Brain Tumors and how treatment

Selasa, 14 Juni 2011

Brain Tumors   
                                                                                                                
DEFINITIONS
Benign brain tumors are abnormal tissue growth within the brain, but not malignant. Malignant Brain Tumor is a cancer in the brain that have the potential to infiltrate and destroy the tissue next to or that has spread (metastasis) to the brain from other parts of the body through the bloodstream.
Several types of benign brain tumors can grow in the brain and are named according to the cell or tissue of origin: - Schwannoma originating from Schwann cells that wrap around the neural - Ependimoma derived from cells that limit the part of the brain - Meningioma originated from meningen (tissue that lines the outside of the brain) - Adenoma derived from gland cells - Osteoma originating from the skull bone structure - Hemangioblastoma derived from blood vessels.
Benign brain tumor that could be inherited disorders are: - Kraniofaringioma - Kordoma - Germinoma - Teratoma - Dermoid cyst - Angioma.
Meningiomas are usually benign, but can recur after being picked up. These tumors are more common in women and usually appears at age 40-60 years, but it is also possible appear in childhood or at a more advanced age. Symptoms and possible revelation of this tumor depends on the size, growth rate and its location in the brain. If it grows very large, can cause mental deterioration such as dementia (senility).
Malignant brain tumors are the most common is the spread of cancer from other parts of the body. Breast cancer and lung cancer, malignant melanoma and cancer of blood cells (such as leukemia and lymphoma) can spread to the brain. This deployment could occur in one area or several different parts of the brain.
Primary brain tumors derived from the brain, which consists of: - Gliomas derived from tissues that surround and support nerve cells, some of which are malignant - Glioblastoma multiformis is the type most often found - Anaplastic astrocytoma, very rapid growth - Astrocytoma, slow growth - Oligodendroglioma - Meduloblastoma, a rare, usually affects children before they reach puberty - Sarcoma and adenosarkoma is a rare cancer, which grows from structures other than nerve cells.


SYMPTOMS 
Both benign and malignant tumors, the symptoms arise when brain tissue is damaged or the brain gets the emphasis. If a brain tumor is a spread of other tumors, it will arise the symptoms associated with cancer origin. For example, slimy and bloody stones occur in lung cancer, breast lumps can occur in breast cancer.
Symptoms of brain tumors depends on the size, growth speed and location. In some parts of the brain tumor can grow until it reaches a size big enough before the onset of symptoms, whereas in other parts of the brain, tumor size kecilpun can cause a fatal effect.
Early symptoms of brain tumors is often a headache. Frequent headaches due to tumor recurrence or perceived continuous, severe, can occur in someone who had never experienced headaches, occur at night and remained there until awakened.
Other early symptoms are often found is a disorder of balance and coordination, dizziness and double vision.
Advanced symptoms can include nausea and vomiting, intermittent fever and pulse rate and respiratory rate of abnormal fast or slow. Before she died, there was great fluctuation of blood pressure.
Some brain tumors cause seizures. Seizures are more common in benign brain tumors, meningioma and slow-growing cancer.
Tumors can cause arm or leg on one side of the body becomes weak or paralyzed and could affect the ability to feel heat, cold, pressure, light touch or a sharp object. Tumors can also affect hearing, sight and smell.
Emphasis on the brain can cause personality changes and causes the sufferer to feel sleepy, dazed and unable to think. These symptoms are very serious and require immediate medical attention.
Astrocytoma & Oligodendroglioma Astrocytoma and oligodendroglioma is a slow-growing tumors and may only cause seizures. If more malignant (anaplastic astrocytoma and anaplastic oligodendroglioma) can cause abnormalities in brain function, such as weakness, loss of taste and a faltering step. The most malignant astrocytoma is a glioblastoma multiformis, which grow very rapidly causing increased pressure inside the brain and cause headaches, thought to be slow and sleepiness or even coma.

Meningioma 
Benign tumor originating from the membrane that encloses the brain (meningen) can cause various symptoms depending on the location of growth. It could happen weakness or numbness, seizures, disturbances of smell, bulging eyes and impaired vision. In elderly patients can cause memory loss and difficulty in thinking, similar to those seen in Alzheimer's disease.
Tumor Pinealis
Pinealis gland located in the mid-brain, which controls the body's biological clock, particularly on normal cycles between wake and sleep. Pinealis atypical tumor (germ cell tumors) most often occurs in childhood and often cause early puberty. This tumor can damage the drainage of fluid around the brain, causing brain and skull enlargement (hydrocephalus) and serious brain dysfunction.
Pituitary tumor 
Pituitary gland located at the base of the skull, functioning regulate the body's endocrine system. Pituitary gland tumors are usually benign and produce abnormally large amounts of pituitary hormones: - Increasing levels of excess growth hormone cause gigantism (growth is very high) or akromegali (a disproportionate enlargement of the head, face, hands, legs and chest)- Increased levels of corticotropin causing Cushing's syndrome - Increased levels of TSH (thyroid-stimulating hormone) cause hyperthyroidism - Increased levels of prolactin cause amenorrhea (cessation of menstrual cycle), galactorrhea (formation of breast milk in women who are not breastfeeding) and gynecomastia (enlarged breasts in men). Pituitary gland tumor can also erusak network that produces hormones, which in turn will cause dalamtubuh hormone deficiency. Other symptoms can include headaches and loss of outside visual field in both eyes.

DIAGNOSIS
Diagnosis based on symptoms and physical examination.
X-rays of skull and brain just gives a little picture of a brain tumor. All types of brain tumors can usually be seen on CT scan or MRI, which also can determine the exact size and location.
Pituitary tumors are usually found if it had hit the nerve of sight. Blood tests showed abnormal pituitary hormone levels and tumor can usually be diagnosed by CT scan or MRI.
Biopsy was performed to determine tumor type and nature (malignant or benign).
Sometimes microscopic examination of cerebrospinal fluid obtained by lumbar puncture, could indicate the existence of cancer cells. If there is increased pressure inside the skull, then a lumbar puncture can not be done due to pressure changes suddenly could cause herniation. In the herniation, increased pressure inside the skull pushing down the brain tissue through a narrow hole at the base of the skull, so that pressing the bottom of the brain (brain stem). As a result, functions that are controlled by the brain stem (breathing, heart rate and blood pressure) will experience interference. If not addressed, herniation can cause coma and death.

TREATMENT 
Treatment of brain tumors depends on the location and type. If possible, the tumor removed surgically.
Surgery sometimes causes brain damage that can cause partial paralysis, changes in taste, weakness and intellectual disorders. But surgery should be performed if its growth threatens important brain structures.
Although removal of the tumor can not cure cancer, but can reduce the size of the tumor, relieve symptoms and help determine the type of tumor as well as other treatments.
Some benign tumors must be surgically removed because they continue to grow in the narrow cavity and can cause further damage or death. Meningioma, schwannoma and ependimoma usually removed surgically. After surgery is sometimes performed radiation therapy to destroy tumor cells remaining.
Malignant tumors treated with surgery, radiation therapy and chemotherapy. Radiation therapy began after as much as possible the tumor removed surgically.Radiation therapy can not cure the tumor, but it helps reduce the size of the tumor so that tumor can be controlled. Chemotherapy is used to treat some types of brain cancer. Primary brain cancer or metastatic brain cancer responds well to chemotherapy.
If an increase in pressure in the brain, is given an injection of mannitol and corticosteroids to reduce pressure and prevent herniation.
Treatment of metastatic cancer depends on the source of the cancer. Often radiation therapy. If the spread is only one area, it can be done surgically.

Prognosis
While treated, only about 25% of brain cancer patients survive after 2 years.
Better prognosis was found in astrocytoma and oligodendroglioma, where the cancer usually does not recur within 3-5 years after treatment.
Approximately 50% of patients treated meduloblastoma survive more than 5 years.
Treatment for brain cancer is more effective on: - Patients who are under 45 years - Patients with anaplastic astrocytoma - Patients are partially or almost the entire tumor was removed surgically. 

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