- Brain tumor: description
- Brain Tumor: Symptoms
- Brain Tumor: Causes and Risk Factors
- brain metastases
- Brain tumor: examinations and diagnosis
- Brain tumor: treatment
- Brain tumor: disease course and prognosis
On brain tumor is a very rare condition for which no cause is usually found. People become ill primarily in childhood or at the age of 70 years. There are many brain tumor types - good and malignant. Your treatment and prognosis vary greatly. In general, a brain tumor can be operated on, irradiated or treated with chemotherapeutic agents. Here you read everything important about the brain tumor.
ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in doctor's letters or on incapacity certificates. D43C71D33
Causes and risk factors
Examinations and diagnosis
Disease course and prognosis
Brain tumor: description
The term brain tumor refers to any benign and malignant tumor within the skull. Brain tumors are relatively rare compared to bowel, lung, breast or other cancers. In 2010, according to cancer registry data of the Robert Koch Institute, approximately 2,900 women and 3,800 men in Germany contracted a brain tumor. In both genders, most illnesses were recorded between the ages of 70 and 75 years. About 100 females and 200 males were under 20 years old.
Brain tumor is relatively common in children compared to other cancers. According to the Childhood Cancer Registry, about a quarter of childhood cancers are due to tumors of the central nervous system.
Brain tumor is not equal to brain tumor. First, there are as mentioned both benign and malignant brain tumor forms ("brain cancer"). In addition, a distinction is made between primary and secondary brain tumors: primary brain tumors
The primary is a brain tumor that develops directly from cells of the brain or the meninges. Such tumors are also referred to as brain tumors.
Tumors that originate from a cranial nerve are often counted among the primary brain tumors. The cranial nerves are to a large extent in the skull, but are not attributed to the central nervous system (CNS: brain and spinal cord), but the peripheral nervous system. If a tumor in the head of a cranial nerve, it is therefore actually a neoplasm of the peripheral nervous system.
The primary brain tumors are subdivided according to different criteria. The World Health Organization (WHO) divides the individual tumors according to what tissue they are derived from and to what extent the brain tumor is malignant or benign. This distinction influences both brain tumor treatment and prognosis. Interestingly, only a small proportion of brain tumors are derived from neurons. More than every second primary brain tumor develops from the supporting tissue of the brain and thus belongs to the group of gliomas. The following table gives an overview of the most important brain tumors:
They are derived from the support cells of the CNS. These include, for example, astrocytoma, oligodendroglioma and glioblastoma.
This brain tumor is formed by cells that line the inner brain chambers.
The medulloblastoma is formed in the cerebellum. It is the most important brain tumor in children.
This tumor is based on cranial nerves. He is also called Schwannom.
This brain tumor develops from the meninges.
CNS lymphoma forms from a cell group of white blood cells.
Germ cell tumors
Germ cell tumors include germinoma and choriocarcinoma.
Brain tumor of the Sellaregion
These tumors are found in a specific place in the brain, the sella turcica. This is usually the pituitary gland. They include the pituitary adenoma and the craniopharyngioma.
In each age group, individual brain tumors are more common than others. Among the primary brain tumors, gliomas, meningiomas, and pituitary tumors are most common in adults. If a brain tumor occurs in children, it is usually a medulloblastoma or a glioma.
Secondary brain tumors
Much more common than a primary brain tumor are secondary brain tumors. They arise when cells from other organ tumors (for example, lung cancer, skin cancer, breast cancer) enter the brain and form a daughter tumor here. These are therefore brain metastases. They are not considered by some professionals as a "true" brain tumor.
With the brain metastases one differentiates between removals in the brain tissue (parenchyma metastases) and those in the meninges (meningeosis carcinomatosa).
Brain Tumor: Symptoms
You can read all about possible signs of a brain tumor in the article Brain Tumor - Symptoms.
Brain Tumor: Causes and Risk Factors
So far, it is largely unknown why a primary brain tumor forms. For most people affected, no triggering factor can be found.If no brain tumor causes are known, experts also speak of a sporadic brain tumor.
In contrast, there is also a hereditary brain tumor. It may be caused by certain hereditary diseases such as neurofibromatosis, tuberous sclerosis, von Hippel-Lindau syndrome or Li-Fraumeni syndrome. However, these diseases are extremely rare. Only a small proportion of brain tumors can be attributed to one of these clinical pictures.
CNS lymphomas are more likely to develop in patients with a severely weakened immune system, such as HIV or the use of immunosuppressants to prevent rejection after organ transplantation.
Otherwise, the only known risk factor for a brain tumor is the radiation of the nervous system. It is used in life-threatening conditions such as acute leukemia. Overall, very few people develop a brain tumor after brain irradiation. Incidentally, ordinary X-ray examinations do not cause brain tumors.
Secondary brain tumors, ie brain metastases, form when there is cancer in the body. Therefore, if there are risk factors for a specific cancer, the risk of brain metastases increases. However, not every malignant tumor spreads to the brain.
You can read more about this topic in the article on brain metastases.
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Cancer - eleven nurse's tales
The fear of cancer inspires the imagination and drives bizarre flowers. The Cancer Information Service has questioned the rumors. From truth to old wives' tales: the biggest cancer myths in the science check.
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Cancer by deodorant?
Deodorants reduce perspiration. And that is supposed to reduce the exudation of pollutants and thus increase the risk of cancer. In fact, it is mainly the kidneys, bladder and intestine that transport pollutants out of the body. Whether ingredients of cosmetics such as parabens or aluminum are harmful is at least doubtful. At the moment this seems unlikely.
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Vitamin pills instead of fruits?
Do vitamin pills protect better than fruits? Many people seem to believe that and are taking vitamin pills daily. But dietary supplements are expressly not recommended for cancer prevention. Much more important is a balanced diet, my experts. In case of a proven deficiency condition, however, one should provide a sensible supplement in consultation with the doctor.
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There is a grain of truth in every myth. Even vegetables can make you sick: even green tomatoes and raw potatoes contain alkaloids, which are described as slightly toxic. Ripe tomatoes and cooked potatoes, on the other hand, are healthy.
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Breast cancer through tight bras?
A persistent rumor states that too tight bras promote breast cancer. But that belongs in the realm of the Ammenmärchen. Busty but may be prone to cancer. American studies suggest that women with cup size C and D are at higher risk for breast cancer than women with smaller breasts.
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Is cancer contagious?
The fear of contracting a deadly disease has many. For cancer, however, this concern is unjustified - cancer itself can not be infected. However, viruses play a role in the development of cancers such as cervix and stomach cancer.
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It used to be preached that illness (especially cancer) was the punishment for moral offenses. But that's just a myth used to enforce norms. However, one's own behavior can actually influence cancer risk. Decisive is not the moral attitude, but a healthy lifestyle. He can help reduce the risk.
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Simply starve the cancer?
Again and again you hear about cancer diets. Can you starve cancer by removing sugar and carbohydrates? This view is not experts. They recommend a balanced diet and gaining or maintaining normal weight. Underweight, however, can be very dangerous for cancer patients.
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Are the hormones to blame?
Yes and no. Hormones actually affect the development of some cancers. However, the artificial intake can have both protective and harmful effects. Estrogen and progestin prevention may increase the risk of breast cancer to a small extent, but it protects against uterine and ovarian cancer. Data on hormone replacement therapy for menopausal symptoms are clearer - it is riskier.
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Wake up OPs tumors?
Biopsies and surgeries are standard in cancer diagnosis and treatment. However, some patients fear that needles and knifes rouse cancer cells and make them aggressive. Others believe that the air that gets to the tumor gives it the opportunity to develop. At the moment there are no indications.
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Miracle pill for cancer?
Again and again, self-proclaimed healers offer alleged miracle pills and cures against cancer. However, the only ones who benefit from it are the quacks themselves.In the worst case, the desperate patients neglect the conventional medical therapy, which could perhaps save their lives. A secret recipe against cancer is not in sight. But there are also alternative healing methods that can support the cancer therapy or mitigate their side effects.
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Injuries as a cause?
Sometimes the connection seems clear: Some time after an injury, the doctor finds a tumor at the same site. In fact, assumptions that bumps, bruises, bruises, bruises, and other traumas promote cancer development go back to outdated views several centuries ago. The exception: Lymphedema or burn scars may be the cause of certain tumors. This happens very rarely.
Brain tumor: examinations and diagnosis
The right contact person for a brain tumor is a specialist in neurology (neurologist). In order to be able to carry out the correct diagnostic steps, he / she has to precisely record your medical history (anamnesis). He asks for your specific complaints, any pre-existing conditions and medical treatments. Possible questions are for example:
- Do you suffer from new headaches (especially at night and in the morning)?
- Do you have a headache when lying down?
- Do you use conventional headache medication?
- Do you suffer from nausea and vomiting (especially in the morning)?
- Do you have blurred vision?
- Did you have a seizure? Did one half of the body jump involuntarily?
- Did you have or have problems moving or coordinating a body part?
- Did you have or have problems speaking?
- Do you notice restrictions when you concentrate, memorize, or understand something?
- Have any new hormonal disorders occurred?
- Do your relatives or friends think that your personality has changed?
After that, the doctor performs a neurological examination. He tests muscular reflexes, muscle strength and coordination. He also checks if the cranial nerves are functioning properly, such as asking you to frown, or by looking you in the eyes to test the pupil reflex. He also checks your visual field and looks at the fundus with an examination light.
Thereafter, further investigations may follow, such as computed tomography (CT), magnetic resonance imaging (MRI), electroencephalography (EEG) and nerve water examination. If these examinations indicate a brain tumor, the removal of a tissue sample (biopsy) may be necessary for a more detailed investigation.
If your neurologist suspects that your symptoms are caused by brain metastases, the causative cancer must be diagnosed. Depending on the suspicion, you may be referred to another specialist (such as a gynecologist or gastroenterologist).
CT and MRI
In CT, the patient is placed on a couch in the examination tube, where the brain is X-rayed. On the computer, one can then recognize the brain structures on individual sectional images. With this procedure one can recognize especially bleeding and calcifications well.
In recent years, an MRI is increasingly made in suspected brain tumor. This examination also takes place in a test tube. It takes longer than a CT, but does without X-rays. Instead, images of the body are made using magnetic fields and electromagnetic waves. The representation is often even more detailed than in CT.
Sometimes both procedures are performed one after the other. Both examinations are not painful. The narrow tube and the high noise level are perceived by some patients as unpleasant.
Measurement of electrical brain waves (EEG)
In a brain tumor, the electrical currents in the brain may be altered. An electroencephalogram (EEG) that records these currents can be very enlightening. Small metal electrodes are attached to the scalp and connected with cables to a special measuring device. Now, the brain waves can be derived at rest, during sleep or under light stimuli. Based on the results, a brain tumor, for example, can be distinguished from a seizure disorder. In addition, one can often use EEG to determine the origin of a brain change. This procedure is neither painful nor harmful and therefore particularly popular for the study of children.
Nerve water examination (CSF)
To exclude altered brain water pressure (CSF pressure) or meningitis, a nerve water puncture may be necessary. In addition, one can detect in the nerve water by a brain tumor modified cells.
The patient usually receives a tranquilizer or light sleep aid prior to this examination. In children, a general anesthetic is usually performed. Then first the lumbar area is disinfected on the back and covered with sterile towels. So that the patient has no pain during the puncture, a local anesthetic is first injected under the skin.Subsequently, the doctor can advance a hollow needle into a liquor reservoir in the spinal canal. So he can determine the CSF pressure and take some CSF for a laboratory examination.
The spinal cord can not be injured in this examination because a point below the spinal cord end is chosen as the puncture site. Most people find the examination uncomfortable but bearable, especially as the CSF usually takes only a few minutes.
Taking a tissue sample
To classify a brain tumor, a tissue sample must be taken and examined under the microscope. This can be done either by an open brain tumor operation or a stereotactic surgical technique.
In open brain tumor surgery, the patient is placed under general anesthesia. The skullcap is opened, and the tumor structures are visited. This procedure is usually chosen when the brain tumor is to be completely removed in the same operation. Then the entire tumor tissue can be examined under the microscope. Of the result often depends on the further treatment.
Stereotactic surgery, on the other hand, is almost always done under local anesthesia, so the patient does not feel pain. His head is fixed in a scaffold for sampling. An imaging procedure determines exactly where the tumor is located in the head. At a suitable place then a small hole in the skull is drilled (Trepanation), over which the operating tools can be introduced: The biopsy forceps can be led computer-controlled to the brain tumor and purposefully remove a tissue sample.
Read more about the investigations
- lumbar puncture
- Neurological examination
Brain tumor: treatment
Not every brain tumor is treated the same. Basically, you can operate a brain tumor, irradiate or perform chemotherapy. But even these three options can be performed in very different ways or combined with each other.
Which brain tumor treatment is suitable in a particular case depends on the type of tissue, the cell change and special molecular biological characteristics. Of course, it also takes into account how advanced the disease is and what wishes the person expresses. Not every treatment option is an option for every patient, but there are usually alternative treatments available.
Brain tumor: surgery
A brain tumor operation can have different goals. Some brain tumors can be completely removed by surgery. In other cases, the tumor can only be resized in surgery. However, this can sometimes relieve the symptoms and improve the prognosis, because the tumor reduction creates better conditions for subsequent treatments (radiotherapy, chemotherapy).
An operative procedure in brain tumor patients may also have the goal to compensate for a tumor-related outflow disorder of the nerve water. Because the CSF can not flow away undisturbed, the pressure in the brain increases, which causes serious discomfort. In an operation, for example, a shunt can then be implanted, which dissipates the brain water, for example, into the abdomen.
In most cases, open brain tumor surgery is performed under general anesthesia: the head is fixed to a metal framework. After the skin is severed, the skull bone can be sawn and the hard meninges opened. The brain tumor is visited and operated under a special microscope. Some patients receive a fluorescent agent that is taken up by the brain tumor before surgery. During the operation, the tumor then shines under a special light. As a result, it can be better distinguished from the surrounding healthy tissue.
If the tumor is located near important brain centers, these are monitored by special examinations. Thus, for example, sensitive and motor functions or the Hörbahn be protected. The language center can only be monitored if the operation is performed under local anesthesia. Sometimes the operation is interrupted to check the operation success by means of imaging (CT, MRI).
After surgery, bleeding is stopped and the wound closed. The patient is initially transferred to a monitoring station until his condition is stable. In the further course, imaging is usually initiated again in order to check the result of the operation. In addition, patients usually receive a cortisone preparation for a few days after surgery. It should prevent the brain from swelling up.
Brain Tumor: Irradiation
Some brain tumors are treated exclusively with radiotherapy. For others, this is just one of several treatments.
When irradiated brain tumor cells are destroyed, but adjacent healthy cells are spared as possible. Generally it is not possible to record only the brain tumor. Thanks to good technical possibilities, however, it can be very well calculated with a previous imaging, which area should be irradiated. The irradiation takes place in several individual sessions, because this improves the result. In order not to have to redefine the tumor area at each session, individual face masks are made.Thus, the patient's head can be brought exactly in the same position each time for the irradiation.
With radiation therapy side effects can occur. For example, the skin may redden over the irradiated area. Headache and nausea also occur. The doctor will tell you about possible side effects before radiotherapy and tell you how to deal with them.
Brain Tumor: Chemotherapy
Special cancer drugs (chemotherapeutics) are used to kill brain tumor cells or to stop their reproduction. If the chemotherapy is done before surgery (to make the tumor smaller), it is called neoadjuvant chemotherapy. On the other hand, if it adheres to the surgical brain tumor removal (to kill residual tumor cells), professionals call it adjuvant.
Different medicines are suitable for the different types of brain tumors. Some brain tumors do not even respond to chemotherapy and must therefore be treated with another therapy.
Unlike other cancers, in a brain tumor chemotherapeutics first have to cross the blood-brain barrier to reach their destination. In individual cases, the chemotherapeutic agents can also be injected directly into the spinal canal. They then enter the brain with the nerve water.
As with radiotherapy, chemotherapy also detects healthy cells. This can cause certain side effects, such as a disorder of blood formation. The typical side effects of the drugs used are discussed in a doctor's consultation before treatment.
Brain Tumor: Supportive Therapy
The term "supportive therapy" summarizes all measures that support the patient during his illness. It does not fight the tumor directly, but only the symptoms that it causes or the treatment (such as chemotherapy). For example, headache, increased intracranial pressure, vomiting, nausea, pain, infections or blood changes can be treated with medication. A psycho-oncological care can also be part of the supportive therapy: It is intended to support patients and their relatives in dealing with the serious illness.
Read more about the therapies
Brain tumor: disease course and prognosis
Every brain tumor has a different prognosis. The course of the disease and the chances of cerebral tumor healing depend very much on how the tissue of the tumor is built up and how fast it grows. As an indication to physicians and patients, the WHO has developed a classification of tumors according to severity. Overall, there are four severity levels, which are mainly defined by the tissue examination:
- Grade I: Benign brain tumor with slow growth and very good prognosis
- Grade II: Benign brain tumor, but can turn into a malignant
- Grade III: Malignant brain tumor
- Grade IV: Very malignant brain tumor with fast growth and poor prognosis
This classification serves not only to estimate the personal brain tumor healing chances. It also focuses on how a brain tumor is treated. Thus, a first-degree brain tumor can usually be cured by a brain tumor operation. A second-degree brain tumor can recur after surgery. At WHO grade III or IV, the brain tumorHealing chances so bad that after surgery in each case a radiation and / or chemotherapy is recommended.