Fifteen months ago, Ted Kennedy was diagnosed with a malignant tumor. He passed away surrounded by all those who loved him including his wife, children, and other family member. However, we must all remember him for his life-long goal of achieving universal health care. Although his illness thwarted his efforts of negotiations, he brought forth a rising issue that could transform the health care industry, while in his sick bed. He also played major roles in passage of the Civil Rights Act of 1964, Voting Rights Act of 1965, American with Disabilities Act and the Family and Medical Leave Act.
Senator Kennedy suffered from a seizure caused by a malignant glioma, which is a type of primary brain tumor that starts in the brain. However, unlike most common cancers, gliomas usually do not spread by metastasis from one organ to another. Malignant gliomas are difficult to treat and there are about 10,000 to 15,000 new diagnoses each year. Senator Kenndy suffered from a glioma in the left parietal lobe, which is important for sensory functions on the right side, especially visual senses.
The causes of brain tumor are unknown as it may be either hereditary, environmental or in some cases, it is both. One may inherit a certain gene that would cause brain tumor or are affected by environmental factors such as food, radiation or chemicals, which can cause changes in the gene, resulting in formation of tumors.
As gliomas affect brain functions, which are significant in controlling the human body, the symptoms are usually dispersed. However, some common symptoms are listed below.
Common Symptoms of Glioma:
- Personality change
- Paralysis/sensory loss
- Visual loss
- Speech impaired
- Increased pressure within the skull
- Intellectual disabilities
- Convulsions and lack of emotions
- Poor coordination
In order for the doctor to diagnose a patient with glioma, they first perform scrupulous neurological exams, paying special attention to vision, hearing, balance, coordination, and reflexes. If problems are present, then the physician will order imaging test in order to understand where the problem is located. Most neurologists would perform an MRI scan, CT scan, EEG, angiogram, x-ray of the skull or a biopsy. Biopsy is necessary to confirm what type of brain tumor the patient has.
Types of Glioma:
Treatment options for all gliomas depend upon the type of the tumor.
Astrocytomas: Astrocytomas can occur in most parts of brain and even spinal cord, making the most common type of glioma. They originate from cells called astrocytes, which are found within the cerebrum. Age is not a significant factor, but they are more common in adults.
Grade I astrocytomas can be treated by surgically removing the tumor. This stage has the best prognosis because even if the tumor is not completely removed, it remains inactive and can be effectively treated with radiation therapy.
Grade II tumors penetrate into the normal brain, making surgery a difficult task. Because this tumor has infiltrated the brain, they are more likely to reappear. However, the patient has a choice between radiation therapy and chemotherapy, which can lower the risk of recurrences if started immediately after the surgery. The survival rate is dependent upon age (younger you are the better) and one’s ability to perform daily tasks.
Grade III tumors are called anaplastic astrocytoma which cause seizures, headaches, and neurological deficit. Standard treatment starts of with a surgical process to remove as much of the tumor as possible with combination of radiation therapy to prolong the survival. Generally, patients survive from two to three years.
Grade IV tumor is a glioblastoma multiforme which we will come back to as it is considered to be a distinct type of gioma and is the most aggressive.
Glioblastoma multiforme: This grade IV astrocytoma is the most aggressive and malignant type of brain tumor. It is known to quickly spread to other parts of the brain, making it difficult to treat. If the surgeon can avoid causing injury to the brain, then surgical removal of the tumor is the most common treatment. Radiotherapy helps increase the survival of the patients without curing the glioblastoma. Recent studies also show the importance of adjuvant chemotherapy using temozolomide as it is beneficial to patients with glioblastoma multiforme. In the study, patients who received temozolomide and radiotherapy increased their survival by 2.5 months.
Ependymomas: Ependymomas begin in the ependyma, which are cells that are lined up in the passageways of the brain. Within these passageways, special fluids are made and stored whose function is to help protect the brain and spinal cord. This type of glioma is highly uncommon and could be found anywhere within the brain or spine, usually in the cerebrum. However, these tumors are risky as they can spread from the brain to the spinal cord due to the movement of fluids. Lower grade ependymomas can be treated with surgical removal and radiation therapy. Ependymomas usually do not respond to chemotherapy (only 20% of these tumors do).
Oligodendrogliomas: Oligodendrogliomas are primary tumors, which begin in oligodendroctyes, brain cells that support and nurture the cells in transmitting nerve impulses. They are more common in adult men than women. These tumors are uncommon as they account for no more than 10 percent of primary brain tumors. Those with low-grade oligodendroglimoa can survive for approximately 10 years and usually suffer from seizures. The survival time is dependent upon a genetic feature called 1p/19q status, which are pieces of DNA in the tumor. If the 1p or 19q are missing from the tumor cells, then the patients have a longer lifespan. Treatments usually include surgery, chemotherapy, and radiation therapy.
Because brain tumors are a form of cancer and can be caused by environmental factors, try to make some changes within your lifestyle in order to prevent cancer.
- Do not smoke
- Exercise regularly
- Maintain a healthy weight
- Eat a healthy diet
- Limit alcohol consumption
- Reduce exposure to radiation such as sun rays and tanning beds
- Use safety to handle chemicals