Is brain tumor curable in the second stage

Brain tumor


A brain tumor and other tumors (growths) inside the skull can be benign or malignant. The higher the proportion of degenerate (diseased) cells in the tumor tissue, the more malignant the brain tumor and the faster it grows. The tumor is not only due to degenerate cells, but also through abnormally sprouting blood vessels because it needs more nutrients dissolved in the blood than healthy tissue for its rapid growth.

The following types of tumors occur inside the skull:

  • Tumors of the brain (brain tumor)
  • Metastases from other primary tumors
  • Meninges tumors
  • Cranial nerve tumors


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Symptoms of a brain tumor

The particular problem with tumors of the inside of the skull lies in the organization of the brain, where important functional areas lie next to one another in a very small space. Even the smallest damage can severe consequences in brain function have such. B.

  • Paralysis of the limbs
  • Visual disturbances
  • Speech disorders
  • Breathing or swallowing disorders
  • Seizures
  • mental disorders or behavioral problems

The delimitation by the bony skull makes a brain tumor in comparison to other parts of the body (e.g. the abdomen) little space. A brain tumor, even a benign tumor, if it has exceeded a certain size, will take up space, displace healthy brain tissue, and Intracranial pressure sign draw attention to yourself.

Signs of increased intracranial pressure are:

  • a headache
  • Nausea, vomiting, especially vomiting on an empty stomach in the morning
  • Drowsiness and impaired consciousness
  • Seizures
  • Paralysis or abnormal sensations in the arms and legs or in the supply area of ​​the cranial nerves

Diagnosis of a tumor inside the skull

All of these disturbances can be caused by a neurological examination to be established. Also one ophthalmological examination is important. Further examination methods to confirm the diagnosis of a brain tumor are:

  • CT and / or MRI (computed or magnetic resonance imaging)
  • Angiography (vascular imaging) for surgical planning
  • If necessary, biopsy (taking a tissue sample) for a tissue examination
  • The EEG (electroencephalogram, brain waveform) is justified in assessing the progression. It is mainly used to document convulsive activity. Even with intracranial pressure, it shows pathological changes. However, it does little in the way of initial diagnosis of a brain tumor.

Treatment of brain tumors

The treatment depends on the exact form of the tumor:

  • brain tumor, i.e. a brain tumor in the true sense of the word
  • Brain metastases
  • Meningioma tumor
  • Cranial nerve tumor

Treatment of brain tumors (brain tumors)

Different brain tumors can develop from the different brain tissue cells. According to the recommendations of the World Health Organization WHO, tumors originating from the brain are in four degrees assigned:

  • Grade I (benign)
  • Grade II (predominantly benign)
  • Grade III (starting malignant)
  • Grade IV (malignant)

Operative therapy

The best therapy is as complete as possible surgical removal of the tumor by the neurosurgeon, including cutting off his blood supply.

The surgical options are often limited by the location of the tumor in the brain. For example, there can be movement or language centers in the immediate vicinity of the tumor and one complete removal impossible do. It is possible that only parts of the tumor can be removed during the surgical procedure. In some cases, it is only possible to take a tissue sample. The removed tumor tissue is examined microscopically in order to enable statements to be made about the type and prognosis (chance of recovery, course of the disease) and to decide on further treatment methods.

Further treatment measures

  • Chemotherapy (treatment with agents that inhibit cell growth)
  • Irradiation of individual brain regions or the entire brain, depending on the type of tumor

If an operation is not possible at all, treatment for malignant tumors often consists of a combination of radiation and chemotherapy.

In the case of malignant tumors, edema (brain swelling due to the accumulation of fluid in the tissue) is found in the immediate vicinity of the tumor. This can be easily influenced by drugs, including adrenal cortical hormones, so-called glucocorticoids, in tablet or syringe form. This often reduces symptoms (headaches go down, paralysis improves, etc.).

Benign tumors that grow very slowly may not require surgery. Imaging diagnostics (MRI) and a clinical neurological examination are then necessary at regular intervals in order to determine the progression of the disease in good time and to initiate the necessary treatment.

What are the prospects for a cure in brain tumors?

The chances of recovery vary depending on whether the tumor is benign or malignant. Benign tumors generally do not shorten life expectancy.

Malignant tumors tend to have a bad prognosis. This depends on several factors:

  • Location of the tumor in the brain
  • Radicality of the operation
  • Effectiveness of possible other treatment methods (e.g. radiation or chemotherapy)
  • Type and rate of growth of the tumor (grading)

For grade IV glioblastoma, the most common brain tumor in adults, the average survival rate with modern treatment is just over a year.

Treatment of brain metastases

Metastases are settlements (daughter tumors) of a malignant tumor located elsewhere. Tumor cells can peel off and travel to the brain via the bloodstream. There they cross the blood-brain barrier, are deposited in the brain tissue and begin to grow there. Metastases make approx. 10% of all brain tumors out.

The so-called primary tumors are often in

to find. Daughter tumors of black skin cancer (melanoma) are relatively common. A certain type of blood cancer, lymphoma, can also metastasize to the brain. At the same time as brain metastases, daughter tumors can also form in other organs.

Depending on their location in the brain, metastases lead to the same symptoms as the brain's own malignant tumors, such as B. headache, paralysis and seizures. Sometimes they are the first sign of a tumor growing in the body. Often one finds multiple metastases in the brainthat are different sizes and can be located in different areas of the brain.

Brain metastases are confirmed in CT (computed tomography) or MRI (magnetic resonance tomography). The brain wave image (EEG) plays a rather subordinate role, but can provide information on the question of the development of intracranial pressure in the course of the disease. If the original tumor is still unknown, appropriate diagnostics must be initiated.


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Treatment of brain metastases

The treatment of the metastases is initially carried out within the Treatment of the primary tumor. Chemotherapy usually plays a role here. It depends on the type of tumor that has started. If edema has formed around the metastases, these can be treated with medication, as is the case with malignant brain tumors. Radiation therapy is the most important and most effective therapeutic measure. Various techniques are available here, e.g. stereotactic one-time irradiation, which is very gentle on the patient as the irradiation does not take a long time.

In the case of controlled primary tumor disease, surgical removal of individual brain metastases should always be sought with subsequent radiation therapy of the entire brain skull. If there are multiple brain metastases, whole-brain irradiation is in the foreground. In exceptional cases, several brain metastases can be surgically removed, e.g. if the tumor is slowly growing and the previous clinical course suggests longer-term tumor control.

What are the chances of healing with brain metastases?

If a single brain metastasis can be surgically removed and the underlying tumor is well treated, there is a chance of a cure. Otherwise, the overall chances of recovery are to be assessed as poor. Life expectancy is limited by the underlying disease and the damage to brain function caused by the metastasis (es).
Irradiation can, however, quickly relieve symptoms, so this treatment approach usually makes sense.

Treatment of meningeal tumors

Meningiomas are meninges mostly benign growthsn that emanate from the meninges and are superimposed on the brain. In the case of tumors adjacent to the skullcap, brain structures are usually not impaired. Meningeal tumors in the area of ​​the skull base can be more problematic.

Signs of meningeal tumors are varied and depend on the location. So z. B.

  • Olfactory disorders (in tumors in the area of ​​the anterior skull base),
  • Vertigo and balance disorders (in the area of ​​the middle skull base) and
  • epileptic seizures

occur.

The disease is confirmed by CT (computed tomography) or MRI. Meningeal tumors in the area of ​​the roof of the skull are often not noticed by those affected. Some of them are incidental findings that are detected during a computed tomography scan that is performed due to other diseases (e.g. a stroke).

The therapy of choice is surgery; however, the benign tumors do not have to be operated on in every case if the slow growth does not lead to any impairment of brain structures even over a long period of time. In this case, regular computed tomography checks and regular neurological checks are again sufficient. In certain situations (faster growing meningiomas), radiation can also be considered.

Treatment of cranial nerve tumors

The cranial nerve tumors originate from the envelope structures of the nerves, the so-called Schwann’s cells, and are usually benign (Grade WHO I). The rare malignant so-called neurogenic sarcomas (grade WHO III-IV) are an exception. The acoustic neuroma is the best known representative of the cranial nerve tumors. The tumor grows from the envelope structures of the auditory and equilibrium nerves and is benign.

Starting from its origin, it will draw attention to itself through dizziness, balance and hearing disorders. Sometimes it can reach a considerable size. Here, too, the most important examination methods are CT (computed tomography) and MRI. It is possible to wait for regular checks to be carried out closely. This would be possible, for example, in the case of acoustic neuromas that either do not grow at all or grow extremely slowly or that do not cause any symptoms.

If symptoms persist and the tumor grows, this is the surgical removal of the tumor the therapy of choice to prevent impending hearing loss and damage to neighboring brain structures. Sometimes the tumor cannot be completely removed. In this case, the tumor is reduced in size and the person concerned is regularly monitored in order to have another operation if necessary. Radiation therapy is also possible in some cases. Which of these therapies is the “best” for the person concerned must be decided with the patient on a case-by-case basis.

What are the chances of healing for cranial nerve tumors?

The prognosis for acoustic neuroma is good, but the auditory or equilibrium nerves cannot always be preserved during the operation.