12 - Brain Tumors Flashcards
How common are brain tumors?
- 20,000 brain/spinal cord tumors/yr
- 1.3 % of all cancers
What are the types of primary cancers that commonly lead to a large majority of brain mets?
*** KNOW THIS **
- Melanoma
- Lung
- Breast
- Colon
- Kidney (these like to go to the brain - you see this on the boards)
** KNOW THIS **
Are the large majority of brain cancers primary or mets?
Large majority are METS***
Describe primary brain tumors
- There are cancerous primary brain tumors and non-cancerous
- Cancerous are invasive and aggressive
- While “benign” brain tumors lack those qualities, they can also be life threatening due to limited space in the brain
- Both can lead to bleed, stroke or seizures, etc.
*** Even though it is better to have a benign than a cancerous, both are bad
What are the chances of a primary brain tumors leaving the brain?
They RARELY leave the central nervous system
What are the risks for developing primary brain tumor?
These are rare
- Gene mutations
- MEN 1 (pituitary)
- Neurofibromatosis
- Retinoblastoma (malignant retinal glioma)
Describe environmental contributions to brain cancer?
Vinyl Chloride – used in mfg of chloride (and is present in tobacco smoke). People who work in the plants or live near-by have an increased risk. Pretty accepted risk factor although accounts for small number
Does being married to someone with brain cancer increase your risk?
Environmental
NO
Spouses had no increased risk. First degree relatives had 2-3 times the risk.
Describe the risk of brain cancer associated with smoking
No association of brain cancer to maternal smoking or exposure to smoke as a child
Describe the risk of cancer in patients who have had chicken pox
Patients with Primary Brain Cancer had medical records reviewed. Having a first degree relative with brain cancer increased risk. Having Chicken Pox or Shingles in history DECREASED risk
Describe the risk of brain cancer in cell phone use
- Cell phone use – emit low level radiation.
- Recent studies showing risk
Describe the signs and symptoms of brain tumors in the pituitary
- Behavioral changes
- Sexual issues
- BP chages
- Na changes
KNOW THIS ONE ***
Describe an astrocytoma
- Originates in astrocytes (brain glue)
- Number one type of brain cancer in kids
- This type as an adult can become undifferentiated (along with other cells like spongioblasts) and is called Glioblastoma Multiform which is the most common type in adults.
- Glioblastomas aka glios or GBM
What are the four types of astrocytomas and the WHO grades for each type?
- Plocytic astrocytoms (WHO = I)
- Diffuse astrocytoma (WHO = II)
- Anaplastic astrocytoma (WHO = III)
- Glioblastoma (WHO = IV)
What is the 5 year survival rate for each type of astrocytoma?
- Plocytic astrocytoms (77.4%)
- Diffuse astrocytoma (30.4%)
- Anaplastic astrocytoma (21.9%)
- Glioblastoma (2.4%) ***** (this is the bad kind)
How is a glioblastoma (“glio”) treated?
- Surgery
- Radiation (Gamma knife, Cyber knife)
- Chemo
We use everything that we have!
Increasing life span by months is considered successful - there is NO cure
Describe a medulloblastoma
Medulloblastoma
- 2nd most common brain cancer in kids
- Tumor originates in the 4th ventricle from primitive neural cells
Describe a menigioma
Meningiomas
- Slow growing
- 75% are asymptomatic
- These can grow and have compression issues
- It is the 2nd most common type of brain tumor (that causes symptoms)
- There is a 70% survival after 5 years
- Treatment is surgery with or without radiation
Describe a piruitary adenoma
- 3rd most common adult type that causes issues
- Most common problem is hormone disruption (sex hormones are the most sensitive, then give thyroid and growth hormone)
- Can also have problems with headaches or visual changes
- Treatment is surgical removal
This is a pretty easy to remove and is curative - this is the one you want to have *****
What are the other types of brain tumors?
- Acoustic Neuroma – Vestibularcochlear Nerve
- Lymphoma – common in HIV (very bad deal, you don’t want this)
- Schwannoma – myelin sheath
