Brain tumor: symptoms, treatment & cure
Brain tumor: symptoms, treatment & cure in India
The brain controls the entire the functioning of the body. It is a soft, spongy mass made up of a large number of tissues. The bones & the different layers of the tissues play a vital role in protecting the brain. The cerebrospinal fluid that flows between the spaces of the meninges & the ventricles, also contributes in protecting the brain. The brain controls the voluntary & the involuntary muscles which help us to perform various tasks such as walking, talking, etc (voluntary) and breathing, response to stimuli etc (involuntary) actions. The brain also controls the sense organs, memory systems, physical & mental emotions and an individual’s personality.
The 3 main parts of the brain that control various activities are:
- Cerebrum: this part of the brain processes the information from all the sense organs which help us in understanding the surrounding and also enables us to respond accordingly. It controls activities like reading, thinking, talking, emotions, & learning. The cerebrum is divided into 2 cerebral hemispheres: the left & the right hemisphere. The left cerebral hemisphere controls the muscles on the right side of the body & the right cerebral hemisphere controls the muscles on the left side of the body.
- Cerebellum: this part of the body controls various complex actions such as the balance of the body while walking or standing.
- Brain stem: the brain stem is responsible for connecting the brain to the spinal cord. It controls various body functions such as breathing, body temperature, blood pressure, etc.
Any small damage to the brain can alter the entire system of the human body. Have you ever noticed a very common headache has the ability to make you feel very weak & tired? You feel inactive and it often dozes you to sleep. In that case, you can very well imagine how horrible it would be to suffer from a brain tumor. So, this article mainly emphasizes on the types of brain tumor, diagnosis, & treatment procedures.
A primary brain tumor is the one that originates in the brain and is usually not cancerous & do not spread that easily to surrounding tissues. The exact cause of brain tumor is not known till date. There are only a few risk factors that can lead to or increase the chances of causing a brain tumor. Some of which are listed below:
- Exposure to high levels of radiations
- Genetic disorders such as neurofibromatosis
- Age is also a risk factor when it comes to this health condition. People between 65 to 80 years of age are at greater risk of brain tumor.
Types & grades of brain tumor:
The normal metabolic process of the body is that the normal cells grow old or get damaged with time and gradually die. New cells take up their place and the process continues. What happens at times is that there are chances that this process might go wrong. New cells grow when the body does not require it or the damaged cells may not die as and when they should. This leads to the extra cells being buildup which eventually forms a mass of tissue called the tumor.
Primary brain tumors may be benign or malignant and are never cancerous. These tumors can be easily removed and they usually don’t appear again. The benign tumor cells neither affect the tissues surrounding it nor do they spread to other parts of the body. However, these tumors may turn out to be serious & cause life-threatening situations when they develop on sensitive areas of the brain.
Unlike benign tumors in other parts of the body, benign brain tumors may be malignant which means they might turn out to be cancerous. Malignant brain tumors are otherwise called as brain cancer. These tumors are more serious and are often a threat to life. They grow rapidly and also affect the nearby healthy cells & tissues.
Doctors have categorized the tumors by grades. The grades are based on how the tumor cells look under a microscope. The tumors are broadly divided into 4 grades.
- Grade 1: In this, the cells look like normal brain cells under a microscope. They grow very slowly and do not affect the surrounding tissues and hence are benign tissues.
- Grade 2: the cells when viewed under a microscope do not look the same like normal brain cells. They grow & multiply rapidly as compared to grade 1 tumor cells. The tissues are malignant in this case.
- Grade 3: in this grade, the malignant cells look very much different from the normal brain cells under a microscope. The abnormal cells grow actively and spread at a faster rate.
- Grade 4: the malignant cells look very abnormal under a microscope and spread more rapidly to the surrounding tissues.
What are the symptoms of a brain tumor?
The symptoms of a brain tumor depend on the size, location & type of brain tumor. The symptoms are not readily noticeable at the initial stages of a brain tumor. The symptoms become noticeable when a tumor presses on a nerve or harms a part of the brain. The symptoms may also develop when the tumor blocks the pathway of the fluid that flows around the brain or when the brain is likely to swell when the fluid starts building up.
Those listed below are some of the common symptoms of brain tumor:
- Frequent headaches which get worse in the mornings
- Sudden noticeable changes in speech, vision & hearing
- Vomiting & Nausea
- Problems in balancing the body or walking
- Frequent mood swings
- Abnormal changes in personality
- Difficulty in concentrating
- Problems in memory
- Numbness in the legs & arms
- Frequent muscle seizures or muscle pulls
- Weakness in one part of the body
The above symptoms are quite common to a number of other health conditions. Don’t assume that you are suffering from a brain tumor just because you experience one of the above symptoms. It is always better to check with your doctor.
How is brain tumor diagnosed?
The doctor begins the examination by inspecting you with your medical history, family history and also asks questions about the symptoms and how long have you been suffering from it. The doctor then goes for a physical & neurological exam. In case, he/she suspects a brain tumor then he may suggest you take up one of the following tests.
Imaging tests such as CT or MRI scan will help in retrieving detailed images of the brain. Angiogram and X-ray of blood vessels in the brain may also be taken to observe signs of a brain tumor or abnormal blood vessels.
Sometimes, the doctor may also suggest for a biopsy to see if the tumor is cancerous. A tissue sample is taken from the brain either during the surgery or by inserting a small needle through a small hole drilled into the skull before the treatment commences. The sample is then sent to the lab for further testing.
A spinal tap is a procedure in which the doctor removes a cerebrospinal fluid from the lower part of the spinal cord. This is performed using anesthesia. The doctor uses a long thin needle to remove the fluid. This procedure will take about 30 minutes. You will have to lie flat to keep from getting a headache.
What if the tumor is in the brain stem or in any other sensitive part of the brain? It is not that easy to remove a sample tissue from these parts without actually disturbing the surrounding normal brain cells. Then, in such a case, the doctor will recommend you go for an MRI or CT scan to study as much as possible about the brain tumor.
How is the brain tumor treated?
There are various treatment options available for people with brain tumors. Brain surgery, radiation therapy & chemotherapy are some of the treatment options. Many people go in for a combination of treatments. The type of treatment depends on various factors such as the location of the tumor in the brain, the size of the tumor, the type & grade of brain tumor, the age and health of the patient.
The doctor might also need to know if the brain cancer has affected the cerebrospinal fluid. You doctor will make you aware of the treatment options, the associated side effects & the expected outcomes. You and your healthcare team can work together to develop the treatment plans, how the treatment will affect your normal activities and so on. The treatment plan developed should be in such a way so as to meet your personal & medical needs.
Surgery is usually the first treatment for brain tumor. A craniotomy is a surgery performed to open the skull. The surgeon will make a small incision through your scalp and uses a special type of saw to take a piece of bone from the skull. You will be awake when the surgeon removes part or whole of the tumor. You will be asked to move your hands & legs, count, tell a story or say the alphabets. Your ability to respond correctly to these commands will help them to protect the important parts of your brain.
Once the tumor is removed, the surgeon closes the opening in the skull with help of a piece of bone, metal or fabric. The surgeon then closes the incision on the scalp.
Other treatment options such as radiation therapy or chemotherapy are preferred when the brain tumor cannot be removed by surgical means. This happens when the brain tumor is located in the cerebrospinal fluid or another sensitive part of the brain.
After the brain surgery, you might feel very weak & tired. The healing time after the surgery varies from person to person. Sometimes a second surgery may be needed to drain the fluid. Another complication after the surgery is that there is a high risk of infections. If this happens then you will be treated with an antibiotic.
Sometimes brain surgery may unknowingly damage other normal brain tissues & cells. Brain damage is a serious problem as it will adversely affect the thinking, reading, balancing, and other physical activities of a person. These damages may lessen or disappear over time, but sometimes they might turn out to be permanent damage. One may require speech therapy, physical therapy & occupational therapy to recover slowly from this effect.
Uterine fibroid
With the present lifestyle and eating habits, we are very much aware of the deadly disease called cancer. Till date, we have not found the exact cause of cancerous cells being multiplied in our body. On the other hand, there is also another type of tumor cells which are noncancerous and do not multiple within called the fibroids.
What are fibroids?
Fibroids are the most frequently seen tumors of the female reproductive system. Made of smooth muscle cells & fibrous connective tissues, fibroids are firm & compact tumor cells that develop in the uterus.
It has been found that about 30-50% of the women in the reproductive age have fibroids although, all of which are not diagnosed. So, fortunately, in about 99% of the fibroid cases, the tumors are non-cancerous. These tumors are in no way associated with cancer and do not increase the risk of uterine cancer in women.
Uterine fibroids also called as leiomyomas or myomas are non-cancerous cells that develop in the uterus often during the pregnancy periods. They are not associated with the increased risk of uterine cancer and never develop into cancer.
Fibroids are undetectable by the human eye and often range from the size of a seedling to bulky masses that can distort or enlarge the uterus. You may develop a single fibroid or multiple ones. Sometimes, the fibroids may expand the uterus so much that it will reach the rib cage.
It is most commonly developed at the time of menopause as well. Most women do not know that they have uterine fibroids as it does not cause any symptoms.
Your doctor may detect the presence of fibroids at the time of pelvic exam or prenatal ultrasound.
What are some of the noticeable symptoms?
Most women with fibroids have no symptoms at all. Some develop mild symptoms while others have severe & disruptive symptoms. The following are the most common symptoms of uterine fibroids:
- Irregular menstrual periods
- Abnormal bleeding during menstrual periods
- Pelvic pain
- Frequent urination
- Pain in the lower back
- Pain during intercourse
- A firm mass located near the pelvic region
In some cases, irregular menstrual periods, or the abnormal bleeding between periods, can lead to iron-deficiency and result in anemia, which then requires treatment. The treatment for fibroids depends on the location, size & number of fibroids. However, these symptoms may differ from individual to another individual. A fibroid can cause acute pain when it gets less amount of blood supply and begins to die.
Fibroids are classified depending on their location.
Intramural fibroids develop in the uterine wall. Those fibroids that develop in the uterine cavity are called submucosal fibroids. The fibroids that project outside the uterus are called subserosal fibroids.
What causes fibroids in women?
Doctors do not know the exact reason of uterine fibroids. Researches & studies have found out the following to be the main causes of uterine fibroids. The causes include:
- HORMONES: the 2 main hormones, estrogen & progesterone that play a vital role in the development of uterine lining at the time of pregnancy or menstrual cycle are responsible for stimulating the growth of fibroids in the uterus. Fibroids contain a large number of these hormones than the normal muscle cells do. After the menopause, the amount of hormone secretion gradually reduces. As a result, the fibroids tend to shrink.
- GENETIC CHANGES: many fibroids contain changes in genes which are quite different from those in the normal muscle cells.
- OTHER GROWTH FACTORS: insulin-like growth factors that help the body to maintain tissues might affect the growth of fibroids.
The uterine fibroids develop from a stem cell in the smooth muscular tissue of the uterus. A single cell divides repeatedly forming a rubbery mass. The growth patterns of fibroids largely depend on person to person. The growth may appear slowly or rapidly. At times, it seems to remain in same size throughout.
What are the risk factors associated with uterine fibroids?
Other than being a woman of reproductive age, there are other risk factors associated with uterine fibroids. Other factors that influence the fibroid growth include:
- HEREDITY: if your mother or sister had one, then even you are at increased risk of developing a fibroid.
- RACE: Black women are more likely to have fibroids than women of other racial groups. They are likely to develop one at an earlier age and may also have fibroids of larger size.
Other complications that affect the growth of uterine fibroids are:
- Onset of menstruation at an early stage
- Use of birth control pills
- Obesity
- Vitamin D deficiency
- Diet higher in red meat & lower in green vegetables, fruits & dairy
- Excessive alcohol consumption
Fibroids do not interfere with getting pregnant. However, fibroids might cause infertility or loss of pregnancy. Other complications that result from fibroids include placental abruption, fetal growth restriction & preterm delivery.
How are uterine fibroids diagnosed?
Uterine fibroids are found during the pelvic exam. The doctor may observe some abnormalities in the shape of your uterus thereby suggesting the presence of fibroids.
Your doctor may suggest you take up the following tests:
- Ultrasound: Ultrasound is used to confirm the presence the fibroids. It uses sound waves to detect the presence of fibroids and also to measure its size and location. The doctor places the ultrasound device over your abdomen or places it inside your vagina to get the images of the uterus.
- LAB TESTS: if you have abnormal menstrual bleeding, then your doctor may suggest you take up a lab test to identify the potential cause. This might include complete blood count (CBC) to see if you are anemic due to abnormal blood loss and other types of blood tests to rule out issues like thyroid problems & bleeding disorders.
If the traditional ultrasound does not provide necessary information then the doctor might suggest other advanced imaging techniques. These include:
- MAGNETIC RESONANCE IMAGING (MRI): this test helps to identify the size & location of fibroids, different types of tumors and also help with appropriate treatment options.
- HYSTEROSONOGRAPHY: this technique is also called as saline infusion sonogram. It makes use of sterile saline to expand the uterine cavity. This makes it easy to get images of the endometrium & the submucosal fibroids.
- HYSTEROSALPINGOGRAPHY: it makes use of a contrast medium or a dye to highlight the uterine cavity & the fallopian tubes so that these areas are well seen under an x-ray This helps the doctor to identify any abnormalities in the shape of the uterus. It helps not only in detecting fibroids but also to identify if the fallopian tuare open.
- HYSTEROSCOPY: in this medical procedure doctor inserts a small device called Hysteroscope through your cervix into the uterus. He then injects saline into the uterus, which expands the uterine cavity and allows the doctor to examine the uterine walls
What are the treatment options for uterine fibroids?
The noninvasive treatment procedures include:
Some of the minimally invasive procedures include:
Minimally invasive procedures include destroying the uterine fibroids without actually removing it through surgery.
Uterine artery embolization: the arteries supplying the uterus are injected with small particles. These particles will then prevent the blood flow to the uterine fibroids, thereby stunting its growth. In due course, it will shrink the fibroids and causes it to die. We need to be aware of the complications that might occur if the blood supply to other ovaries and organs are blocked.
Myolysis: it is a laparoscopic technique that uses radiofrequency energy, electric current & laser to destroy the fibroids. This technique also shrinks the blood vessels that feed them. Cryomyolisis is a similar procedure that freezes the fibroids.
Robotic myomectomy: in this technique, the doctor removes the fibroids without disturbing the uterus. If the fibroids are small and few in number, you and your doctor may opt for a laparoscopic or robotic procedure, which uses small instruments inserted through small incisions in your abdomen to remove the fibroids from your uterus. Another procedure called as morcellation is a method by which the fibroids are removed by breaking them into smaller pieces.
Hysteroscopic myomectomy: if the fibroids are present inside the uterus, then this method may be opted. The surgeon removes fibroids using instruments that are inserted through your vagina and cervix into the uterus.
Options for traditional surgical procedures include:
- Abdominal myomectomy.If you have multiple fibroids, very large fibroids or very deep fibroids, your doctor may use an open abdominal surgical procedure to remove the fibroids
- Hysterectomy: it is a major surgical procedure that involves the removal of the uterus to put an end to the uterine fibroids. It is a proven permanent solution for uterine fibroids.
In the next section of this article let us have a deeper look at the hysterectomy procedure.
Why is hysterectomy performed?
The doctor may suggest you undergo hysterectomy for the following reasons:
- Uncontrollable vaginal bleeding
- Chronic pelvic pain
- Fibroids which are tumors that grow in the uterus
- Cancers of uterus, cervix or ovaries
- Pelvic inflammatory diseases which are the main causes of infection in the reproductive organs
- Uterine prolapsed which occurs when the uterus drops through the cervix and comes out of the vagina
- Endometriosis, a disorder in the inner lining of the uterus that grows outside of the uterine cavity causing pain.
Hysterectomy is a safest and low-risk surgical procedure. However, it should not be used on all women who still wish to give birth in the future. Fortunately, many conditions that are treated with hysterectomy can also be treated by others ways. For instance, hormone therapy can be used to treat endometriosis and fibroids can also be removed by simple surgery. Hysterectomy is the only option when it comes to uterine or cervical cancer.
Types of hysterectomy:
- Partial Hysterectomy: during this procedure, only a part of your uterus is removed. The cervix is left intact.
- Total Hysterectomy: during this procedure, the entire uterus is removed along with the cervix. You will have to have regular pelvic examinations.
- Hysterectomy and salpingo-Oophorectomy: during this procedure, the entire uterus along with one or both the ovaries and fallopian tube is removed. One may need hormone replacement therapy if both the ovaries are removed.
How is hysterectomy performed?
Hysterectomy can be carried out in many ways. All the methods require general or local anesthesia. A general anesthesia will put you to sleep where as a local anesthesia will numb that particular area alone but you will still be awake. Sometimes anesthesia will be combined with a sedative so that you feel sleepy and relaxed throughout the procedure.
Abdominal hysterectomy: In this procedure, the uterus is removed through a large cut in the abdomen. The incision may be vertical or horizontal. Both these types will heal quickly and leave a scar on the surface.
Vaginal hysterectomy: In this procedure, the uterus is removed through a small incision in the vagina. There are no visible cuts and no scars seen on the outer body.
Laparoscopic hysterectomy: In this procedure, the doctor uses a small instrument called laparoscope. It is a long narrow tube, which consists of a high-intensity light and high-resolution camera to capture the images. These images will be displayed on the screen. In this, 3 or 4 incisions are made in the uterus instead of one large incision. The surgeon then cut the uterus into small pieces and removes one piece at a time.
What are the risks of hysterectomy?
This is considered to be the safest procedure. Any medical procedure has its own advantages and risks associated with it. Some of the risks associated with it are:
- Heavy bleeding
- Infection around the incision site
- Injury to bladder, intestines and surrounding blood vessels
Once the surgery is over you will be monitored for your heartbeat and breathing. If everything turns normal then you can be discharged. However, you will have to stay in the hospital for 3 to 5 days. Doctors will encourage you to do light exercises such as walking as it helps to prevent blood clots. If you have undergone vaginal hysterectomy, then you may experience bloody or brownish drainage from the vagina for 10 days. So using a menstrual pad is advisable.
Even after you are discharged, you should avoid doing certain activities such as pushing or pulling objects, bending, lifting heavy objects, sexual intercourse, etc
Recovery time is comparatively longer if one undergoes an abdominal hysterectomy. Complete recovery will take about 4 to 6 weeks.
Cancer: Signs and Symptoms
Cancer is the uncontrolled division of cells of the affected area thereby destroying the adjoining tissues. As the disease grows, this pushes the nearby organs, blood vessels and nerves which makes the symptom appear. This may cause unusual pain. Pancreatic cancer might obstruct the bile duct, thus causing the jaundice.
Some common symptoms include:
- Extreme tiredness
- Fatigue
- Fever
- Weight loss
- Change in bowel habit
- White patches inside mouth or white spots on tongue
- Sore that do not heal
- Unusual bleeding or discharge
- Thickening or lump in breast or other parts of the body
- Indigestion or troubled swallowing
- Recent change in wart or mole
- Cough or hoarse voice
- Skin change-Darker skin, Yellowing of eyes and skin, Itching, Excessive hair growth
Earlier the detection, greater is the chance of survival of a cancer patient.
