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Dr. Joseffer explains recent brain tumor diagnosis of Sen. John McCain
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Brain cancer has been brought to the forefront since Senator Edward Kennedy’s diagnosis of malignant astrocytoma in May, 2008. This has raised a number of questions regarding the diagnosis, treatment and prognosis of brain tumors in general.
Brain tumors can be classified as primary (intrinsic) if they develop from the cells within the brain substance or secondary if they originate from cells located elsewhere in the body (metastatic). Astrocytomas are a subtype of a broader classification of intrinsic brain tumors called gliomas. In other words, gliomas arise from the glial cells that are found in brain tissue. About 12,000 new cases are diagnosed per year in the United States. Astrocytomas are the most common primary brain tumor. If we consider all malignant brain tumors as a group, metastatic tumors are the most common. According to the American Brain Tumor Foundation, about 100,000 people are diagnosed with metastatic brain tumors per year.
There are no known causes for the development of primary brain tumors. Although a small subset of brain tumors can be attributed to genetic or hereditary factors, a majority of them have no known cause. Certain brain tumors may develop because of a weakened immune system as in acquired immunodeficiency syndrome (AIDS). Radiation therapy has also been implicated in the development of certain type of brain cancers. On the other hand, the effect of certain environmental and behavioral factors on the development of brain cancer remains unclear. Such factors include dietary patterns, physical activity, weight, tobacco use, infectious agents, sunlight, chemicals and pollutants, and cellular phones. The risk for developing certain brain cancers does increase with age. Incidence rates for malignant gliomas especially glioblastoma multiforme, the most malignant of the gliomas, peaks between 75- 84 years of age.
The signs and symptoms associated with brain tumors are variable depending on the location, size and aggressiveness of the tumor. Generalized symptoms like headaches, usually worse in the morning, nausea, vomiting and vision problems may be secondary to an increase in pressure inside the skull. This can be due to either swelling from the tumor or hydrocephalus (fluid build up inside the closed cavity of the skull). Other signs or symptoms may include seizures, weakness on one side of the body, speech and language problems, personality and memory deficits, confusion, difficulty in cognition, and balance problems. Any of these symptoms should prompt one to seek immediate medical help.
In general, the diagnosis of a brain tumor begins with a complete neurological exam that includes vision and eye movement, hearing, facial movement and sensation, motor skills, reflexes, bodily sensation, balance and coordination. Imaging studies may be needed such as a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan to look for structural changes in the brain. In addition, CT scans of the body such as chest and abdomen/pelvis or a bone scan or mammograms may be needed if metastatic brain disease is suspected. Although these noninvasive tests may narrow the list of diagnostic possibilities, tumor tissue is necessary in the majority of cases to determine the final diagnosis and treatment plan. A biopsy is required to obtain tissue samples for pathology.
LastUpdate: 2017-07-24 22:44:11