Brain Cancer

Understanding brain cancer and its symptoms.

Brain cancers are generally named after the tissues which they originate from. The majority are glioma arising from glial cells in the brain. These include astrocytomas, oligodendrogliomas, ependymomas and mixed cell type gliomas. The other forms of brain cancers are meningiomas, medulloblastomas, chordomas and central nervous system lymphomas.

Brain cancers can be fast-growing (high grade), such as glioblastoma multiforme, or slow-growing (low grade), such as pilocytic astrocytoma.

Cancers from other organs can spread to the brain and are called brain metastases. Brain metastases comprise cancer cells from the original site of cancer, such as lung cancer cells and breast cancer cells.

How Common is Brain Cancer?

This is an uncommon cancer in Singapore. Between 1968 and 2007 there were about 1,903 cases reported. Most were astrocytomas and glioblastoma multiforme.

Age of Onset

Even infants have been reported to have brain cancers. However, the risk increases after the age of 35 years. During childhood, primary brain and spinal cord cancers are the second leading cause of death from cancer.

Brain Cancer Symptoms

Adults with brain cancers are usually diagnosed after they develop fits or seizures. Other signs and symptoms that suggest increased pressure within the skull include persistent headaches associated with vomiting and double vision. Pressure builds up within the skull because the skull is a bony structure that cannot expand. A cancer growing within the brain inside the skull causes the pressure to increase. Other patients may develop a weakness of one side of their body that is similar to a stroke.

Brain Cancer Causes  

Little is known about the cause of brain cancer. These cancers are characterised by a variety of appearances at surgery, under the microscope and by gene analysis.

Brain Cancer Diagnosis

Computerised tomography (CT) scans and magnetic resonance imaging (MRI) scans of the brain are able to detect most brain cancers. These scans may also determine if there is increased pressure within the skull. The exact type of cancer will be determined after a biopsy of the cancer. Sometimes, because of the position of the cancer, a biopsy is not attempted because the risk of causing damage to neighbouring important structures is very high.

Brain Cancer Treatment

Surgery reduces the amount of cancerous brain cells and also provides the pathologist (a doctor who looks at tissues under the microscope) with tissue to diagnose the exact type of brain cancer. Patients who have increased pressure within the skull because of brain cancer sometimes need to have a shunt put in surgically leading from the skull to the abdomen. This shunt drains some of the fluid within the skull and reduces some of the pressure within the skull.

Radiotherapy is often recommended once the brain cancer is diagnosed. Radiotherapy consists of high-energy rays directed onto the cancer and the surrounding tissues. Usually, five to eight weeks of radiotherapy is administered. Patients may experience hair loss and some lethargy during the treatment period.

Chemotherapy is not always used. Fast-growing brain cancers respond better to chemotherapy than slow-growing brain cancers. Patients who have recurrence after surgery and radiotherapy or patients whose cancers have not responded well to radiotherapy are recommended to go for chemotherapy. Chemotherapy drugs are given orally as well as by injection.

Recently, the use of chemotherapy wafers that are implanted into the brain cancer at the time of surgery to reduce the growth of the cancer is being studied.

Prognosis of Brain Cancer

Clinical examinations, X-rays and pathology reports all help the medical team to decide what the progress of an individual case of brain cancer may be. The appropriate course of treatment will then be put into action. The treatment strategy will vary from person to person. With prompt and appropriate treatment, the outlook for a person with brain cancer is reasonably positive. Young patients tend to survive longer than older patients with brain cancer. Other features that are important are the patient's exact type of brain cancer, the extent of brain function affected by the cancer and whether the cancer is operable.

Brain Cancer FAQs

I have headaches all the time. Could I be suffering from brain cancer?

Headaches have many causes, such as stress, eyesight problems, and migraine. Seek medical help if there are symptoms, such as vomiting, double vision, weakness on one side of the body, seizures or if the headache is getting progressively worse.

My mother had breast cancer. Now she has brain cancer. Will she die soon?

When breast cancer spreads to the brain, the cancer cells there are still breast cancer cells. It is an advanced stage of breast cancer. With appropriate treatment, some of her symptoms may be controlled. Cancer that has spread to the brain does not necessarily mean that it is immediately life-threatening if appropriate treatment is sought.

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