What makes cancerous tumors go away

Brain tumors

Brain tumors (Brain tumors): benign or malignant tumors ("growths") that have their origin in brain tissue or are colonizations of cancerous ulcers outside the brain (Brain metastases). The first complaints are usually diffuse headaches or seizures, depending on the location, changes in personality or neurological deficits such as paralysis also occur. Brain tumors are rare, but due to their location in the brain, they are usually life-threatening. All age groups are affected; older adults are more likely to develop the disease than younger ones.

The most important treatment option for brain tumors is surgery. H. complete removal of the tumor. If this is not possible, radiation therapy or chemotherapy are used. The prognosis depends on what type of brain tumor it is. With a 10-year survival rate of 95%, meningiomas have a good prognosis, whereas medulloblastomas have a much worse prognosis.

Leading complaints

  • Changes in personality, e.g. B. lack of interest, irritability, slowing down, drive or concentration disorders
  • Failures, e.g. B. paralysis, visual disturbances, speech disorders, loss of sense of smell, dizziness
  • Cerebral seizures
  • Headaches that gradually increase, never go away, and are often strongest when you wake up
  • Morning sickness, vomiting, then headache reduction
  • Disturbed consciousness up to unconsciousness.

When to the doctor

In the next few days if

  • Headaches have been increasing for a long time and will not go away
  • mental changes occur that cannot be explained.

Call a doctor immediately, if

  • a cerebral seizure occurs for the first time
  • (Neurological) failures occur.

The illness

Classification

Two large groups can be distinguished:

  • The rarer ones primary brain tumors arise in the brain and occur at any age. They are the "real" brain tumors and, like the tumors of other organs, are benign or malignant. The cause of primary brain tumors is still unclear. The only known risk factor is radiation to the brain as part of cancer therapy, e.g. B. in blood cancer. The most common are the various Gliomasthat of the envelope or Glial cells go out around the nerve cells, and the Meningiomasthat arise from the soft meninges. Other primary brain tumors are the medulloblastoma, which occurs mainly in children and has its origin in the cerebellum, and the acoustic neuroma, which originates from the 8th cranial nerve. Another, rare brain tumor is the germinoma, which arises from the germ cells.
  • More often, malignant tumors outside the brain deposit daughter tumors into the brain. These are particularly common in lung and breast cancer secondary brain tumors or to observe brain metastases.

"Benign" brain tumors are also often "malignant"

In the case of tumors outside of the brain and spinal cord, the distinction is clear: benign tumors generally grow in a displacing manner and generally do not damage the surrounding tissue. This is not the case with brain tumors: if a benign tumor is located in a strategically important location (often in the brain stem), it can, even if it "only" grows in a displacing manner, damage vital structures through pressure to such an extent that they can no longer fulfill their function.

There is another reason why brain tumors occupy a special position: the space for the brain is limited by the bony skull and there is hardly any buffer volume. As a tumor grows, the pressure inside the skull increases rapidly, thereby damaging the brain. This is why benign brain tumors can also be life-threatening.

clinic

The first symptom of brain tumors is often the diffuse headache. Because the symptoms depend on where exactly the tumor is located, a large number of other symptoms are possible. Does the tumor affect z. If, for example, the point in the cerebrum from which the movements of the right hand are controlled, paralysis or a cerebral seizure with twitching of the right hand are likely. If the tumor is located in the frontal lobe of the cerebrum, it sometimes causes changes in nature or poor memory. As already mentioned, brain tumors not infrequently increase intracranial pressure; the consequences are morning headaches, gushing vomiting and visual disturbances.

Usually the symptoms of brain tumors increase slowly over weeks and months. Sometimes, however, the fragile tumor tissue bleeds and suddenly leads to the symptoms of a stroke.

Diagnostic assurance

If a brain tumor is suspected, the most important diagnostic measure is magnetic resonance imaging. If the intracranial pressure is normal (the patient has neither headache nor nausea and vomiting), the doctor takes cerebrospinal fluid (cerebral fluid) with a lumbar puncture and examines it to rule out inflammation and possibly to obtain tumor cells for an examination. Blood tests are only useful in certain cases, such as suspicion of hormone-producing tumors.

In order to plan how to proceed, a tissue examination of the tumor is necessary. The tissue sample required for this is taken as part of an operation that is already necessary or by means of a separate biopsy (tissue removal). This tissue sample is also the basis for therapy and prognosis (see below).

If the brain tumor is one or more metastases from a malignant tumor outside the brain, the search for the primary tumor is up. Brain metastases are particularly common in malignant tumors of the lungs, breasts, skin or kidneys.

Differential diagnoses. Headaches, cramps, intracranial pressure signs and paralysis are also symptoms of a number of other brain diseases. Important differential diagnoses are epilepsy, stroke, encephalitis, cerebral haemorrhage, and subdural hematoma.

treatment

Treatment focuses on surgery, radiation therapy and - somewhat less commonly used - chemotherapy. Doctors often combine these procedures with one another to make them more effective. The additional treatment is then called an adjuvant (accompanying) therapy. If this therapy is carried out before another measure, it is called neoadjuvant (e.g. neoadjuvant radiation before surgery to reduce the tumor mass).

surgery. If possible, primary brain tumors are surgically removed or at least reduced in size. State of the art process of Neuronavigation make it possible to use the path of the surgical instruments before the operation, for. B. plan of magnetic resonance or CT, "follow up" during the operation and show the position of the instruments on the image. At some centers, nuclear spins can even be performed during the operation. This is to protect functionally important areas of the brain as much as possible while at the same time removing the greatest possible tumor. Neurosurgeons also try to surgically remove individual metastases, depending on the location. In almost all malignant tumors, the operation is followed by radiation or chemotherapy or a combination therapy of both.

radiotherapy. If the tumor is so inconvenient that an operation would lead to severe functional impairment, if it has spread or if there are multiple metastases, doctors recommend radiation treatment. There are many options available today from which Whole brain radiation about the very precise Radiosurgery with the gamma knife up to the introduction of the smallest "radiating" particles that only irradiate their immediate surroundings. The effectiveness of these modern procedures reaches that of surgery in some areas.

chemotherapy. Depending on the location of the tumor and its malignancy, doctors also use chemotherapeutic agents, either alone or in combination with radiation (adjuvant or neoadjuvant). The patient is given the active ingredients intravenously or orally as a capsule. In order to be able to reach the brain tumor, the active ingredients have to cross the blood-brain barrier. However, only a few chemotherapeutic agents can do this, such as temozolomide, which is used in glioblastoma (e.g. Temodal®), etoposide for the treatment of germinoma (e.g. Vepesid®) or cisplatin and carbiplatin.

Accompanying measures. In addition, the doctors combat particularly stressful symptoms: headaches with brain tumors respond well to high-dose cortisone, which swells the area around the tumor and thus lowers intracranial pressure. Doctors treat cerebral seizures with anti-epileptic drugs. If the liquor-draining pathways (the channels through which the cerebrospinal fluid flows) are blocked, an operation to drain the liquor may be necessary.

If failures remain after treatment, rehabilitation often takes months, and a stay in a specialized rehabilitation clinic is often required.

forecast

Based on the results of the examination of the tumor tissue, the brain tumor is assigned one of 4 degrees of severity (WHO classification). In addition to the age of the patient, the size of the tumor and any concomitant diseases, this severity has a decisive influence on the prognosis. For example, grade I tumors such as acoustic neuroma and meningioma have a 10-year survival rate of> 95%. Grade IV brain tumors such as medulloblastoma have the worst prognosis with a 10-year survival rate of 40 to 60%.

Your pharmacy recommends

In most cases, headaches are harmless and widespread; they are rarely caused by serious illnesses and only in the worst case by a brain tumor. However, if you repeatedly suffer from headaches, they get worse and never go away completely, a visit to the doctor is the order of the day.

The same applies to changes in personality: If you or one of your family members notice significant changes in personality such as If, for example, you have unusual, increased irritability, you should listen carefully and speak to your doctor.

Further information

  • www.hirntumorhilfe.de - website of the Deutsche Hirntumorhilfe e. V., Leipzig: Detailed and well-explained information on the cause, symptoms,

Authors

Dr. med. Nicole Menche in: Health Today, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update: Dr. med. Sonja Kempinski | last changed on at 13:08


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.