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Brain Tumor :

Brain tumour is a disease in which abnormal cells form in the tissues of the brain. The tumours are formed by the abnormal growth of cells and may begin in different parts of the brain or spinal cord.

The tumours may be benign (not cancer) or malignant (cancer). Benign brain tumours grow and press on nearby areas of the brain. They rarely spread into other tissues. Malignant brain tumours are likely to grow quickly and spread into other brain tissue. When a tumour grows into or presses on an area of the brain, it may stop that part of the brain from working the way it should.

A brain tumour that starts in another part of the body and spreads to the brain is called a metastatic tumour. Tumours that start in the brain are called primary brain tumours.

SYMPTOMS OF BRAIN AND SPINAL CORD TUMOURS

The symptoms caused by a brain tumour depend on where the tumour formed in the brain, the functions controlled by that part of the brain, and the size of the tumour. A doctor should be consulted if any of the following problems occur:

  • Morning headache or headache that goes away after vomiting.
  • Frequent nausea and vomiting.
  • Vision, hearing, and speech problems.
  • Loss of balance and trouble walking.
  • Weakness on one side of the body.
  • Unusual sleepiness or change in activity level.
  • Unusual changes in personality or behaviour.
  • Seizures.
  • Back pain or pain that spreads from the back towards the arms or legs.
  • A change in bowel habits or trouble urinating.
  • Weakness in the legs.
  • Trouble walking.

PDQ (PHYSICIAN DATA QUERY) COMMONLY SPREAD TO THE BRAIN AND SPINAL CORD :

  • Adult Hodgkin Lymphoma Treatment
  • Adult Non-Hodgkin Lymphoma Treatment
  • Breast Cancer Treatment
  • Carcinoma of Unknown Primary Treatment
  • Colon Cancer Treatment
  • Melanoma Treatment
  • Non-Small Cell Lung Cancer Treatment
  • Non-Small Cell Lung Cancer Treatment
  • Small Cell Lung Cancer Treatment

MAJOR PARTS OF BRAIN:

The cerebrum is the largest part of the brain. It is at the top of the head. The cerebrum controls thinking, learning, problem solving, emotions, speech, reading, writing, and voluntary movement.

The cerebellum is t1in the lower back of the brain (near the middle of the back of the head). It controls movement, balance, and posture.

The brain stem connects the brain to the spinal cord. It is in the lowest part of the brain (just above the back of the neck). The brain stem controls breathing, heart rate, and the nerves and muscles used in seeing, hearing, walking, talking, and eating.

The spinal cord connects the brain to nerves in most parts of the body.The spinal cord is a column of nerve tissue that runs from the brain stem down the centre of the back. Spinal cord nerves carry messages between the brain and the rest of the body, such as a signal from the brain to cause muscles to move or from the skin to the brain about the sense of touch.

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Anatomy of the brain, showing the cerebrum, cerebellum, brain stem, and other parts of the brain.

TYPES OF BRAIN AND SPINAL CORD TUMOUR:

The types of cancer that commonly spread to the brain are melanoma. The types of cancer that commonly spread to the spinal cord are lymphoma and cancer of the lung, breast, and prostate. About half of metastatic brain and spinal cord tumours are caused by lung cancer. Leukemia, lymphoma, breast cancer, and gastrointestinal cancer may spread to the leptomeninges (the two innermost membranes covering the brain and spinal cord).

The grade of a tumour may be used to difference between slow- and fast-growing types of the tumour. The grade of a tumour is based how quickly the tumour is likely to grow and spread.

Grade I (low-grade) — The tumour grows slowly, has cells that look a lot like normal cells, and rarely spreads into nearby tissues. It may be possible to remove the entire tumour by surgery.

Grade II — The tumour grows slowly, but may spread into nearby tissue and may recur (come back). Some tumours may become a higher-grade tumour.

Grade III — The tumour grows quickly, is likely to spread into nearby tissue, and the tumour cells look very different from normal cells.

Grade IV (high-grade) — The tumour grows and spreads very quickly and the cells do not look like normal cells. There may be areas of dead cells in the tumour. Grade IV brain tumours are harder to cure than lower-grade tumours.

ASTROCYTIC TUMOURS

An astrocytic tumour begins in star-shaped brain cells called astrocytes, which help keep nerve cells healthy. An astrocyte is a type of glial cell and is sometimes called a glioma. Astrocytic tumours include the following:

  • Brain stem glioma
  • Pineal astrocytic tumour
  • Pilocytic astrocytoma (grade I)
  • Diffuse astrocytoma (grade II)
  • Anaplastic astrocytoma (grade III)
  • Glioblastoma (grade IV)

OLIGODENDROGLIAL TUMOURS

An oligodendroglial tumour begins in brain cells called oligodendrocytes, which help keep nerve cells healthy. Oligodendrocytes are a type of glial cell and are sometimes called a glioma. Grades of oligodendroglial tumours include the following:

  • Oligodendroglioma (grade II)
  • Anaplastic oligodendroglioma (grade III)

MIXED GLIOMAS

A mixed glioma is a brain tumour that has two types of tumour cells in it — oligodendrocytes and astrocytes. This type of tumour most often forms in the cerebrum.

EPENDYMAL TUMOURS

An ependymal tumour usually begins in cells that line the fluid-filled spaces in the brain and around the spinal cord. Ependymal cells are a type of glial cell and are sometimes called a glioma. Grades of ependymal tumours include the following:

  • Ependymoma (grade I or II)
  • Anaplastic ependymoma (grade III)

 EMBRYONAL CELL TUMOURS (MEDULLOBLASTOMA (GRADE IV))

A medulloblastoma is a type of embryonal tumour. The tumour forms in brain cells when the fetus is beginning to develop. This type of brain tumour often begins in the cerebellum. The tumour may spread from the brain to the spine through the cerebrospinal fluid (CSF).

PINEAL PARENCHYMAL TUMOURS

A pineal parenchymal tumour forms in parenchymal cells or pineocytes, which are the cells that make up most of the pineal gland. These tumours are different from pineal astrocytic tumours. Grades of pineal parenchymal tumours include the following:

  • Pineocytomas (grade II)
  • Pineoblastomas (grade IV)

MENINGEAL TUMOURS

A meningeal tumour, also called a meningioma, forms in the meninges (thin layers of tissue that cover the brain and spinal cord). It can form from different types of brain or spinal cord cells. Types of meningeal tumours include the following:

  • Meningioma (grade I)
  • Meningioma (grade II and III)

GERM CELL TUMOURS

A germ cell tumour forms in germ cells, which are the cells that develop into sperm in men or ova (eggs) in women. Germ cell tumours usually form in the center of the brain, near the pineal gland. Germ cell tumours can spread to other parts of the brain and spinal cord. Germ cell tumours can be either benign or malignant.

TUMOURS OF THE SELLAR REGION: CRANIOPHARYNGIOMA (GRADE I) AND PITUITARY TUMOUR

A tumour of the sellar region begins in the center of the brain, just above the back of the nose. It can form from different types of brain or spinal cord cells.

OTHER BRAIN TUMOURS

There are many other types of brain tumours that are rare.

RECURRENT BRAIN TUMOURS

A recurrent brain tumour is a tumour that has recurred (come back) after it has been treated. Brain tumours often recur, sometimes many years after the first tumour. The tumour may recur at the same place in the brain or in other parts of the central nervous system.

TESTS THAT ARE USED TO DETECT BRAIN TUMOURS

  • Physical exam and history
  • Neurological exam:
  • Visual field exam:
  • Tumour marker test:
  • Gene testing:
  • Lumbar puncture:
  • CT scan (CAT scan):
  • MRI (magnetic resonance imaging) with gadolinium:
  • SPECT scan (single photon emission computed tomography scan):
  • PET scan (positron emission tomography scan):
  • Angiogram.

FACTORS AFFECT PROGNOSIS (CHANCE OF RECOVERY) AND TREATMENT OPTIONS.

The prognosis and treatment options for primary brain tumours depend on the following :

  • The type and grade of the tumour.
  • Where the tumour is in the brain.
  • Whether the tumour can be removed by surgery.
  • Whether cancer cells remain after surgery.
  • Whether there are certain changes in the chromosomes.
  • Whether the cancer has just been diagnosed or has recurred (come back).
  • The patient’s general health.

The prognosis and treatment options for metastatic brain tumours depend on the following:

  • Whether the patient is younger than 60 years.
  • Whether there are more than two tumours in the brain or spinal cord.
  • Where in the brain or spinal cord the tumours are.
  • How well the tumour responds to treatment.
  • Whether the primary tumour continues to grow or spread.

Stages of Brain Tumours

The extent or spread of cancer is usually described as stages. Brain tumours that begin in the brain may spread to other parts of the brain and spinal cord, but they rarely spread to other parts of the body. Treatment of brain tumours is based on the type of cell in which the tumour began, where the tumour formed in the central nervous system, the amount of cancer left after surgery, and the grade of the tumour. Treatment of brain tumours that have spread to the brain from other parts of the body is based on the number of tumours in the brain.

Treatment

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