the topic “How the diagnosis is made”.
It may seem strange that an operation is performed just to have a biopsy done, but even that is very important, as it can help doctors define what is the best approach to treat the problem.
However, sometimes surgeries cannot be performed, as the tumor is located very close to a vital region of the brain. This type of inoperable tumor is treated in ways other than surgery.
In addition, traditional surgery carries many risks. There is a real possibility that brain damage may be caused that can lead to partial paralysis, changes in sensitivity, weakness and intellectual deterioration.
Even so, it is essential to remove a tumor that is compromising important brain structures, whether it is cancerous or not. Even when a cure is impossible, removal of the tumor is extremely important, as it can help relieve symptoms and allow the doctor to determine whether another type of treatment is warranted, such as chemotherapy and radiotherapy.
Radiotherapy uses x-rays or other high-energy rays to destroy tumor cells. This type of therapy serves to stop or slow the growth of a tumor and is typically used right after surgery and preferably in conjunction with chemotherapy.
The most common type of radiotherapy used is the one with external beams, in which the radiation is injected through a non-invasive process by a machine that sends radiation to the patient. This technique can be called radiotherapy with external beam.
It can also be done internally, in an operation called brachytherapy, in which radioactive sources in the form of special applicators (needles, seeds or threads) are placed in direct contact with the tumor site.
Quando o paciente é submetido à radioterapia, ele deve seguir uma rotina em que recebe doses periódicas de radiação por um período definido de tempo.
Como nos casos de tumor cerebral é muito difícil injetar uma substância diretamente no local do tumor, a técnica utilizada é a dos feixes externos, que pode ser feita das seguintes maneiras:
O local a ser tratado é determinado através de exames realizados previamente e em locais estratégicos. Em algumas situações, como quando todo o cérebro precisa receber a radioterapia para evitar a metástase, essa técnica é bastante apropriada.
Por outro lado, o grande problema desse tipo de tratamento é a falta de precisão. Se forem necessários cuidados mais minuciosos, outras técnicas pode ser aplicadas.
Radioterapia conformacional tridimensional
Através de imagens coletadas por meio de de tomografias computadorizadas e ressonâncias magnéticas, um modelo tridimensional do tumor e do tecido saudável é construído num computador.
Esse modelo é usado para direcionar a radiação diretamente para o tumor, deixando o tecido saudável intacto, livre das altas doses de radiação.
Radioterapia de intensidade modulada (IMRT)
Assim como a radioterapia conformacional tridimensional, a IMRT (do inglês Intensity Modulated Radiation Therapy) é capaz de direcionar a radiação diretamente para o tumor, sem afetar o tecido saudável.
Na IMRT, os feixes de radiação, que já são pequenos, são quebrados em feixes ainda menores e mais precisos, tendo sua intensidade minuciosamente controlada.
Terapia por prótons
It is a type of external beam therapy that uses protons instead of x-rays. High-energy free protons have the potential to kill tumor cells. It is used more when it is not necessary to use as much radiation.
Tumors near the optic nerve and bones, such as the base of the skull, are the ones that typically receive proton therapy.
Single dose stereotactic radiation therapy
This procedure consists of directing a single high dose of radiation directly to the tumor site, avoiding the healthy tissue that surrounds it. It is most effective in tumors that affect only a single part of the brain and some non-cancerous tumors.
It can also be used when the patient has more than one tumor undergoing metastasis in the brain.
Fractional dose stereotactic radiotherapy
This is the same procedure as single-dose stereotactic radiotherapy, but done in fractional doses over weeks. This technique is used for tumors located near sensitive structures, such as the optic nerve.
Chemotherapy consists of using drugs that destroy tumor cells by preventing their ability to grow and divide. The goal of chemotherapy can be to destroy tumor cells, slow the growth of the tumor or simply reduce the symptoms.
It is prescribed by an oncologist , a doctor who specializes in treating tumors with medications. Another doctor who can prescribe chemotherapy is the neuro-oncologist .
Common ways to apply chemotherapy are through oral pills or intravenous injections that are given in cycles over a predetermined period of time. The patient can receive one medication at a time or a combination of several.
As is well known to all, chemotherapy has a number of quite uncomfortable side effects. Among them, we can highlight:
- Loss of hair;
- Mouth and skin sores;
In the case of brain tumors, the evolution of the problem is monitored by performing frequent magnetic resonances, every 2 or 3 months, while the treatment is carried out. Depending on the evolution of the tumor, the intervals between resonances may become longer or shorter, if the tumor is not regressing.
In this last circumstance, that of the tumor is not regressing even with chemotherapy, other therapeutic approaches must be considered and put into practice.
In the human body, there are a number of proteins responsible for causing cells to divide. In cancer cells, similar molecules perform this same function in an uncontrolled manner, causing a tumor to form.
The target therapy is nothing more than directing the action of drugs to combat these molecules and stop the uncontrolled division of tumor cells. The differential of this treatment is that it is directed exclusively or almost exclusively at the damaged cells, thus reducing the number and severity of side effects.
What if the treatment fails?
Curing or slowing the progression of a brain tumor is not always possible. In those cases where the tumor cannot be controlled, it becomes terminal.
This type of diagnosis is very frustrating and stressful and, therefore, quite difficult to discuss. However, it is very important to talk openly and honestly with doctors and people around you about your feelings, preferences and concerns.
It is not for nothing that the treatment is done by a multidisciplinary team. These people are there not only to help you get rid of the disease, but also to make you better deal with it, reduce your stress levels and start living a more complete life, which is good for you, not only for you, but also for your family members.
There is a diverse range of drugs used to treat brain tumors, from those used to relieve symptoms to those used to attack actual tumor cells (chemotherapy drugs). Check out the difference:
These drugs help to reduce swelling in the brain, if present, in addition to relieving other symptoms, such as the regulation of metabolism. Treatment is continuous and can only be stopped with the doctor’s approval.
As we saw in the previous topics, brain tumors can cause seizures and seizures. However, the indication of this type of medication will depend on the patient’s condition, since these medications can often interfere with other drugs, such as chemotherapy drugs.
Some examples of commonly used anticonvulsants are:
- Phenobarbital ;
Hormonal treatments are only used if the pituitary gland, which controls the levels of different hormones in the body, is damaged by the tumor itself or by treatments, such as surgery or radiation therapy.
In such cases, administration of pituitary hormones and other hormones may be necessary to replace the absence or lack of these components.
Chemotherapy, much talked about, but little known, uses anticancer drugs to destroy tumor cells. It is a systemic treatment and, therefore, it affects not only cancer cells, but also healthy cells in the body.
That is why it causes so many side effects, such as hair loss, nausea and vomiting. Its mechanisms of action attack cells that divide very quickly, the case not only of tumor cells, but also of bone marrow, the lining of the mouth and intestines and hair follicles.
This treatment is most often administered intravenously, but some drugs are administered orally.
The main chemotherapeutic agents used in the treatment of brain tumor are:
- Carmustina (BCNU);
- Cisplatin ;
- Cyclophosphamide ;
- Lomustina (CCNU);
- Methotrexate ;
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
It is very difficult to give a certain prognosis for the brain tumor, as it will depend on countless variables that will change from patient to patient. When we talk about brain tumors, we must always take into account that each case is different.
However, although it may seem scary, there are patients who can cure brain tumors. That doesn’t make the disease any less frightening, I know, but it can be a hope for someone in need.
Still, there is enough data to calculate the survival rate of patients diagnosed with a brain tumor.
The survival rate refers to the percentage of patients who live at least 5 years after the diagnosis of the disease. Still, it is important to note that there are people who live much longer than 5 years and there are still those who are completely cured.
Check the data available for the most common types of brain tumor:
- Low-grade astrocytoma: 65% of patients between 20 and 44 years old live 5 years or more. From 55 to 64 years old, the rate is only 21%;
- Anaplastic astrocytoma: 65% of patients between 20 and 44 years old live 5 years or more. From 55 to 64 years old, the rate is 10%;
- Glioblastoma: 49% of patients between 20 and 44 years old live 5 years or more. From 55 to 64 years old, the rate is only 10%;
- Oligodendroglioma: 85% of patients between 20 and 44 years old live 5 years or more. From 55 to 64 years old, the rate is only 64%;
- Anaplastic oligodendroglioma: 67% of patients between 20 and 44 years old live 5 years or more. From 55 to 64 years old, the rate is only 38%;
- Ependymoma and anaplastic ependymoma: 91% of patients between 20 and 44 years old live 5 years or more. From 55 to 64 years old, the rate is only 85%;
- Meningioma: 92% of patients between 20 and 44 years old live 5 years or more. From 55 to 64 years old, the rate is only 67%.
For children and adolescents, the data are different. The survival rate is:
- Astrocitoma pilocítico: 95%;
- Astrocitoma fibrilar: 80% a 85%;
- Astrocitoma anaplásico: 30%;
- Glioblastoma: 20%
- Oligodendroglioma: 90% a 95%;
- Ependimoma and epileptic epilepsy: 75%;
- PNETs (including medulloblastoma and pineoblastoma): 60% to 65%.
Living with a brain tumor is not an easy task, not only because of the symptoms, the treatment and its side effects, but also because the disease is still very much linked to taboo issues, such as death.
It is not true that the diagnosis of brain tumor is a fatal diagnosis. Many patients live normal lives, for long years undergoing treatment, and yet the taboo surrounding the disease and its fatality remains great.
That is why it is so difficult to live with the brain tumor. However, there are ways to improve the quality of life for the patient and the people around him. Research shows that patients who live better with the disease have a better prognosis and increase their chances of having an effective treatment.
Here are some tips for better living with the disease:
Dealing with uncertainties
Nothing in this life is certain. It is not possible to predict the future or the paths that await us. Regardless of faith, religion or belief in destiny or purpose, the only certainty that we can all have is that the future is uncertain.
And this is especially true and becomes even more evident for patients who are diagnosed with some type of tumor, in particular brain tumors.
Because its treatment is more complicated, it is very difficult for the doctor to arrive at a clear and reliable prognosis. Each case is different and many things, good or bad, can happen during treatment, which increases the levels of uncertainty to truly distressing levels.
The false sense of security that we all have, that we will live a long life, live to see the growth of our children and grandchildren, often disappears when a tumor diagnosis is present.
However, despite all the symbolic weight involved in the expression “brain tumor”, it is very important to keep calm and serenity in order to at least try to observe things from a realistic point of view, preferably based on evidence.
Therefore, talking a lot with the medical team that is providing emotional support and physical treatment is extremely important. These professionals deal with similar cases every day, they are trained and specialized in calming their patients and helping them to see the world with more positive perspectives.
There are even a number of problems that patients often suffer from. Knowing more about them can help you live better with your feelings. Check out some of them:
- Postponing plans and commitments: making commitments and plans can be a difficult task due to a series of practical factors, such as the length of treatment, the presence or absence of physical symptoms, etc. So even scheduling a lunch with a friend can become a complicated task, since you don’t know how well you will be on the scheduled day. The important thing is to know that this is normal and that it happens to many people;
- Feeling afraid of the treatment and its side effects: the side effects of chemotherapy are well known and make anyone who is going to undergo it quite apprehensive. This is also normal and the best thing to do is to talk to the doctor responsible for the treatment and observe how well the body reacts to the situation;
- Feeling afraid that the treatment will not work: the most important thing to keep in mind in these situations is that each case is different. Some treatments can be effective, others not so much. Just know that it is important to remain resilient and always try to keep your head up, ready for the next challenge;
- Fear of dying or of losing someone you love: confronting death is an extremely difficult taskThe feeling of fear is completely natural and not handling it well does not make you a weak person or anything like that. The best thing to do, at these times, is to seek help and emotional support.
Recognizing the uncertainties of the future is an agonizing task that can even bring physical symptoms, such as interrupting a night’s sleep. But it is very important that you have some perspectives and take some actions, such as:
- Talk to your doctor and the multidisciplinary team about your feelings and how they have been affecting your daily life;
- Learn as much as possible about brain tumor and its consequences. That way, you will know what to expect and how to react to the consequences that the future has in store for you;
- Bear in mind that there are situations that we can control and situations that we cannot control. It may seem difficult, but the best thing to do is to focus on the situations that we can control and not on others. After all, it is as the Dalai Lama says: “If there is no solution to a problem, then there is no reason to worry about it. If there is a solution to the problem, then there is no reason to worry about it ” .
Dealing with self-image
Self-image is the way a person sees himself, the way he sees himself. As the symptoms and treatment for the brain tumor can bring about many emotional and physical changes, patients who suffer from this problem may experience positive or negative changes regarding self-image.
Both tumors and their treatment can cause sudden changes in appearance. Some of the most common transformations are:
- Hair loss;
- Weight gain or loss;
- Surgical scars;
- Skin rashes, caused by the use of some medications;
Talking to doctors and people close to you about your appearance, as well as looking for ways to feel better with your own body are strategies that should be used to improve the quality of life.
A brain tumor can affect many parts of a person’s life, from personal relationships to day-to-day work. Depending on the severity of the disease and the chances of recovery, many feelings may arise, such as:
Entretanto, ainda assim, muitas pessoas relatam mudanças positivas em seus estados emocionais, como:
- Apreço maior pelos relacionamentos;
- Conscientização de que a vida é curta e muito especial;
- Clareza do sentido da vida e dos objetivos pessoais.
Entretanto, é impossível dizer que tipo de reação emocional um paciente vai ter ao ser diagnosticado com tumor cerebral. E é importantíssimo ressaltar que não há nada de errado em se sentir triste e deprimido. Isso é comum e pode ser tratado, como veremos a seguir.
O que fazer para melhorar?
Algumas dicas para lidar melhor com as mudanças pelas quais você vem passando são:
- Dê tempo ao tempo. Aceitar o diagnóstico de tumor cerebral e o seu tratamento é algo que muda drasticamente a vida de uma pessoa. Por isso, tempo é necessário para que você se acostume às mudanças que estão por vir;
- Procure e aceite. Não se prenda a atividades que estão te fazendo mais mal do que bem, passe-as adiante. Não há nada de errado em pedir ajuda de amigos para limpar a casa ou preparar refeições, por exemplo;
- Crie uma rede de amigos e familiares que podem te ajudar a melhorar e a se sentir mais positivo;
- Mantenha a calma e, se possível, tente ser bem humorado. Uma boa sessão de risadas trás muitos benefícios para o organismo e pode te ajudar a relaxar durante períodos mais tensos;
- Stay active as much as possible. Physical activity creates energy and can help you feel better during treatment. Social activities can also help you focus on something other than your own condition.
Depression and anxiety
Depression and anxiety are two symptoms that can affect the patient before, during or even after the treatment of a brain tumor. These are two very common psychiatric disorders not only in patients with brain tumors, but in the population as a whole.
If it is no longer easy to deal with the brain tumor, it is even more difficult to have to treat these two disorders together. However, don’t worry, that’s why the multidisciplinary team is at your side.
By talking to psychologists and doctors on your team, they can identify if there is a more serious problem, in which there is a need to take medication and, if this is not the case, they can teach you techniques and offer the necessary psychological support. to reverse this situation.
It is very difficult to talk about your problem with people who do not have the ability to fully understand it. It is to supply this need that there are several help groups scattered around.
In them, you will find people who suffer from the same problem as you and who can offer you the emotional support that you lacked.
The key to handling any issue well is communication. And with brain tumor cases, the answer is no different.
Communicate with your partner, with your children, with your family, with your friends, with your doctors, with other people who have cancer, in short, with anyone you feel has enough intimacy to know about your condition and that you he thinks he can help you live better with the disease.
This does not mean, too, that you should go around announcing to the world that you have a brain tumor. It is an intimate matter, but talking and learning more about the subject can make you feel more confident, which will give you strength to face a complicated treatment with your head held high.
Tumors do not cause symptoms only in the brain, but in different regions of the body, as they compromise control functions in several organs. Among the main complications caused, there are:
As the nervous system is compromised, the practice of daily tasks becomes more difficult and costly, causing symptoms of weakness to appear.
Difficulty in limb movement and loss of balance
A brain tumor can end up making movement difficult in general, since different areas of the nervous system can be compromised. That is why one of the symptoms is “clumsiness”.
The person affected by a brain tumor really becomes more clumsy, loses his balance more easily and has more risks of suffering motor accidents.
Because of swelling in the brain, many brain tumor patients report severe and frequent headaches.
Swelling in the brain region can also cause seizures of varying intensities. It can happen as a simple shaking of a limb or a generalized seizure, taking over the entire body.
The size of the skull is fixed, making the brain volume always the same. This means that after the skull has fully developed, the brain volume is the same for the rest of your life.
This is the big problem with tumors. As stated earlier, they are a cellular cluster that is dividing in an uncontrolled way, that is, growing. This growth increases intracranial pressure, causing previously mentioned symptoms, such as headaches and seizures.
The problem is when this growth is so great that it causes a part of the brain to displace through an intracranial orifice and this can bring about a series of problems and complications, such as:
- Cardiac arrest;
- Loss of all brainstem reflexes;
- Loss of consciousness;
- For respiratory.
Among the two forms of cerebral herniation, two are considered the most serious: temporal herniation, in which the lower part of one of the temporal lobes undergoes compression, and cerebellar herniation, where that part of the nervous system undergoes displacement.
Visual changes and hearing loss
The brain is the one that processes the sensory information, therefore, a brain tumor located in any of the places responsible for the interpretation of this information, such as the visual or auditory cortex, can cause problems in the performance of these functions.
Visual and auditory hallucinations are not so uncommon in patients with brain tumors.
In his book “An Anthropologist on Mars” , Oliver Sacks, a famous American neurologist, describes the case of a patient Hare Krishna who developed a brain tumor that caused him to go blind and lose his memory for an entire decade.
The most interesting thing about the case is that the patient did not believe he was ill, even if he was going blind, but that the gradual loss of vision and the dejection caused by the disease were signs that he was reaching enlightenment.
A brain tumor can bring about a series of behavioral and psychiatric changes. They are very rare and do not usually happen often.
As a curiosity, and also to exemplify how a brain tumor can have different effects, let’s look at a clinical case that happened in the United States in the early 2000s.
The patient’s identity was not revealed for reasons of right to privacy, but the case was published in 2002 at the annual meeting of the American Association of Neurology, held in New York.
According to the publication, the patient, a 40-year-old man, teacher, married and who was always considered by the family to be a quiet and caring man, suddenly began to show aggressive and hypersexualized behavior.
He began to visit massage parlors, where he paid prostitutes, to become obsessed with sex and, what is more disturbing: he began to secretly access child pornography sites on the internet and molest children.
When his wife found out about her husband’s actions, she was horrified, threw him out of the house and reported him to the police. In court, he was sentenced to a rehabilitation program in a help group for sex addicts.
However, his treatment did not last long. His behavior was still very much altered and he was expelled from the program after harassing women in rehab.
Before being arrested, exactly the night before, the man sought help from a hospital complaining of severe headache and saying that he was afraid he might end up raping the owner of the apartment in which he was living.
The man was taken to the hospital’s psychiatric department when his symptoms worsened and he began to complain of dizziness and balance problems. The doctors then decided to do an MRI scan and, during the exam, they detected the presence of a tumor the size of a chicken egg in the patient’s brain.
He underwent cancer treatment and had the tumor removed. When he completed treatment and served his sentence with the help group, he was able to return home. However, in October 2001, he began to experience severe headaches and obsession with sex again, returning to consuming pornographic magazines and videos very often.
A new magnetic resonance imaging was performed, in which it was found that the tumor recurred. After a new removal surgery, the patient’s behavior returned to normal.
The specialists who followed the case closely, Russel Swerdlow and Jeffrey Burns, believe that, most likely, the tumor in the brain of this patient was responsible for the sudden anomalous and repulsive behavior of this man, and that changes in the brain may be related to the sexual crimes.
Still, the two point out that this hypothesis only applies to people who have suddenly become obsessed with sex and who have no history that includes this type of behavior.
The implications of this case still involve a great diversity of moral and ethical dilemmas to be discussed, but this is not the purpose of exposing this report. Rather, it serves as an anecdotal example of how a brain tumor can have serious consequences and how difficult it is to diagnose this type of problem.
It is also worth remembering that cases like this, in which sudden changes in behavior happen, are very rare .
As the exact causes of brain tumors are not known, talking about prevention becomes a difficult task. However, there are some steps you can take if you are afraid of developing the disease. They are good not only for preventing brain tumor, but for countless other illnesses that can also be a risk to your health.
Search family history
The brain tumor, in some way, seems to be related to family history. People who have family members who have suffered from the disease are more likely to also develop it.
So, even if it is not possible to prevent it from happening (if it is for a brain tumor to affect you, it will affect you, it is possible, knowing its risks, to be diagnosed early, which increases the chances of success of a possible treatment.
Pay attention to environmental conditions
Tumors in the brain are caused by cellular and molecular mutations in the brain. These mutations can be influenced by environmental factors, such as exposure to carcinogenic materials, such as tobacco.
Check your immune system
Some disorders in the immune system can lead to the development of a specific type of brain tumor called primary central nervous system lymphoma. Loss of vision and weakening of the muscles are some of the symptoms that should be evaluated by the doctor in case of suspicion.
That’s the golden tip. Exercising, having a healthy and nutritious diet, not smoking and keeping stress levels low are very important attitudes, not only to prevent brain tumor, but to prevent other diseases as well.
Why is it so difficult to treat a brain tumor?
Because they are located in the brain, our center for controlling thoughts, emotions and movements. A treatment that is not done in detail in this organ can have severe physical and mental consequences.
In addition, there is a huge variety of brain tumors. They affect different areas of the brain and have the most diverse types of symptoms varying from case to case.
How do I know if I should get a second opinion?
There is no way to know if you should seek a second opinion, but there are several reasons that may lead you to want one, such as:
- Comfort with the choice of treatment;
- If the type of tumor is very rare;
- If there is more than one option to treat the tumor;
- If the first doctor is not a cancer specialist;
- If the health plan requires it.
Brain tumor is a disease that is difficult to treat and quite unpredictable with respect to its symptoms and evolution. Given the complexity of the brain and its functioning, each case is different and the sooner the diagnosis is made, the greater the chances of a successful treatment.
Is that you? Do you know someone who had a brain tumor? Have you? Tell us in the comments!