Brain Cancer

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WHAT IS BRAIN CANCER?

Cancer of the brain and nervous system were ranked as eleventh most common cancer in males and thirteenth in females (Malaysian National Registry Report, 2007-2011).

Cancers of the brain are the consequence of abnormal growths of cells in the brain. There are 2 major types of brain tumour:

Benign (non-cancerous) – Benign tumours are a slow-growing tumour and less likely to relapse after treatment. Common benign tumours include meningiomas, neuromas, pituitary tumours and craniopharyngiomas.
Malignant (cancerous) – Malignant tumours are cancerous tumours which either start in the brain (primary) or aggressively spreads to other parts of the body. Common malignant tumours include astrocytomas, oligodendrogliomas, glioblastomas and mixed gliomas.

Primary brain tumours, which start in the brain and almost never spread to other parts of the body.
Secondary tumours (or metastases), which are caused by cancers that began in another part of the body.

Brain cancer symptoms vary depending on the type, extent and location of the tumour, as well as the patient’s age and health history. The symptoms of a brain tumour include:

Headaches
Seizure
Slurring of speech
Paralysis depending on the region of the brain affected

Persistent, severe headaches are often the first symptom of a brain tumour. However, it is important to note that headaches are not always the result of a brain tumour. Seek medical advice if any of the symptoms persist.

Other symptoms include:

Difficulty in speaking or remembering words
Disturbed vision
Hearing
Smell or taste
Severe or mild seizures
Weakness or paralysis in parts of the body
Loss of balance,
Drowsiness or a change in personality
Nausea
Vomiting

The exact cause of most brain tumours is unknown.

The following factors have been proposed as possible risk factors for primary brain tumours, but whether these factors actually increase an individual’s risk of a brain tumour is not known.

Radiation to the head
A hereditary (genetic) risk
Cigarette smoking
Environmental toxins (for example, chemicals used in oil refineries, embalming chemicals, rubber industry chemicals)

Brain Cancer Diagnosis

An accurate diagnosis is the first step in developing a brain cancer treatment plan. At Beacon Hospital, a multidisciplinary team of experts uses a variety of tests for diagnosing brain cancer, evaluating the disease and customizing a treatment plan based on each patient’s situation.

A brain tumour diagnosis is usually done with imaging technology such as:

Other tests that are sometimes used include:

Magnetic Resonance Spectroscopy
Positron Emission Tomography (PET) scan
Lumbar puncture or spinal tap

Based on the results of the MRI, CT scans and other tests, a doctor can determine the grade of cancer. Grading describes the size of brain cancer and how far it has spread beyond the brain.

Grades of Brain Cancer

Brain tumours are usually graded on a scale of I to IV, based on how quickly they are growing and their ability to invade nearby tissue.

Grade I: The tumour grows slowly and rarely spreads into nearby tissues.

Grade II: The tumour grows slowly but may spread into nearby tissues or recur.

Grade III: The tumour grows quickly, is likely to spread into nearby tissues, and the tumour cells look very different from normal cells.

Grade IV: The tumour grows and spreads very quickly, and the tumour cells do not look like normal cells.

Brain Cancer Treatment

Various treatments are used to treat brain cancer, including:

Chemotherapy

is a treatment option that involves the use of drugs given by injection or orally to prevent the cancer cells’ ability from dividing and reproduce. It treats cancer by penetrating the tissues and organ via the bloodstream. These drugs are toxic to the cancer cells but they may also cause some side effects to the normal tissues.

Surgery

Surgery by an experienced neurosurgeon to remove the brain tumour.

Amputation

External beam radiation therapy (EBRT) to deliver high doses of radiation to destroy brain tumour cells and to relieve symptoms caused by the tumour.

At Beacon Hospital’s Cancer Centre, treatment may comprise a number of healthcare professionals depending on the type of treatment. We adopt a multidisciplinary approach which the clinical oncologist, medical oncologist, physician, neurologist, neurosurgeon, cancer nurses, as well as other allied health professionals such as dietician, physiotherapists, speech and occupational therapists.

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Prognosis

An individual’s prognosis depends on the type and stage of cancer, as well as their age and general health at the time of diagnosis.

For benign tumours that can be completely removed, a cure is likely.
For malignant tumours, outcomes depend on how slowly or quickly the tumour develops and response to treatment.

Treatment options and best-estimated prognosis should be discussed with the patient’s doctor.

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