May is the’Brain Tumor Awareness Month’. For this occasion, we consulted with Dr. Suat Günsel University of Kyrenia Hospital Head Physician Prof. Nail Bulakbaşı MD. , who gave detailed information about the brain and spinal cord tumorfacts:
What is Brain and Spinal Cord Tumors?
The Central nervous system (CNS) consists of the brain and spinal cord. The Peripheral nervous system (PNS) consists the nerves of these structures. There are more than 130 types of brain and central nervous system. CNS tumors account for approximately 1.4% of all cancers. Approximately 84,000 newly diagnosed cases are attributed to these tumors each year. Since it is a group of tumors that changes and makes life difficult, they may cause permanent brain damage and has increased risk of mortality. These tumors cause deterioration of brain and spinal cord functions according to their location. You should consult a neurologist or neurosurgeon in case of such symptoms.
How are tumors detected and monitored?
People with tumors are usually monitored by radiological imaging methods. Magnetic resonance imaging (MRI) is the most common and accurate method. Tumor diagnosis, dissemination, and disruption of functions caused by factors other than environmental anatomical structures can be visualized by using MRI techniques such as MR spectroscopy, diffusion, perfusion and functional MRI. Sometimes computed tomography (CT) scans and positron emission tomography (PET) are also used. How often the imaging is performed will be determined by your doctor. A neuroradiologist will read your results from your scans and share them with your doctor.
Who examines the tumors to make a definitive diagnosis?
The definitive diagnosis is made by the examination of the tissues collected during a biopsy. A neuropathologist should review the tumor tissue. A neuropathologist will determine the degree and type of the tumor by performing microscopic examination. He/She will also identify your tumor based on genetic alterations and share the information with your doctor.
How are tumors rated?
Primary CNS tumors are grouped according to how the tumor tissue appears under the microscope and sometimes according to some genetic changes that may be present in the tumor. Tumors are classified as grade I, grade II, grade III or grade IV according to World Health Organization (WHO) classification. Some tumors are low-grade tumors (I and II) and some are high-grade (III and IV). The treatment and survival of primary CNS tumors depend on the location of the tumor, the type of tumor, extent of tumor spread, genetic findings, age of the patient and the tumor remaining after surgery.
What is a tumor type?
CNS tumors are grouped by the type of cell they originate or by the locus in the CNS. Subtypes are then identified in each tumor type, depending on specific tissue characteristics or changes in the DNA. Texture features include:
- Appearance of cancer cells under a microscope
- The presence of specific substances in cells
- The presence of specific changes in the DNA of cells
There are more than 130 tumor subtypes. It is important to know your tumor subtype, if possible, in order to plan treatment and to determine survival time. Ask your doctor whether your tumor has subtypes and how your tissue can be assessed .
Are CNS tumors genetic?
Basically, all cancers are genetic diseases. This means that certain changes in the genes that control the functioning of the cells may be the reason. Bu, hücrelerin işleyiş şeklini kontrol eden genlerdeki belirli değişikliklerin neden olduğu anlamına gelir. These changes usually occur when the cells grow and divide. Most cancers are caused by changes in the genes within the tissue or organ they develop. In contrast, only 5 to 10% of all cancers are hereditary, meaning that they pass through family.
Are CNS tumors inherited?
Most of the CNS tumors are not hereditary. The small percentage of hereditary CNS tumors is caused by rare syndromes that increase the likelihood of one having specific cancers. Doctors can find people and families at risk by offering genetic counseling and testing. If you are concerned that your family or medical history will increase your chances of developing cancer, consult a genetic counselor.
How are CNS tumors treated?
For patients with CNS tumors, different types of treatment can be used alone or in combination depending on the type and location of the tumor. Five types of standard treatment are applied:
- Active Observation: It is usually performed by imaging follow-up in low-grade tumors.
- Surgery: Removal of the tumor by advanced surgical techniques.
- Radiation Therapy: Tumor radiation therapy can be used alone or in combination with surgical treatment. In some cases radiosurgery techniques such as gamaknife or syberknife can be applied. Bazı tümörlere gamaknife veya syberknife gibi radyocerrahi teknikleri uygulanabilir.
- Chemotherapy: It can be used to control the disease in some tumor groups or to increase the radiosensitivity .
- Targeted Treatment: Treatment for cancer cells without damaging normal cells.
In clinical trials, new types of therapy are tested experimentally.
- Proton Radiation Therapy: It is a higher energy radiation treatment.
- Biological Therapy: Treatments with tumor vaccines and derivative vacines works on the immune system.
Treatment of adult central nervous system tumors can cause side effects. Supportive care is given to reduce the problems caused by the disease or treatment.