Cancer Treatment and Health Care

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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