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The challenge of brain cancer

Brain cancer is a growth of abnormal cells in the brain. The National Cancer Institute estimates that brain and other nervous system cancers will account for 13,700 deaths this year. Approximately 22,910 new cases will be diagnosed. Brain cancer survivor Gus Kingman believes that patients recently diagnosed with brain cancer should know that "although the condition is rare, they are not alone."

Causes
Normal cells can acquire DNA mutations that cause the cells to multiply and expand disproportionately to the brain's need. These abnormal cells outlive normal cells and eventually accumulate into a tumor.

A primary brain tumor begins in the brain or its surrounding tissue. This can include the pituitary gland, pineal gland, cranial nerves or meninges (protective membranes). The Mayo Clinic explains that the type of cells afflicted by the initial cancer determines the exact type of cancer. Ependymoma, germ cell tumor, medulloblastoma and oligodendroglioma are examples of different brain tumors.

Secondary brain tumors begin elsewhere in the body (breast, colon, lung or elsewhere) and metastasize to the brain.

Symptoms
The National Brain Tumor Society reports that warning signs may include seizure, imbalance, numbness in extremities, vision and hearing loss, speech difficulty and double vision. They also noted nausea, vomiting and disorientation as possible symptoms.

Diagnosis
Jennifer Clarke
, assistant clinical professor of neurological surgery at UCSF's Brain Tumor Research Center, said that brain cancer diagnosis "requires quick action to get patients set up for appropriate care. The insurance system in the US is not set up to move as quickly as we should, and in this disease days can really matter."

If someone exhibits warning signs related to brain cancer, he or she should contact a health care professional. Proper diagnosis necessitates a full neurological examination.

If the patient lags behind in any of these tests, an MRI, CT scan or PET scan will be administered. With computer technology, the doctor will produce images of the brain. These will highlight any abnormalities in the brain tissue.

If a brain tumor is likely, a surgeon will be forced to perform a craniotomy, the removal of a fraction of the skull to access the brain.The surgeon then completely (or partially) removes the tumor in a biopsy, for a pathology report, which will determine whether the tumor is malignant or benign. The surgeon immediately returns the piece of skull back to its previous position. If the tumor is hard to reach, the surgeon may drill a small hole in the skull and remove a sample of tissue from the tumor with a needle.

Treatment
Treatment varies based on the tumor's type, location, grade and size. Treatment is often a combination of surgery, radiation therapy, radiosurgery, chemotherapy and more.

Vikram C. Prabhu, a neurosurgeon at Loyola University Medical Center, recommends finding "a surgeon who is board certified in neurosurgery, and has sub-specialty fellowship training in neuro-oncology."

Brain surgery is performed when the patient is heavily sedated. Along with the aforementioned craniotomy and biospy, the American Brain Tumor Association reports that there are many common procedures: craniectomy (like craniotomy but without replacing skull), debulking (reduction of tumor), partial removal (to avoid neurological damage), shunt (establishment of a drainage system to rid the brain of excess fluid), ommaya reservoir (small container inserted into scalp to remove fluid, deliver chemotherapy and more), skull base surgery and transphenoidal surgery.

Prabhu also explained that surgery is only one part of treatment. He suggested, "Seek care at a center that offers a multi-disciplinary team approach that includes neurosurgeons, otolaryngologists, neuro-oncologists, radiation oncologists, medical oncologists and neuroradiologists."

Radiation therapy uses powerful X-rays to destroy cancer. Stereotactic radiosurgery is a kind of radiation that uses high-focused X-rays to target specific spots, to avoid harming healthy tissue.

Costeroids (a type of steroid) may be used to reduce fluid buildup surrounding the tumor, effectively lowering swelling. Chemotherapy uses drugs to kill cancerous cells, but treatment is replete with challenges.

Clarke explained that because the tumors are located in the brain, surgery and radiation are extra challenging with regard to not creating new symptoms. She added, "The tumors are behind the blood-brain barrier, also, which makes it harder to get chemotherapy drugs to the right place."