Brain tumors can be malignant or benign. A malignant tumor, also called brain cancer often grows rapidly and invades the healthy areas of the brain. Benign tumors do not contain cancer cells. Viewed under a microscope to look normal, usually grow slowly.

Brain tumors can be of two types: primary or metastatic. Primary brain tumors originate in the brain, and appear when metastatic cancer cells elsewhere in the body spread to the brain. For this reason, metastatic brain tumors are almost always malignant, while primary tumors may be benign or malignant.

Brain tumors are classified according to tumor location, type of tissue affected, whether the tumor is benign or malignant, and other factors. If it is determined that a tumor is malignant, cells were examined under a microscope to determine the degree of malignancy. According to this analysis, tumors classified by their degree of malignancy from least to most malignant. Some factors that determine the extent of the tumor are the speed of cell growth, the amount of blood supplied to the cells, the presence of dead cells in the center of the tumor (necrosis), if cells are confined to a specific area, and the degree of similarity between cancer cells and normal.

The cause of primary brain tumors, genetic and environmental factors could be the cause of some. Previous exposure to therapeutic radiation during childhood appears to be a causative agent in a few patients. The symptoms of a brain tumor include headache, nausea, vomiting, seizures, behavioral changes, memory loss and impaired vision or hearing.

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Symptoms and Complications

Brain cancer causes symptoms when it pushes on the brain that destroys brain tissue. Symptoms depend on the size and location of the tumor, and the speed at which it multiplies. Although headaches are often a symptom of brain cancer, it is important to remember that most headaches are not caused by cancer but are caused by less serious conditions such as migraine or tension. Headaches caused by brain tumors are often severe, associated with nausea and vomiting and often worse early in the day. They can last long or occur intermittently.

Other symptoms include:

* Dizziness

* Impaired vision as double vision

* Impaired coordination

* Weakness or numbness on one side of body

* Seizures

* Changes in mood, senses, personality or feelings

* Impaired memory

* A state of confusion or difficulty concentrating

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Are used anticonvulsants and corticosteroids as supportive therapy in some patients.

Definitive treatment includes surgery, radiotherapy and chemotherapy.

In low grade gliomas the recommended treatment is surgery and radiation. We recommend intermediate-dose radiotherapy (50 Gy) and has been shown that the administration of radiation therapy in the postoperative period does not increase the survival of these patients with respect to administered when the disease progresses, but increases the time in which the tumor is controlled.

In high grade gliomas treatment has demonstrated improved survival is the combination of surgery (when feasible), radiation at a dose greater than in low grade gliomas and chemotherapy.

The postoperative treatment component has been shown greater benefit for radiation and for this reason it is recommended to administer an adequate dose (60 Gy) in a confined volume of sophisticated techniques to exclude outside the radiation field the largest proportion of healthy brain tissue avoid toxicity.

This uses various innovative techniques such as three-dimensional radiotherapy formed, radiation therapy with intensity modulation of the beam and stereotactic techniques. They have incorporated new chemotherapeutic drugs that have shown activity (15-30% response) in high-grade tumors such as temozolomide, taxanes, irinotecan.

Also recently approved in Spain the use of BCNU polymers (camurstine) that are deposited in the surgical cavity during surgery and are slowly releasing the drug to treat residual disease around the surgical bed.

The simultaneous combination of temozolomide and radiotherapy has shown a survival benefit versus exclusive radiotherapy in malignant gliomas. Also, the combination of molecular chemotherapy drugs (anti recipients of growth) and bevacizumab, are showing high response rates.

The treatment of brain metastases may be surgical (or symptomatic solitary metastasis) or radiosurgery (metastases less than 3 cm). This treatment is usually associated with radiotherapy of the entire cranial contents (radiotherapy holocraneal).

What about after treatment?

After completing the treatment should follow up of patients with brain MRI. Every 6 months in low grade gliomas and every 3 months for high grade gliomas.

There are two situations in which resonance is sometimes not identify with certainty the observed images. A relatively frequent occurrence in the follow-up period of a high-grade glioma on a low-grade glioma and the other is called the remarks after radiotherapy treatment of a residual lesion called necrosis that is indistinguishable from a high-grade tumor . In these circumstances you can use the PET that can solve thes

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How is brain tumor diagnosed?

Suspecting a brain tumor, the imaging technique to be recommended is the MRI because it has better anatomic definition than CT and more precisely defines brain tumors.

The definitive diagnosis is made pathologically after resection or biopsy of the tumor. The latter must always be done if the tumor is unresectable or inoperable. It is true that in some cancer sites such as the brainstem biopsy is not recommended for the serious consequences that may result from it.

In cases of lung cancer, especially small cell melanoma and renal tumors is performed MRI to rule out brain metastases before starting the primary tumor treatment by the high probability of spreading to the brain.

There is a known metabolic PET scan (positron emission tomography) that is capable of measuring the behavior of the tumor (more or less aggressive) by the addition of glucose or other labeled molecules. In this diagnostic phase may be useful in directing biopsy to an area of high-grade features, or where biopsy is contraindicated in addition to information provided by brain MRI.

What are known prognostic factors in brain tumors?

The prognosis of patients with brain tumors are inversely correlated with age and histological grade and directly related to the patient’s clinical situation. Some molecular markers have been identified as prognostic factors (eg 1p19q deletion in oligodendrogliomas).

In low-grade gliomas I and II with good prognosis factors that have been identified include age younger than 40 years, tumor diameter less than 6 cm, the tumor does not exceed the median line, histological type and the absence of oligoastrocytoma neurological deficits. Depending on the varying number of these factors predicted a better or worse survival of 9-2 years, respectively.

Good prognostic factors for gliomas III and IV are age (under 40 years), have good general state autonomy, normal mental state and get a complete surgical resection. Survival in patients with high-grade tumors is lower, ranging between 2 years and 6 months according to the prognostic group.

Age less than 60 years, the presence of single brain metastasis and no other location of metastatic disease are factors associated with better prognosis in patients with brain metastases.

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Brain tumors can be primary tumors or metastatic tumors. Primary tumors originate from the very cells that make up the various brain structures and metastatic tumors are tumors that have spread to the brain from another location extracerebral.

The latter are 10 times more common than primary brain tumors is estimated that about 20-40% of cancer patients develop brain metastases.

Primary brain tumors are highly variable group of tumors with very different origin, prognosis and treatment.

They can range from very rare tumors such as pilocytic astrocytoma curable with surgery alone to glioblastoma multiforme virtually incurable despite treated with surgery, radiotherapy and chemotherapy.

What primary brain tumors are most common?

The primary tumor is the most common benign meningioma (tumor originated in the brain coverings called meninges). In adults, the most common primary malignant tumors are gliomas or astrocytomas. Gliomas arise from astrocytes or glial cells of the brain that form, together with the vascular network, the support of neurons. In turn, astrocytomas as less aggressive or more are classified as grade I, II, III (anaplastic astrocytoma) and IV (glioblastoma multiforme).

Is there any reason known to produce brain tumors?

There is no known cause responsible for this disease. Less than 5% of gliomas have a known family history and there are various degenerative brain diseases that can predispose people gliomas. Nor was it shown that mobile phones are causing an increased incidence of brain tumors, nor alcohol intake or smoking.
What symptoms can lead to suspicion of the presence of a brain tumor?

Headache is the most common non-specific symptoms and often is difficult for us to suspect its presence in a brain tumor. nausea, vomiting and symptoms resulting from increased intracranial pressure such as drowsiness may be more indicative of the presence of a brain tumor.

There are other more specific signs and symptoms that appear depending on the location of the disease such as focal signs (loss of strength, difficulty speaking or visual field deficits), seizures and bleeding.

e diagnostic doubts.

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TUMORS

* Astrocytomas: originate in cells called astrocytes that vary in degree of malignancy.

* Oligodendroglial tumors originate in the brain cells oligodendrocytes.

* Glioblastoma Multiforme: also known as grade IV astrocytoma, has developed rapidly.

* Ependymomas: originates from the ependyma, the area where it is produced and stored cerebrospinal fluid.

* Mixed Gliomas: develop in more than one type of cell, as cells of astrocytes, oligodendrocytes, cells and / or ependymal cells.

SYMPTOMS

* Headache.

* Vomiting.

* Difficulty walking.

* Difficulty speaking.

* Changes in vision, double vision.

Weight gain.

* Seizures.

* Hearing problems

* Trouble concentrating.

* Fever.

* Difficulty coordinating movements.

* Lack of reflections.

* Facial paralysis

* Difficulty swallowing

* Earthquakes.

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Since each brain area is responsible for specific functions, symptoms vary greatly. Tumors in the frontal lobe of the brain can cause weakness and inability to move one side of the body, known as paralysis, mood disturbances, difficulty thinking, confusion and disorientation, and wide emotional mood swings. Parietal lobe tumors can cause seizures, numbness or paralysis, difficulty with handwriting, inability to perform simple mathematical problems, difficulty with certain movements, and loss of sense of touch. Tumors in the occipital lobe can cause vision loss in half of each field of vision, visual hallucinations, and seizures.

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