Symptoms and Treatment Methods of Brain Tumors

Brain tumors are divided into two groups: benign (non-cancerous) and malignant (cancerous).

Brain Tumors: Benign and Malignant
Benign tumors are generally easier to treat because they can often be completely removed through surgical methods. The likelihood of recurrence and regrowth is much lower compared to malignant tumors.

Malignant brain tumors are made up of cells that destroy surrounding tissues and exhibit a tendency for repeated growth. Some of these tumors originate from the brain's own cells, while others spread from other parts of the body to the brain. When cancer cells from other organs, such as the lungs, breasts, liver, stomach, or uterus, spread to the brain and cause disease, it is referred to as metastasis in medical terms. If the tumor originates from the brain's own cells, it is called a primary brain tumor. Tumors that spread from other systems of the body to the brain (metastasis) are called metastatic brain tumors.

Malignant Brain Tumors
Malignant brain tumors, which originate from the brain's own cells, do not spread to other parts of the body, but they can spread to distant parts of the brain or spinal cord. Since the tumor cells spread along the nerve fibers in a way that is not visible to the naked eye, complete removal is often not possible. These tumors can create problems in various regions of the nervous system due to their spread through both the spaces between cells and via the cerebrospinal fluid.

Causes of Brain Tumors
The exact cause of brain tumors is not known. Environmental factors, hereditary characteristics, and viral causes are being researched as potential contributing factors. Studies conducted in large population groups have found that primary brain tumors develop in 9 out of every 100,000 individuals annually. Tumors that spread from other systems of the body to the brain have the same incidence rate. Recently, there has been an increase in metastatic tumors. The primary reasons for this are the longer life expectancy of cancer patients and the advanced imaging techniques that allow for the detection of tumors.

What Are the Symptoms?

Symptoms and signs generally develop depending on the size of the tumor and the affected area of the brain. As the tumor continues to grow, it may affect other parts of the brain, leading to the development of new symptoms and signs. Sometimes, the symptoms develop so slowly that a long time passes between the start of tumor growth and the diagnosis.

When a tumor develops inside the brain, it grows by pressing against the brain because the skull cannot expand. This increased intracranial pressure leads to severe headaches. The patient may wake up with a headache in the morning, which often decreases throughout the day. Vomiting is another common symptom. The patient typically starts vomiting upon waking up. A general sense of sluggishness and drowsiness may occur. Coordination of movements may be impaired. Various types of seizures may also emerge.

Additionally, depending on the location of the tumor, visual disturbances, tinnitus or hearing loss, loss of smell, speech disorders, and weakness in the arms and legs may also develop.

What Are the Risk Factors?

Primary brain tumors can occur at any age. Metastatic brain tumors are more commonly seen in adults. Primary brain tumors are the second most common cause of cancer-related deaths in children under the age of 15. These tumors are especially common in children under the age of 10.

Additionally, primary brain tumors are the second most common cause of cancer-related deaths in adults aged 15-34. In adults aged 35-54, primary brain tumors are the third most common cause of cancer-related deaths.

The exact cause of brain tumors is not known. Factors such as radiation, certain chemicals, viruses, and chromosomal changes have been mentioned as potential contributors.

How Are Brain Tumors Treated?

The treatment of brain tumors requires the collaboration of a neurosurgeon, radiation oncologist, medical oncologist, and experienced nurses, all of whom must have the necessary expertise.

After various diagnostic tests, one or more treatment methods may be considered. The primary treatment methods for brain tumors include surgery, radiation therapy, and chemotherapy. Any of these methods may be used alone or in combination.

Surgical Intervention:
The first choice and most effective treatment method for brain tumors is the surgical removal of the tumor. Thanks to advancements in technology, tumor surgery has made significant progress. With the use of an operating microscope, it is possible to remove tumors from even the deepest and most delicate areas. Additionally, with the use of neuronavigation systems, it has become easier to remove deep-seated and small tumors. By using three-dimensional patient images loaded into the navigation system’s computer, smaller incisions are made, and normal brain tissue is minimally damaged. This has made it possible to remove many tumors that were previously considered inaccessible. In benign tumors, surgery removes the tumor completely, and the patient recovers. Malignant brain tumors spread to adjacent tissues, making it difficult to clearly distinguish their boundaries. Due to their malignant nature or location, sometimes only part of the tumor is removed, leaving a portion in place. By partially removing the tumor, the patient's symptoms are alleviated, and intracranial pressure is reduced. Additionally, the remaining tumor mass is more responsive to other treatment methods, and tissue diagnosis helps confirm the disease. Surgical removal of the majority of the tumor has been shown to extend the patient's life and improve quality of life. Pathology experts examine the excised tissue using various staining techniques to determine the cell type.

Radiation Therapy:
Most tumor cells are sensitive to radiation therapy. Radiation therapy is based on killing tumor cells without harming normal tissues. Traditional radiation therapy, internal radiation therapy, and methods like CyberKnife® are used. Each method has its specific advantages and disadvantages.

Chemotherapy:
Chemotherapy uses drugs that kill tumor cells. This treatment may be applied before or after surgical or radiation therapy. The choice of drugs and how they are combined depends on the type of tumor. In this context, collaboration between the oncologist and neurosurgeon is crucial.