Brain Tumours

A brain tumour is an abnormal growth or mass of cells inside the skull. There are more than 120 types of brain tumours categorised as primary or secondary.

Primary brain tumours originate in the brain (brain cells, blood vessels in the brain, nerves, which emerge from the brain or the brain membrane) and are either benign and slow growing, or malignant (fast growing and cancerous).

Although benign tumours can exert potentially damaging pressure on the brain, they do not spread to the surrounding brain tissue unlike the malignant ones that tend to spread to the surrounding brain tissue.

Secondary or metastatic brain tumours grow from cancer cells elsewhere in the body (e.g. lung) but travel to the brain. These tumours are more common and are one of the leading causes of cancer deaths in children and young adults.

The brain, being the command headquarters for the human body, controls our thoughts, movements and emotions. Thus, if it is affected by a tumour, it can significantly affect a person's physical and mental well-being. It can also lead to an inability to control or perform the essential tasks for everyday living.

Who are at risk?

Research has found that several genetically inherited diseases may increase the risk of a brain tumour. For instance, in the case of the inherited condition known as the Hippel Von Lindau Syndrome, children, siblings and relatives can develop tumours in the cerebellum, and also tumours elsewhere in the body, e.g. malignant kidney tumours.

Also, research has unearthed identifiable genetic abnormalities in some brain tumours. Malignant brain lymphomas can occur in some AIDS patients. Nevertheless, the causes for the vast majority of cases remain unknown.

Furthermore, there is no clear evidence that injury, chemical exposure, viral infection, environmental factors (e.g. mobile phone use) or mental stress can cause the growth of primary brain tumours.

Granted that this condition may happen to anyone regardless of age, brain tumours in children are nonetheless different from those in adults.

What are the symptoms?

Patients with symptoms of brain tumours should be evaluated by a neurologist for diagnosis and treatment. As challenging as they are to treat, many brain tumours are benign and can only be cured by their complete removal.

The generalised symptoms of a brain tumour include:

recurring headaches that seem more pronounced upon awakening

seizures

nausea and vomiting

Depending on the area of the brain affected, some localised symptoms can occur. These include:

progressive weakness or numbness of limbs

memory loss or confusion in everyday matters

changes in behaviour or personality

vision problems e.g. blurred vision, double vision or loss of peripheral vision

speech and hearing difficulties

It should be noted that some of these symptoms may be caused by other medical conditions. To be sure, consultation with a qualified neurologist should be sought.

How is it diagnosed?

A neurologist will record your full medical history, conduct a detailed physical and neurological examination to eliminate other possible causes of the reported symptoms.

In Singapore, specialised tests such as a Computed Tomography (CT) Scan, Magnetic Resonance Imaging (MRI) and cerebrial angiogram are available to determine the presence (or absence), size and location of any tumour in your brain.

This would also allow a tentative diagnosis of the tumour type and thus help the neurologist to map out the most appropriate course of treatment.

How is it treated?

Many types of brain tumours can be successfully treated with one or more treatment methods. In addition, technology enables doctors to target tumours more accurately while researchers continue to develop innovative treatments which augurs well for the future of brain tumour patients.

Currently, many brain tumours are treated with a combination of therapies to ensure that as much of the tumour is removed. This is to prevent any possible recurrence.

In the majority of brain tumour cases, surgery via microsurgical techniques (using an operating microscope) is required to remove the tumour. Even though high-tech guidance and navigational equipment are employed, this is still a delicate procedure that only a highly-skilled neurosurgeon can perform to minimise injury or damage to the brain.

This is vital since the brain tissue is delicate and any damage through excessive pressure or interference with its blood supply is irreparable. In addition, risks include infection, bleeding, paralysis, coma or death.

When cancerous brain tumours cannot be totally removed through surgery, doctors may follow up with radiotherapy treatment. This involves delivering an external beam of radiation through a linear accelerator for a period of between two and six weeks to try and destroy the remaining tumour cells.

In some instances, Radiosurgery or Gamma Knife Surgery is undertaken to stop the tumour growth. This involves focussing intense gamma rays (radiation) of the right size on the tumour for between one and two hours to stop tumour growth without the need for surgery. Although brain-imaging devices are used for guidance, no scalpels are involved.

A course of chemotherapy drugs may also be administered, either orally or through injection, to help in the effort to kill any cancerous tumour cells. Hair loss, nausea, and susceptibility to infection are some side effects that may occur.

Source : Singapore Medicine

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