Brain tumors are always very complex and serious, as they are located in one of the most important organ of the human body. The extent of danger of these tumors depends on the area of location on the brain. The closer the brain tumor is to the vital centers, the more likely it will be fatal. However, not every brain tumor is a death sentence. Many of them are quite successfully amenable to treatment. We will analyse what a brain tumor is, brain tumor types, what can cause a brain tumor and what can you expect when diagnosed with a tumor.
What is a brain tumor?
A tumor is an abnormal growth or voluminous formation, namely a group of atypical, rapidly increasing cells. A brain tumor can be both benign and malignant, in other words either harmless or harmful.
All neoplasms of the central nervous system are divided into primary and secondary:
- Primary - those that developed directly in the brain
- Secondary - those are metastases of malignant neoplasms of other locations. (lungs, kidneys, etc.)
There is a large number of different classifications of tumors of the nervous system. The most important ones are the histological structure of the neoplasm and its localization.
When discussing localization, primary tumors are divided into two large groups:
- Brain tumors - up to 90% of all tumors of the central nervous system
- Tumors of the spinal cord - 10% of neoplasms of the central nervous system
There are also oncological pathologies which are simultaneously located in the brain and spinal cord. However, their total number is insignificant - it is a fraction of a percent.
Neoplasms can also be of the same origin:
- Intracerebral - originate from the brain cells
- Extracerebral - originate from vessels, nerve membranes, fragments of embryonic tissue or the pituitary gland
Malignant primary brain tumors of intracranial localization have a number of characteristics that distinguish them from cancer of any other localization:
- They practically do not metastasize. That is, they do not form secondary tumors in the lymph nodes and other organs.
- The central nervous system is separated from the rest of the body by a hematoencephalic barrier. Therefore, such tumors usually do not spread beyond the brain.
- Because of the great danger of damage to the functionally important parts of the brain, most of these tumors are inoperable.
In view of the above mentioned, neurological classification of TNM tumors (tumor size, regional and distant metastases) is basically not used. The stage of the tumor is determined on the basis of the histological type of the neoplasm, and not by how much the oncological process spread.
According to WHO, 10 histological types of tumors of the central nervous system are distinguished:
- From neuroepithelial tissue
- From the meninges
- From nerves
- From a hematopoietic tissue
- Germinogenic - from germ cells
- Cysts and tumor-like formations
- Neoplasms, growing into the cranial cavity
- Tumors of the Turkish saddle (fragment of one of the skull bones where the pituitary gland is located)
- Metastatic tumors
- Unclassifiable neoplasms
Gliomas are tumors that originate in neuroepithelial tissue. They account for more than half of all CNS neoplasms. This type of brain tumor is most often the result of genetic mutations. These include glioblastomas, astrocytomas, ependymomas. Some of them develop for a very long time over years. Others quickly progress and result in death within a few months.
Gliomas have 4 degrees of malignancy. Usually tumors of 1-2 degrees are called benign, tumors of 3-4 degrees - malignant. The latter include glioblastoma and anaplastic astrocytoma, which are the most common neuroepithelial tumors of the central nervous system. They account for up to 80% of all neoplasms of this type.
Tumors that originate in the meninges
These tumors form in the membranes of the brain. They make up about 20% of the primary CNS tumors. 95% of cancers of this type are meningiomas. The remaining 5% account for fibrotic histiocytoma, hemangiopericytoma, melanoma, diffuse sarcomatosis and others.
Some risk factors of this brain tumor have been established. This what what causes brain tumor:
- Head trauma
- Ionizing radiation (including radiation therapy)
- Eating nitrites
There were genetic defects identified in chromosome 22, which can cause a brain tumor. The cause is a mutation at the locus 22q12.3-qter.
Malignant meningiomas are divided into 3 groups:
- 1 degree - includes 9 histological types, the most frequent ones are meningoepithelial (60% of cases), transitional or mixed (25%) and fibrotic (12%)
- 2 degree - atypical meningiomas, characterized by rapid cell division and rapid growth
- 3 degree - anaplastic meningiomas (old name - meningosarcoma)
Occasionally, multiple brain tumors can develop. Their causes are not known. They account for about 2% of all diagnosed meningiomas. Such neoplasms are characterized by a favorable clinical course. In 90% of cases a person lives a full life with this brain tumor, without having any symptoms. Only 10% of cases require surgical removal of tumors.
Tumors of the pituitary gland
Up to 10% of all intracranial neoplasms are pituitary tumors. They are almost always benign. They usually originate in the cells of the adenohypophysis (anterior lobe of this gland). Such neoplasms are called adenomas or microadenomas if they have a diameter less than 1 cm. What causes a brain tumor of the corresponding localization has not yet been established. Although some of the risk factors are known.
- Brain infection
- Craniocerebral trauma
- Poisoning with toxins
- Use of oral contraceptives
The causes of a brain tumor originating in the pituitary cells can be gene mutations. Hereditary predisposition is also of no small importance. What age can the brain tumor of adenohypophyseal origin develop? This is one of the most "young" tumors. It can develop in a person of any age, including children. The peak incidence has been noted to be from 30 to 50 years.
Most adenomas of the pituitary gland are not accompanied by severe symptoms, so they have low detectability. Usually, doctors choose the conservative treatment (normalizing the level of hormones in the blood). When it stops working, surgical intervention is applied.
Germinoma is the most common type of this brain tumor. It accounts for 0.5% of all brain tumors in representatives of the European race, and up to 3% - in Asians. Why this brain tumor occurs more often in the Asian population has not been determined. It is diagnosed more often in boys. This tumor is malignant. It metastasizes through the cerebrospinal fluid (the fluid that goes around the brain).
Metastatic brain tumours
About 20% of the CNS neoplasms consist of metastatic brain tumors. The causes of these formations are clear: they metastasize from other parts of the body. It is believed that their actual prevalence is even higher than the known one. After all, cancer patients at the stage 4 are often not examined too carefully due to the impossibility of in-depth diagnosis. Even if there is a suspicion that they are developing a brain tumor as a result of cancer of other localization, such patients are no longer referred to neurosurgeons.
What causes a brain tumor? Here are the most common reasons:
- Lung cancer - 40% of metastatic CNS lesions
- Breast cancer - 10%
- Kidneys - 7%
- Stomach or intestines - 6%
- Melanoma - 5% on average
Tumors in children
Even children can develop a brain tumor. Among all childhood cancers, brain tumors account for about 20%. This is the second most common tumor followed by leukemia. They are most common in children during their first year of life. Teratoma is the most common kind among babies. In older children, the most common types are benign astrocytomas (more than 30%), primitive neuroectodermal tumors (medulloblastoma, pineoblastoma - 20%) and ependymomas (15% of cases in children older than 1 year).
At present, it is not known for certain how the brain tumor originates in children. It has been established that boys develop it more often than girls. The reasons why the brain tumor is more common in boys is also not known.
How do people get a brain tumor?
Often patients ask their doctor how one gets a brain tumor. They assume that by knowing the causes, it will be possible to prevent the disease. Unfortunately, this is not true. The basic etiological factors are indeed established for many types of cancer. For example, it is well known that lung cancer occurs mainly due to smoking, cervical cancer is caused by a papillomavirus infection, and liver cancer - by a viral hepatitis C. But what causes a brain tumor is still not known. Despite numerous clinical studies, scientists have not yet been able to establish the causes of a brain tumor.
However, some risk factors have been identified:
Radiation. There are many ways how radiation can cause a brain tumor. Most often this includes radiation therapy for cancer or occupational hazards (radiologists, workers in nuclear industries). Earlier, the cause of the brain tumor in children was an X-ray therapy, used for fungal infections of the scalp.
The connection is not always clearly traced. After all, the first symptoms of brain tumor appear only 10-15 years after radiation. However, a retrospective analysis of medical records may show what can cause a brain tumor. The data of the anamnesis shows that formations of the central nervous system appear more often in people who underwent radioactive irradiation.
Does this mean that the brain tumor is caused by radiography, fluorography or computed tomography? After all, these methods are based on the effects of ionizing radiation. However, this conclusion cannot be made. Even dozens of years ago, when the devices were much less perfect and gave dozens of times the radiation load, there was no reason to believe that a brain tumor could occur as a result of diagnostic procedures. Today, the diagnostic devices are so precise and perfect that radiation produced by them is minimal and it does not damage the cells and cause further mutation.
Heredity. Some genetic anomalies which can cause a brain tumor have been identified. These include type 1 neurofibromatosis, type 2, tuberous sclerosis, Hypelian-Lindau disease and Lie-Fraumeni syndrome. There are other genetic causes of the brain tumor, but they are much more rare.
Immunity. One of the types of neoplasms with intracranial localization is lymphoma. This brain tumor can occur as a result of reduced immunity. It can be caused by treatment for HIV/AIDS, after organ transplantation (immunosuppressive therapy), long-term use of immunosuppressants and glucocorticoids when treating dermatological diseases or systemic damages of connective tissue.
Several mythical causes should be noted as well. Many people are afraid of them, but these fears are false.
These are the factors that cannot cause the brain tumor:
- The use of a mobile phone - contrary to a common misconception, it does not give ionizing radiation
- A football game (players often hit the ball with their head)
- Electromagnetic fields influence
- Hair dye
- Stress and bad habits
Also, we need note several controversial reasons, which can cause a brain tumor. These risk factors are assumed, but not yet completely proven.
- Aspartame (sweetener for diabetics)
- Impact of vinyl chloride (occupational hazards in the production of plastics)
- Viral infections
- Impact of petroleum products
Thus, scientists still do not know exactly what causes a brain tumor. Therefore, the only thing you can do to prevent this disease is to not expose yourself to massive ionizing radiation and, if possible, to maintain a good immune system.
Meningeal brain tumor - prognosis
For meningiomas, survival rate is high. The clinical course of the disease is favorable. Usually they are tumors of the 1st degree of malignancy. If there are no symptoms of pathology, a surveillance strategy is applied. Surgical treatment may not be required, because most of these brain tumors prognosis are favorable.
The first thing that patients are interested in - how many people live with a brain tumor of meningeal origin? This depends on a number of factors. First of all, it depends on the degree of malignancy, as well as the treatment.
If the brain tumor was completely removed during the surgery, how many people survive depends solely on their age and state of health, because in 95% of the case the meningioma does not recur. Only 5% of patients experience relapse within 15 years after the surgery. However, sometimes the formation is localized in the functional-active structures of the central nervous system. In such cases, complete removal is impossible. Nevertheless, even if it was partially removed, the risk of recurrence within 15 years is 50%. In the remaining 50% of cases, the tumor remains the same size - it does not grow. If there is a growth of the meningioma, it can be treated with radiotherapy. Even with malignant meningioma, radiation helps control the growth of the tumor for at least 5 years.
The age of the patient is of great importance. Below you can see data how many people survive a brain tumor that originated in meningeal membranes, depending on age.
The percentage of five-year survival is indicated - that is, the number of people who will live for 5 or more years after the diagnosis:
- Up to 45 years - 87%
- Up to 55 years - 77%
- From 55 to 65 years - 71%
In most cases, after 5 years, the tumor no longer recurs if it has been completely removed during surgery.
Neuroepithelial brain tumor - brain tumors survival rate
If you have been diagnosed with neuroepithelial brain tumor, it is difficult to confirm your prognosis without knowing the histological type of the tumor. The prognosis depends on the structure of the neoplasm and how long the brain tumor has been developing.
Accordingly, 4 degrees of malignancy of neuroepithelial neoplasms of the central nervous system are distinguished as follows:
- 1 degree - pilocity astrocytoma
- 2 degree - protoplasmic, pleomorphic, hemostatic, fibrillar astrocytoma, xanthoastrocytoma and ependymoma
- Grade 3 - anaplastic astrocytoma
- 4 degree - glioblastoma
The 1 and 2 degrees of neuroepithelial brain tumor are considered to be a low degree of malignancy. They have a more favorable outlook. 3 and 4 degree are neoplasms of high malignancy or simply malignant. The worst prognosis are brain tumors of the 4th degree.
How many survive glioblastoma? Unfortunately, this tumor is characterized by a worse prognosis. It develops very quickly and is manifested by necrosis (death) of parts of the brain. From the onset of the tumor to the first symptoms, not even a few months pass, but just weeks. The average life expectancy for patients under 40 years is not more than one and a half year, and for patients after 40 years - less than 1 year.
Five-year survival rate in developed countries, depending on age:
- Up to 45 years - 19%
- From 45 to 55 years - 8%
- From 55 to 65 years - 5%
Patients do not always undergo a surgery, since they die from a brain tumor of grade 4 quite quickly. Often only radiation and chemotherapy are used. However, these methods do not significantly prolong the life of the patient. Unfortunately, glioblastoma is the most common glioma (neuroectodermal tumor). It accounts for about 50% of the structure of these tumors.
Anaplastic astrocytoma is another malignant brain tumor. How many people live with this disease?
Average life expectancy depends on the age of the patient at the time of diagnosis:
- Up to 40 years - about 3 years
- From 40 to 60 years - an average of 2 years
- After 60 years - less than 1 year
Five-year survival rate depending on age:
- Up to 45 years - 54%
- From 45 to 55 years - 32%
- From 55 to 65 years - 14%
Infiltrative growth is characteristic for this pathology. That is, the neoplasm penetrates the brain tissue, but does not shift them. Anaplastic astrocytoma is the second most common neuroectodermal tumor after glioblastoma. It accounts for about 30% of this type of tumor.
The next most common CNS tumor originating from the neuroectodermal tissue is the oligodendroglioma. It accounts for about 5% of all gliomas. The average life expectancy of patients in developing countries, including the CIS, is 6 years. The indicators in the developed countries (Germany, USA) are much better.
Five-year survival, depending on the age of the patient at the time of diagnosis, is:
- Up to 45 years - 88%
- From 45 to 55 years - 81%
- From 55 to 65 years - 68%
Unfortunately, sometimes the oligodendroglioma becomes malignant. In this case, it acquires the 3 degree of malignancy, and the prognosis worsens. The cause of the anaplastic oligodendroglioma is not known. However, the life expectancy of patients with malignant type of this tumor is reduced.
Five-year survival rates for this type of neoplasm in developed countries:
- Up to 45 years - 71%
- From 45 to 55 years - 61%
- From 55 to 65 years - 46%
Ependymomas account for about 3% of gliomas. They are more common in children than in adults. More often these are benign tumors. Anaplastic ependymoma of grade 3 malignancy develops sometimes, but rarely. There is no evidence as to what causes this brain tumor in children. Survival rates vary considerably from country to country. In the CIS, the five-year survival rate for children from 3 years is about 50%, for adults - 70%. In developed countries, statistics are much better due to better treatment.
Five-year survival for patients with ependymoma in contries with well-developed medicine:
- Children - 75%
- Patients from 20 to 45 years old - 92%
- From 45 to 55 years - 89%
- From 55 to 65 years old - 86%
How many survive a brain tumor of embryonic tissue?
Germinogenic tumors are malignant. They are found in children. They are characterized by metastases. The most common tumor is germinoma. It is the most favorable. For most patients, even without surgery, this malignant brain tumor can be cured. How many live after the treatment? Life expectancy is potentially the same as in a person who has never suffered from this pathology. To cure the disease, radiation therapy is sufficient, and sometimes chemotherapy (in children under 4 years). The younger the age of the patient, the better the prognosis.
Unfortunately, the prognosis is much worse for other types of germogenic tumors. They are very rare, but the survival rate of patients is extremely low. These are inoperable brain tumors. How many patients survive? Only 5% of patients after diagnosis live for more than 2 years. Radiation therapy and chemotherapy are used for treatment, since surgical treatment does not improve the prognosis. Only palliative surgeries are performed. For example, shunting surgeries to normalize aqueduct of the brain.
Metastatic brain tumor - how many people survive?
In many cases, cancers are detected only after metastases have appeared in the central nervous system. How many people survive a metastatic brain tumor depends on the treatment. In the natural course of the disease, the average life expectancy of patients is about 3 months. Wth surgical treatment or radiotherapy, it can be reach up to 2 years and more. Life expectancy also depends on the histological type of cancer, localization and the number of metastases. Approximately 50% of cases are multiple, which worsens the prognosis.
Where to go for treatment if you were diagnosed with brain cancer?
The most successful diagnosis and treatment of brain cancer is performed in Germany and other developed countries, which is confirmed by the statistics of patient survival. If you want to use the services of German doctors, contact Booking Health. We will organize your treatment abroad.
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Author: Dr. Nadezhda Ivanisova