Six things to know about brain tumors

World brain tumor day, commemorated on the 8th day of June each year, was celebrated this year to raise awareness about brain tumors and dispel related misconceptions.

Edward Jolayemi, a neurosurgeon at Evercare Hospital, Lekki, and an advocate for increased awareness on said subject shared some insights on brain tumors, described as abnormal growths within or around the brain.

Here are six things to know about the brain, and brain tumours as shared by Jolayemi.

The brain, a complex organ

The brain is a complex organ that is vulnerable to insults from trauma, infections, tumors, drugs including alcohol, and metabolic disorders, to mention a few. Nature’s way of protecting the brain from external insults was to keep it enclosed within the rigid skull (cranium). It is also shielded from within using what we call the ‘blood- brain barrier’ to keep foreign agents at bay.

Each part of the brain is dedicated to a specialised function, for example, movement of a body part, speech comprehension, vocalisation, swallowing, consciousness, hormonal balance, behaviour, memory, emotion, motivation, coordination of movements, breathing, temperature, feeling of hunger and satiety, amongst others.

With long-standing compression of the brain by a tumour, parts of the brain start to wither to accommodate the tumour such that even after tumour removal, the functions of these representative areas of the brain may never be fully regained despite aggressive rehabilitation therapy.

Brain tumours

Brain tumours can be classified as primary or secondary.

Primary tumours are non-cancerous, they tend to grow slowly and have less chance of recurring once completely removed at surgery.

Secondary tumours however are cancerous and often grow rapidly, with a high propensity to recur despite surgical intervention.

Primary tumours arise from structures within and around the brain while secondary tumours get to the brain via spread (metastasis) from other tumours like breast, lung, thyroid cancers, etc.

Causes

The cause of brain tumours is largely unknown. However, risk factors include family history of brain tumours, genetics, exposure to ionising radiation, certain chemicals, and viruses.

There have been studies to define the association of brain tumours with the use of cell phones, but no convincing data has emanated. However, there is suggestion that chronic use of cell phones for at least 10 years may increase the risk.

WHO recommends limiting cell phone use and promoting the use of hands-free headset.

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Tumour size

Brain tumour size is not often proportional to the severity of symptoms, as a bean-sized tumour in a delicate part of the brain, for example, the brain stem, can present devastating symptoms as opposed to a tennis-ball-sized tumour located in a less delicate part of the brain.

Symptoms

Symptoms in persons with brain tumours include acute or persistent headache, often worse in the early hours of the morning and associated with vomiting.

An adult having a first-time seizure has a likelihood of this being caused by the presence of a tumour (commonly) or some other pathology in the brain.

Other symptoms could include worsening eyesight, hearing loss, milky nipple discharge, personality changes, new-onset unsteadiness of gait, weakness or heaviness of a limb or body part (sometimes misdiagnosed as stroke), uncoordinated motor movements, new- onset difficulty speaking or comprehending spoken words, altered consciousness, etc.

Diagnosing brain tumours begins with clinical review by a neurosurgeon, neurologist, or any experienced clinician. Investigations are done to look into the brain and sometimes to assess its function. Treatment options are discussed once a brain tumour is detected.

Treatment

Treatment options for brain tumours include surgery to remove the tumours.

The goal of surgery is complete tumour removal, preservation of normal brain function, and acquisition of tumour sample for laboratory confirmation of its nature.

These surgeries are done by neurosurgeons who employ a wide range of gadgetry to safely take out the tumour. In some instances, especially in the Nigerian setting where late presentation to the hospital is common, complete brain tumour removal may not be feasible. In such scenarios, the surgeon may plan a subsequent surgery or offer other treatment modalities to address the residual tumour.

Cancerous brain tumours have a high propensity for recurrence. For these tumours, supplemental treatment like radiotherapy, and sometimes chemotherapy is employed. Some pituitary (a gland attached to the brain) tumours may be compliant with the use of medication.

The expectation or outcome in patients with brain tumours depends on a host of factors such as the tumour type, size, the presence or absence of brain deficits, patient’s age and fitness level, co-existing illness, etc.