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Brain Tumors


Brain Tumors: Primary brain tumor refers to the conditions which originates in brain tissue. Most other cancers have a tendency to metastasize and spread to the brain, and they are referred to as metastatic brain tumors. Roughly 15,000 Americans develop primary brain cancer every year. The cause of these tumors is unknown.


Signs and Symptoms: Headache, Nausea/vomiting, Seizures, Altered mental status, Altered speech, Visual problems and Paralysis.


Diagnosis: A CT scan or MRI of the brain can establish the diagnosis with a great degree of accuracy. Once the diagnosis is established, treatment should be initiated promptly. The possibility of a metastatic cancer to the brain must be considered and, depending on certain circumstances, other studies may be indicated. Once the diagnosis of a primary brain tumor is established, surgery is the next step. The tumor must be removed and be sent to the pathologist.


Treatment: Surgery for removal of the tumor is the most important step for treating brain tumors. Additional radiation therapy or chemotherapy may be indicated in some patients, especially in situations where complete removal of the tumor is not feasible. Most patients are also treated with steroids to reduce swelling of the brain and anti seizure medicines to prevent seizures.


Radiation therapy: Radiation to the brain is a treatment that is offered over six to eight weeks. Patients may notice some side effects such as: Skin irritation, Loss of appetite, Hair loss, Fatigue. Most of these side effects will subside after completion of radiation.


Chemotherapy: There are very few drugs that are effective and can be used to control brain tumors: Temodar, BiCNU, CCNU, Vincristine, Taxol, Irinotecan and Tamoxifen seem to have some activity in brain tumors.  There are a number of other drugs that have minimal activity in this condition.  

Temodar seems to be more active than other drugs against both primary and metastatic brain tumors and is used in great majority of patients who need chemotherapy for these conditions.  Chemotherapy can also be used in conjunction with radiation therapy for treatment of both primary and metastatic brain tumors.  Carboplatinum can be used on a weekly or even daily schedule along with radiation to enhance the effect of radiotherapy on brain tumors.


Prognosis: The prognosis for brain tumors depends on the nature of the tumor and its type, as well as the extent of the disease at the time of diagnosis and the response to treatment. Most patients with early stage cancers can be cured. With more advanced cancers, the disease can be controlled with treatment for a period of time which may vary from months to years. If the disease reoccurs, it will most likely be treated with surgery or radiation therapy.


Follow-up: After completion of treatment, in any combination that might have taken place, patients need to remain under surveillance for a possibility of recurrence of the cancer. Follow- up should be scheduled on a regular basis, initially every one to three months for between one and two years. The frequency of follow-up will depend on the condition of the patient and his/her disease. In each follow-up visit, the patient is examined thoroughly and, if necessary, a CT scan or MRI of the brain may be obtained.

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