Brain Cancer
Medical Author: Charles Davis, MD, PhD
Medical Editor: Melissa Conrad Stöppler, MD
Brain Cancer Symptoms: Headaches and Seizures
Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD
Most people seek medical care to make certain that nothing bad is happening
in their body.
They seek reassurance from their doctor that all is well. Unasked questions that
linger fill patients and their families with dread until their concerns are
addressed.
"Is my abdominal pain due to
appendicitis?"
"Am I having a heart attack?"
And the 800 pound gorilla in the room: "Is there 'something really
bad' causing my headache?"
For golf legend Seve Ballesteros, there is something bad happening in his
body. Two weeks ago, he
experienced a grand mal seizure for the first time. As part of the evaluation of
a new onset seizure, a CT scan of his brain was done and revealed a
large tumor.
It is amazing that significant parts of the brain can be destroyed and yet the
patient can have normal function. Looking back, though, friends had reported
that Mr. Ballesteros had been complaining of
headaches, and perhaps he had had a
few episodes of unusual or erratic behavior. Often the clues are recognized
after the fact and can help explain previous events.
What is brain cancer?
Brain cancer is a disease of the brain in which cancer cells (malignant) arise in the brain tissue. Cancer cells grow to form a mass of cancer tissue (tumor) that interferes with brain functions such as muscle control, sensation, memory, and other normal body functions. Tumors composed of cancer cells are called malignant tumors, and those composed of noncancerous cells are called benign tumors. Cancer cells that develop from brain tissue are called primary brain tumors while tumors that spread from other body sites to the brain are termed metastatic brain tumors. Statistics suggest that brain cancer occurs infrequently and is likely to develop in about 22,000 new people per year in 2009, with about 13,000 deaths as estimated by the National Cancer Institute (NCI).
Not all brain tumors are alike, even if they arise from the same type of brain tissue. Tumors are assigned a grade depending on how the cells in the tumor appear microscopically. The grade also provides insight as to the cell's growth rate. NCI lists the following grades:
- Grade I: The tissue is benign. The cells look nearly like normal brain cells, and they grow slowly.
- Grade II: The tissue is malignant. The cells look less like normal cells than do the cells in a
grade I tumor.
- Grade III: The malignant tissue has cells that look very different from normal cells. The abnormal cells are actively growing (anaplastic).
- Grade IV: The malignant tissue has cells that look most abnormal and tend to grow quickly.
The most common primary brain tumors are usually named for the brain tissue type from which they originally developed. These are gliomas, meningiomas, pituitary adenomas, vestibular schwannomas, and primitive neuroectodermal tumors (medulloblastomas). Gliomas have several subtypes which include astrocytomas, oligodendrogliomas, ependymomas, and choroid plexus papillomas. When the grades are coupled with the tumor name, it gives doctors a better understanding about the severity of the brain cancer. For example, a
grade III (anaplastic) glioma is an aggressive tumor, while an acoustic neuroma is a
grade I benign tumor. However, even benign tumors can cause serious problems if they grow big enough to cause increased intracranial pressure or obstruct vascular structures or cerebrospinal fluid flow.
What is metastatic brain cancer?
Cancer cells that develop in a body organ such as the lung (primary cancer tissue type) can spread via the bloodstream or lymphatic system to other body organs such as the brain. Tumors formed by
such cancer cells that spread (metastasize) to other organs are called
metastatic tumors. Metastatic brain cancer is a mass of cells (tumor) that
originated in another body organ and has spread into the brain tissue.
Metastatic tumors in the brain are more common than primary brain tumors. They are usually named after the tissue or organ where the cancer first developed (for example, metastatic lung or breast cancer tumors in the brain, which are the most common types found).
What causes brain cancer?
Primary brain tumors arise from many types of brain tissue (for example, glial cells, astrocytes, and other brain cell types). Metastatic brain cancer is caused by the spread of cancer cells from a body organ to the brain. However, the causes for the change from normal cells to cancer cells in both metastatic and primary brain tumors are not fully understood. Data gathered by research scientists show that people with certain risk factors are more likely to develop brain cancer. Individuals with risk factors such as having a job in an oil refinery, as a chemist, embalmer, or rubber-industry worker show higher rates of brain cancer. Some families have several members with brain cancer, but heredity as a cause for brain tumors has not been proven. Other risk factors such as smoking, radiation exposure, and viral infection (HIV) have been suggested but not proven to cause brain cancer. There is no good evidence that brain cancer is contagious, caused by head trauma, or caused by cell phone use. Although many lay press and Web articles claim that aspartame (artificial sweetener) causes brain cancer, as of 2009, the FDA maintains that it does not cause brain cancer and base their findings on over 100 toxicological and clinical studies regarding the sweetener's safety.
Next: What are the symptoms and signs of brain cancer? »
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