Lecture 7 - Brain Cancer Flashcards
What is a frequent complication of cancer/cancer treatment?
Cognitive impairment
In which three cancer patient types does cognitive impairment most commonly show up?
Primary brain tumours, secondary brain tumours and cancer outside the CNS
What are primary brain tumours?
Tumours arising from cells within the CNS
What is the most common benign (non-malignent) tumour?
Meningioma’s (which I think start in the menginus)
What is the most common malignant tumour?
Glioma’s (in the glial cells surrounding neurons)
The WHO has different classifications for brain tumours (1-4, 1 being benign), what often happens when a tumour starts out as a 2?
Lower grade malignant tumours often come back and change to a higher grade
The WHO’s classification is dependent on molecular parameters, what does the presence of mutation in IDH gene usually mean for prognosis
IDH mutant has a better prognosis than wildtype (idk wtf this means)
The WHO’s classification is dependent on molecular parameters, what does 1p/19q codelation for the prognosis?
Codelated has a better prognosis, it responds better to chemo treatment
The WHO’s classification is dependent on molecular parameters, what does MGMT promotor methylation mean for prognosis?
Better response to chemotherapy
What are the three most common locations for brain tumours?
Frontal lobe, Temporal lobe and parietal lobe
Name some common types of brain tumours?
Meningioma, Glioma, neuroma (neurons), pituitary ademona
What are 5 common/important clinical presentations of brain tumours?
Memory loss, cognitive changes, language, personality changes and visual changes
What three functions are a priority for patients and caregivers to retain?
- Brain functioning, 2. Basic physical tasks (like walking) and 3. Reducing pain
What are five causes of cognitive impairment in braim tumour patients?
Tumours, treatment, meds, distress and fatigue
Why do tumours cause cognitive impairments?
Affects healthy brain tissue, affects blood flow, edema (swelling) and possible pressure
What is a primary brain tumour?
The first cancerous tumour originated in the brain (as opposed to in another part of the CNS or body which then spread to the brain)
In what two tumours types is cognition generally worse?
Left-side tumours and more agressive tumours
About 75% of RTL and LTL glioma patients have learning, memory and executive problems, what is this indicative of?
Bilaterality of verbal memory processes
What problems do three quarters of LTL glioma patients have?
attention and languge problems
Which cancer treatment can cause the “most” cognitive impairment and how does it do so?
Radiotherapy, it attacks healthy cells (as well as cancerous cells) which diminish cognitive functioning
What is cognitive impairment in brain tumours most related to?
molecular characteristics of the tumour (IDH1-wildtype tumours tend to, for instance, present with greater cognitive dysfunction)
There are three “phases” of CNS radiation toxicity, explain and what impairments are related to it?
Acute (1-3 weeks): Edema, focal deficits, steroids
Subacute (1-6 months): Demyelination, subcortical profile
Late (>6 months): White matter injury, necrosis, irreversible cognitive impairment
How does chemotherapy differ from radiotherapy?
Both aim to kill off cancerous cells, but chemo focuses on dividing cells (cancerous cells divide much more often, however healthy cells are still affected)
Which brain disorder often co-occurs with glioma tumours?
Epilepsy
What is treatment benefit a combination of?
Survival (disease control) and how a patient feels/functions
Which cancer treatment can help with cognitive impairment? For which type of cancer is it most useful and for which less so?
Meningioma patients show improvement after surgery. Can also be useful in glioma patients, but permanent cognitive decline is possible
