Tumors may be benign or malignant and depend on their growth behavior. The brain is made up of neurons and supportive cells. Every cell has its particular function. Cells typically divide in a specific specified way and regenerate their successors. If a cell loses control over the division, the tumors will develop.

• Benign brain tumors will not have cancer cells; the complete removal of the tumor will usually cease the tumor recurrence. They cause symptoms by pressing the surrounding structures.
• Malignant brain tumors are aggressive and contain cancer cells. They are life-threatening. Malignant brain tumors grow rapidly and invade the tissue surrounding them. Malignant brain tumors may be contained or may be proliferating invasive. 

These brain tumors are graded as low grades (grades I and II) to high grades (grades III and IV). The grading is based on the microscopic cell pattern, corresponds to the malignancy potential, and grows faster. 

Brain Tumors Causes

The causes of brain tumors are unknown. If we know the brain tumor’s origin, targeted tumor therapies will be available. Brain tumors’ source and form in a person are mysterious but are not contagious.  

Brain tumors commonly show bimodal age patterns involving children 3 to 12 years old and adults 40 to 70, but they can occur in any age group.

What are the Risk factors for developing brain tumors?

Oil refining, rubber manufacturing, and drug manufacturing

Chemists and embalmers 

Exposure to viruses is a possible cause. 

Heredity is a cause

In most cases no apparent risk factors. 

Tumors are the result of several factors acting together.

Types of Brain Tumors

Brain tumors can be primary or secondary.

Primary Brain Tumors

Tumors originate within brain tissue. The type of cell origin categorizes primary brain tumors. The most prevalent brain tumors are gliomas arising from supportive tissue glial cells. Gliomas divided into

• Astrocytomas arise from astrocytes. They may present in the brain or spinal cord. In children, they are often found in the brain stem, the cerebrum, and the cerebellum. In adults, they often arise in the cerebrum. A grade III astrocytoma is called anaplastic astrocytoma. A grade IV astrocytoma called GBM (glioblastoma multiforme).
• Oligodendrogliomas arise from the cells that produce myelin, the fatty insulating covering that protects nerves. They commonly occur in the cerebrum. They grow slowly and are usually distinct from the brain tissue.
• Ependymomas form from the lining of the ventricles. They occur in both the brain and the spinal cord. They occur commonly in childhood and adolescence.

Other tumors arise from the different tissues broadly:

• Meningiomas grow from the coverings of the brain called meninges, usually benign. As these tumors grow slowly, the brain adapts to their presence so that meningiomas grow significantly when symptomatic. They occur primarily around 30 to 50 years of age and in women.
• Schwannomas are benign tumors that arise from the counterparts of oligodendrogliomas in the peripheral nervous system, which produce the myelin that insulates peripheral nerves. Acoustic neuromas, V nerve, and XII nerve will commonly grow schwannoma, and spinal nerves will also have this kind of tumor, primarily in adults. This tumor harbors women twice as often as men.
• Craniopharyngiomas develop from Rathke’s pouch remnants near the pituitary gland, usually benign; They are dangerous because they compress the hypothalamus. It follows a bimodal age pattern and occurs mainly in children and after 40 years.
• Germ cell tumors arise from primitive totipotent cells or germ cells. Germinoma is a common type of germ cell tumor in the brain.
• Pineal region tumors originate from the pineal gland. They are either benign, like pineocytoma, or malignant, like pineoblastoma.

Secondary Brain Tumors

Secondary brain tumors will have the source origin somewhere in the body. These are called metastasis. Based on the origin tissue, they will call it. For example, if lung cancer metastasizes to the brain, the tumor is called metastatic lung cancer. Treatment for these tumors depends on the systemic burden and other factors like general health, the patient’s age, and response to previous therapy.

Symptoms of Brain Tumor

The most frequent symptoms and signs of brain tumors include:

• Confusion or personality changes,
• Headaches that tend to be worse in the early morning and ease during the day and are associated with vomiting,
• Nausea or vomiting,
• Seizures (convulsions),
• Stumbling in walking (ataxic gait),
• Weakness in the arms or legs,
• Changes in speech
• Abnormal eye movements or changes in vision,
• Drowsiness

Diagnosis of Brain Tumors

Clinical history is essential as the symptoms sometimes guide us to the tissue of origin, like the brain stem, cerebrum, cerebellum, etc.

Based on the physical and neurologic examinations, we may ask for the following imaging tests:

• CT scan – for bony details and screening 
• MRI (magnetic resonance imaging) – for anatomical details

The doctor may also request other tests such as:

• A skull x-ray – is rare nowadays.
• An angiogram, or arteriogram, for highly vascular tumors.
• Myelogram in those patients, we may not be able to do MRI or 3D purposes.
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Collecting a biopsy tissue –  either through open surgery, minimally invasive surgery, or through the needle called a stereotactic biopsy.

• A stereotactic needle biopsy is an image-guided surgery in which we remove the tissue from the deep-seated parts. We also use a brain path for the same and can remove the entire tumor minimally invasively. The biopsy collected was first seen under a microscope, then adding different markers to know the genetic mutations in cancer. Based on these sophisticated tests, you may get the tumor’s prognosis and the cancer response.

Treatment for brain tumors

Treatment depends on the size, type, location, overall health of the patient, and preferences.

Brain Tumors Surgery:

Indications are brain tumors causing excessive swelling and are an imminent danger to the patient life

Biopsy

Accessible area

Reduce tumor burden

Best for adjuvant therapy like chemo or radiation therapy by reducing the tumor tissue

improve the quality of life along with 

Brain Tumors Radiation therapy

Side effects of radiation therapy depend on the dose and type of radiation received. Radiation therapy has several types – External beam radiation, Brachytherapy, and whole-brain radiation. External beam radiation therapy for benign tumors is around 54 Gy and malignant for tumors 60 Gy in 30 divided factors. Common side effects immediately following radiation include fatigue, headaches, vomiting, memory loss, scalp irritation, and hair loss.

Brain Tumors Stereotactic Radiosurgery

Stereotactic radiosurgery is also called knifeless surgery. Instead of a knife, it uses high-dose radiation to the confined area to control the tumor’s growth. You may get it from Gamma Knife or Linear accelerator, but the results are almost the same, with no difference. Radiosurgery is typically a daycare procedure.

Brain Tumors Chemotherapy: 

Chemotherapy uses drugs to kill tumor cells. Temozolomide is the commonly used drug either for concurrent or individual cycles. 

Chemotherapy can cause side effects depending on the type and dosage of medications. Chemotherapy will be given based on your biopsy results.

Brain Tumors Targeted drug therapy

Targeted drug treatments focus on specific genetic mutations present within cancer cells. By knocking these abnormalities, these targeted drugs can cause cancer cells to die.

Living with a Brain tumor

• Physical therapy 
• Speech therapy 
• Occupational therapy 
• Tutoring for school-age children