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Brain Tumours

Medical & Health Articles by Clinical Specialists & Experts

16/10/2020
in Expert Speaks, Health Care
5 min read
0
Brain Tumours
Authored by

DR. MOHAMMED RAEES TONSE
MD (Oncology)
Consultant Oncologist


Brain Tumours

Brain tumours are quite diverse affecting all age groups. These tumours pose several challenges  from a treatment perspective including rehabilitation and support services of not only the affected  person but also the caregiver. However, due to the improvement in neurosurgical, radiotherapy  techniques and development of newer chemotherapeutic and biological agents, the outlook of these  tumours have improved over the last decade period of time. Moreover, while long term survivors  of brain tumours still have considerable issues in several aspects of their activities of daily living  and quality of life, there are many of them, who are not only enjoying an excellent quality of life  but are also integrating into the mainstream and leading a good social life.  

Worldwide Incidence of brain tumours  

Brain tumours, though uncommon are not a rare entity. Globally brain tumours account for less  than 2% of all cancers (approximately 175000 cases per year worldwide). Its annual incidence is  3.7 per 100,000 for men and 2.6 per 100,000 for women.  

How common is Brain Tumour in India?  

The incidence of a primary brain tumour in India ranges from 2.5 to 4.1 per 100,000 population  for males and 1.4 to 2.6 per 100,000 population for females based on the Indian Council of Medical  Research (ICMR) database. It represents < 1% of new cancer cases detected every year in the  country. However, there has been a steady increase in the incidence of primary brain tumours over  the last decade or so primarily due to higher detection rates, better awareness among individuals  and from the widespread availability of excellent diagnostic imaging in India.  

In children, brain tumours account for approximately 35% of all types of tumours and are the  second most common cancers second only to leukaemias. Data compiled from multiple institutes  of India has shown that most common brain tumour in children are astrocytomas (34.7%), followed  by medulloblastoma and supratentorial primitive neuro-ectodermal tumours (22.4%),  craniopharyngiomas (10.2%) and ependymal tumours (9.8%). The most common astrocytic  tumour was pilocytic astrocytoma.  

These tumours are quite diverse in nature ranging from benign to malignant tumours.  

Benign (Non-cancerous) brain tumours do not contain cancer cells: Majority of the benign tumours  can be removed, and they seldom grow back. Cells from benign tumours do not invade tissues  around them or spread to other parts of the body. However, benign tumours can press on critical  areas of the brain and cause serious and life-threatening neurological problems.  

Malignant (cancerous) brain tumours contain cancer cells: They are likely to grow rapidly and  crowd or invade the surrounding healthy brain tissue. Very rarely, cancer cells may break away  from a primary brain tumour and spread to other parts of the brain, to the spinal cord, or very  occasionally even to other parts of the body. A malignant brain tumour is generally more serious  and often is life-threatening. 

These tumours affect all age groups right from the very young to the very old. Management of  these tumours poses several challenges right from treatment to ancillary care including  rehabilitation and support services.  

In some patients, a low-grade tumour will develop into a high-grade malignant tumour. It is called  malignant transformation or progression to malignancy.  

Primary and Secondary Brain Tumours  

A primary brain tumour is a solid tumour, defined as an abnormal growth of cells within the brain  or the central spinal canal. This abnormal and uncontrolled cell division usually occurs in the brain,  in blood vessels, in the cranial nerves, in the brain envelopes (meninges), skull bone, pituitary  gland, or pineal gland.  

When cancer spreads from its original place to another part of the body, the new tumour has the  same kind of abnormal cells as the primary tumour. Cancer that spreads to the brain from another  part of the body is different from a primary brain tumour. When cancer cells spread to the brain  from another organ (such as the lung or breast) doctors may call the tumour in the brain a secondary  tumour or brain metastasis.  

In India, primary brain tumours are far more common than brain metastasis which is in contrast to  the western countries where metastatic brain tumours are more common.  

Risk Factors & Possible Causes of Brain Tumours  

There are no known causes of brain tumours. Unlike some of the tumours in the body, it is not  caused by an infection or infectious agent. Brain tumours are not contagious and cannot be transmitted from one person to another.  Brain tumours can occur at any age. Certain brain tumours like gliomas usually occur in middle  age and elderly individuals while certain tumours occur during childhood and adolescence.  

1. Exposure to Medical Radiation  

Exposure to radiation is the only definite risk factor for the development of second cancers  especially brain tumours. People who are exposed to radiotherapy, frequent CT scans or X-rays of  the head are at higher risk of developing brain tumours like meningiomas and to a lesser extent,  malignant gliomas Although medical exposure to radiation is kept as low as possible, X-rays and  CT scans are important modalities in diagnosing diseases so that you have the right treatment.  

2. Previous cancers  

Children who have had cancer have a higher risk of developing a brain tumour later in life. For  e.g. children who have had leukaemia (a type of blood cancer) or Hodgkin or Non-Hodgkin  lymphoma (a type of cancer of the lymph nodes) as an adult also have an increased risk of brain  tumour. There is some evidence that there is an increased risk of brain tumours in adults who have  had other types of cancer for e.g. breast cancer survivors who have been treated with chemotherapy 

may have an increased risk of pituitary adenomas. This increased risk has been postulated due to  the treatment for previous cancer, such as radiotherapy to the head. However, it should be kept in  mind that the benefit of treatment for original cancer far outweighs the risk of brain tumour.  

3. Genetic conditions and family history  

Less than 1% of brain tumours is associated with genetic conditions and occurs in members of a  family. Patients with a family history of any of brain tumours need to get themselves properly  investigated with relevant investigations.  

4. Other Medical Conditions and Medicines  

People with HIV or AIDS have double the risk of being diagnosed with a particular type of brain  tumour called lymphoma of the brain which is also called as Primary CNS lymphoma. HIV patients  tend to have this form of a brain tumour at a younger age.  

There is a small risk of women developing brain tumours especially meningiomas. Post menopausal women who are taking hormone replacement therapy (HRT) or a younger woman  who are taking oral contraceptive pills (OCP) may have a slightly increased risk. However, this  link needs to be proved by further research studies.  

5. Mobile Phones  

Cell phones emit radiofrequency electromagnetic radiation. The amount of radiofrequency  electromagnetic radiation a cell phone user is exposed to depend on the technology of the phone,  the distance between the phone’s antenna and the user, and the user’s distance from cell phone  towers. International Agency for Research on Cancer (IARC) has categorized the radiation emitted  from cell phones as a category 2B carcinogen, which means that there is inadequate evidence of  carcinogenicity in humans but sufficient evidence in experimental animals. From the evidence so  far, we still can’t say that mobile phones pose a problem to health. There has been a concern about  them causing brain tumours in particular. But there is no strong evidence that there is any link.  More research is needed because cell phone technology and the way people are using cell phones  have been changing rapidly. Even though there is no strong evidence suggesting that radiations  emitted from cell phones increase the risk of brain cancer, individuals need to be cautious while  using cell phones. 

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