MEDICAL SURFARI: BRAIN TUMORS HIT ALL AGES

Brain tumors do not discriminate as they occur in people of all ages. They are statistically more likely to occur, however, in two age groups --- children under age 15 and older adults. Metastatic brain tumors (tumors that have originated from another part of the body and which have spread to the brain) are much more common in adults.

The cause of primary brain tumors is not well understood and it is most likely that there are many factors in combination that lead to the development of a brain tumor. Brain tumors are not contagious, although in some families there are genetic tendencies toward tumor development. The symptoms of a brain tumor are sometimes vague and confusing and may mimic the symptoms of other diseases and vice versa. The symptoms often develop gradually and may be very subtle. Generally the symptoms are due to the space taken up by a growing tumor and its pressure effect on the normal surrounding brain. The specific symptoms depend upon the tumor's location, type and size.

Headaches are the most common initial symptom and the majority of patients who have brain tumors experience headaches sometime during the course of their disease. Brain tumor headaches are generally not throbbing headaches. They are headaches that come and go and are seemingly worse in the morning. They tend to gradually improve as the day goes on. They sometimes awaken a person from sleep and may be substantially worse with coughing, exercise or a change in body position as in bending or kneeling. Seizures are another common symptom of brain tumors occurring in about half of all patients sometime during the course of their illness. This is due to an abnormal micro electrical discharge in the brain that is irritated by the brain tumor.

Sometimes, depending upon the location of the tumor, mental changes may occur that affect memory, speech, communication, reasoning, concentration, behavior and even temperament. It is also not unusual for these persons to experience some nausea, vomiting, drowsiness, visual changes or even difficulty with speech. Weakness or loss of feeling in the arms or legs and stumbling or lack of coordination in walking may also be symptoms of a brain tumor. Some tumors, especially benign tumors, are completely asymptomatic and are discovered incidentally when a person has an imaging scan of their head for some other reason such as trauma.

Each year many thousands of people in the United States find out they have a brain tumor but not all tumors are cancerous (malignant). Many are non-cancerous (benign). In fact, almost half of all primary brain tumors are relatively benign and can be successfully treated. It requires a very careful, complete history, physical examination and especially a good neurological examination which includes checking for alertness, muscle strength, sensation, coordination and reflexes. Depending upon the results of the physical and neurological examinations, your physician may request a CT scan of the brain which is a special type of x-ray demonstrating the skull and brain, or a MRI scan of the brain which uses a powerful magnet linked to a computer to produce highly detailed images of the brain. The MRI does not use x-rays.

There are many different types of treatments for brain tumors, depending upon their type and location. These treatments may include medications to help relieve some of the swelling in the surrounding brain as well as anti-convulsive medications to help prevent or control seizures. Some patients are good candidates for surgical removal of the tumor. In malignant tumors radiation therapy and chemotherapy are also options that may provide some additional benefits. Some patients may be good candidates for another type of radiation therapy that uses hundreds of precisely guided beams of radiation on the targeted brain tumor.

This type of treatment is called radio surgery, although it does not in fact involve any type of surgery. Radio surgery is entirely noninvasive and is being used more and more in the treatment of some types of tumors, especially very deep-seated tumors. It is an alternative when the patient's age or other medical conditions make neurosurgery too dangerous, and may be used in combination with traditional surgery.

Scientists and researchers are making good progress, with your support, in finding methods that are more effective against brain tumors and have fewer side effects. If you experience any of the above symptoms, please contact your family doctor for an evaluation.

WORLD WIDE WEB RESOURCES

American Brain Tumor Association

www.abta.org/

The American Brain Tumor Association has a wealth of information, including "A Primer of Brain Tumors", which is a very comprehensive review of brain tumors.

National Brain Tumor Foundation

www.braintumor.org/

The National Brain Tumor Foundation's site provides information for patients and families with brain tumors, as well as research and clinical trial information for professionals.

National Cancer Institute

cancernet.nci.nih.gov/wyntk_pubs/brain.htm

This web page of the National Cancer Institute provides a booklet to help patients and families better understand brain tumors.

Dr. Scott Gibbs is a Cape Girardeau neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63702-0699.