Brain Tumors

Brain tumors are abnormal cell growths that occur in the brain or spinal cord. These tumors can be benign (benign) or malignant (malignant, cancerous). Tumors can originate directly in the brain (primary brain tumors) or metastasize to the brain from another body part (metastatic brain tumors). Here is some general information about brain tumors:

Brain Tumor Types:

1. Benign Tumors (Benign Tumors)

• Meningioma: Originates in the meninges, the membrane that surrounds the brain and spinal cord. It often develops slowly and can be surgically removed.
• Pituitary Adenoma: Benign tumors originating from the pituitary gland. They can cause hormonal imbalances.
• Corner tumor (Vestibular Schwannoma): It originates from the hearing and balance nerve. It can cause hearing loss and dizziness.

2. Malignant tumors (malignant tumors):

• Glioblastoma Multiforme (GBM): The most aggressive and deadly type of cancer in the brain. Treatment is difficult and progressive.
• Astrocytoma: Originates from astrocytes, the support cells of the brain. It can be low-grade or high-grade (malignant).
• Ependymoma: Originates from epithelial cells in the spinal cord and brain ventricles.
• Metastatic Tumors: Tumors that start elsewhere in the body and spread to the brain (e.g. metastasis from lung, breast or melanoma).

3. Brain Tumors in Childhood:

• Medulloblastoma: The most common malignant tumor in children. It originates in the cerebellum.
• Craniopharyngioma: It is a benign tumor that develops close to the pituitary gland.
• Pilocytic Astrocytoma:* It is a common low-grade tumor in children.

Symptoms of Brain Tumors

Symptoms vary according to the location, size and type of tumor. The most common symptoms are:

• Headache (especially worse in the morning),
• Vomiting or nausea,
• Vision problems (blurred vision, double vision),
• Sensory or motor weakness (e.g. in the limbs),
• Speech disorders,
• Memory or concentration problems,
• Epileptic seizures
• Personality changes or changes in mental state.

Diagnosis of Brain Tumors

Methods used in diagnosis:

• Neurologic Examination: Reflexes, sensory, balance and coordination tests.
• Imaging Methods:
  • MRI (Magnetic Resonance Imaging): Detailed visual analysis of brain tissue.
  • CT (Computed Tomography): Used to determine the presence and characteristics of tumors.
  • PET Scan: To examine the metabolic activity and spread of the tumor.
• Biopsy: To confirm the type of tumor by taking a sample of its tissue.

Treatment Methods

The treatment of brain tumors is tailored to the individual patient and is planned by evaluating the type, location, size and general health status of the person.

1. Surgical Treatmen

Surgery is often the preferred method of treating brain tumors.

• The tumor is often removed as completely as possible.
• Microscopic surgical methods (e.g. microsurgery) and neuronavigation techniques are used to ensure a precise approach.
• In some cases, the location of the tumor (e.g. sensitive areas) can make complete removal difficult.

Ideally, brain tumor surgeries should be performed in a HYBRID OR. (What does HYBRID OR mean; you can read my explanation in the Hybrid OR section.

Neuronavigation: Maximum tumor removal with real-time imaging.

• Intraoperative MRI/Ultrasound: Intraoperative imaging.
• Awake Craniotomy: Especially in tumors near the tongue/motor area, function is preserved while the patient is awake.
• Fluorescent Dye (5-ALA): Tumor cells are detected with light during surgery.
• Laser Interstitial Thermotherapy (LITT): Minimally invasive, heat tumor ablation.

2. Radiotherapy (Beam Therapy)

High-energy rays (e.g. gamma rays) are used to destroy cancer cells.

• It can be used to destroy tumor cells after surgery or when surgery cannot be performed.
• Techniques: Conformal radiotherapy, stereotactic radiosurgery (Gamma Knife, CyberKnife).

3. Chemotherapy

• Medication is used to kill cancer cells or prevent them from growing.
• It is commonly used for malignant tumors such as glioblastoma.
• Medicines are usually given by mouth or intravenously (e.g. temozolomide).

4. Immunotherapy and Targeted Therapies

• Tumor treatment may involve boosting the immune system or targeting tumor-specific mutations.
• Targeted drugs target the genetic characteristics of tumor cells.

5. Current Research and Promising Developments

• Nanotechnology: Targeted delivery of drugs.
• Oncolytic Viruses: Viruses that selectively kill tumor cells (example: T-VEC).
• Epigenetic Therapies: DNA methylation inhibitors

Conclusion

Treatment of brain tumors requires a multidisciplinary approach (neurosurgery, oncology, radiology). Advances in molecular biology and immunotherapy show promise, especially in aggressive tumors. Early diagnosis and personalized treatments increase life expectancy and quality of life.