May is brain cancer awareness month.  According to the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program, there will be an estimated 23,800 new cases and 16,700 deaths in the US from brain and other nervous system cancers in 2017.

To better understand brain tumors and how they are treated, it helps to understand how they are classified; according to grade from I-IV.

Grade I tumors are often considered benign and tend to grow slowly.  The brain tissue is similar to normal brain cells. Grade II tumors are malignant and the cells look less like normal brain cells than Grade I.  In grade III tumors, the malignant cells look very different than normal cells, and grow rapidly, referred to as anaplastic. Grade IV tumors have the most abnormal appearance and tend to grow the most rapidly and are usually the most aggressive.  Grades I-II tumors are considered low grade, while Grades III-IV are considered high grade.

There are many types of brain tumors that are named based on the type of brain cells they originated from.  Most primary brain tumors begin from glial cells in the brain and are called gliomas. One type of glioma is an Astrocytoma, which can be any grade. Grade I-II astrocytomas are often called a low grade glioma. A grade III astrocytoma is sometimes called an anaplastic astrocytoma, while a grade IV may be called a glioblastoma.

Meningiomas are tumors that arise from the brain’s meninges and can be grade I-III, though are usually grade I and tend to grow slowly.  Oligodenrogliomas come from the cells that surround and protect nerves. These can be Grade II–III.

At this time we still don’t know what causes most brain tumors. There is some link between high dose radiation, like that used in cancer treatment and subsequent development of brain tumors.  There are some rare cases of brain tumors running in families though the vast majority of brain tumors are not related to family genetics. There continues to be ongoing research into areas such as cell phone use, head injury, and chemical use to evaluate for a link, though so far there have not been any consistent results that show a cause.

The symptoms of a brain tumor can vary from person to person. They may include headache, visual changes, seizures, weakness or changes in mood or memory to name a few.

Brain tumors are often treated differently depending on the type, location and grade of tumor. These options may include surgery, radiation therapy and chemotherapy.  Surgery is usually the first treatment, and may involve removing all or part of the tumor. Depending on the grade of tumor and type, location as well as the patient’s age and overall health, this may be followed by additional treatment. This may include both radiation and chemotherapy.  Radiation and chemotherapy are often given in combination following surgery for a period of several weeks. This may be followed by chemotherapy alone for a period of time. Depending on the type of chemotherapy, this may be given as either oral medication or intravenously. 

While being treated, patients will typically have regular monitoring with frequent MRI’s of the brain as well as regular follow up with their doctors including Surgeons, Radiation and Medical Oncologists.  We continue to learn more and more through research and clinical trials into the various types of brain tumors. This research has led to improved treatments that are helping patients to live longer and with a better quality of life than ever before. 

Please feel free to contact me or our team at Virginia Cancer Specialists if we can be of any help to you or your family.

Timothy A. McCarthy, M.D.

 

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