Brain Cancers
Brain cancer refers to malignant tumors that originate in the brain or spread to the brain from other parts of the body. Because the brain controls vital functions such as movement, speech, memory, vision, and behavior, even small tumors can cause significant symptoms. Advances in imaging, neurosurgery, radiation techniques, and systemic therapies have improved safety, outcomes, and quality of life.
Overview
Brain tumors develop when abnormal cells grow uncontrollably within the brain or surrounding structures.
They may be primary (originating in the brain) or secondary (metastatic tumors spreading from other organs).
Brain tumors can be benign or malignant, but both can be life-threatening due to pressure on vital brain structures.
Symptoms depend on tumor size, location, growth rate, and molecular characteristics.
Management requires a multidisciplinary team including neurosurgeons, medical oncologists, radiation oncologists, neurologists, and rehabilitation specialists.
Risk Factors
Non Modifiable
Previous exposure to high-dose radiation to the head
Inherited genetic syndromes such as Neurofibromatosis or Li-Fraumeni syndrome
Increasing age for most adult brain tumors
Prevention Tips
Avoid unnecessary exposure to radiation
Seek genetic counseling if strong family history exists
Prompt evaluation of neurological symptoms
Symptoms
Early
Persistent headaches
Nausea or vomiting
Mild memory or concentration difficulties
Common
Seizures, especially new-onset seizures in adults
Progressive headaches worse in the morning
Vision problems such as blurred or double vision
Speech or language difficulties
Personality or behavior changes
Advanced
Weakness or paralysis of limbs
Loss of coordination or balance
Severe cognitive impairment
Reduced consciousness
Organ Specific
Neurological
Weakness on one side of the body
Difficulty speaking or understanding speech
Sensory loss or numbness
Difficulty swallowing
Diagnosis
Approach
Clinical Evaluation
Detailed neurological examination
Assessment of motor, sensory, speech, and cognitive functions
Tests
Baseline blood investigations
Imaging
MRI brain with contrast (gold standard)
CT scan brain for emergency evaluation
Functional MRI and tractography in selected surgical cases
PET scan in selected cases
Biopsy
Surgical biopsy or tumor resection
Stereotactic biopsy for deep or inoperable tumors
Molecular Tests
IDH mutation testing
1p/19q co-deletion analysis
MGMT promoter methylation
ATRX and TP53 mutation analysis
Staging
Tumor grading based on WHO classification
Assessment of local brain involvement
Treatment
Principle
Surgery
Maximal safe surgical resection
Use of neuronavigation and intraoperative monitoring
Awake craniotomy in selected cases
Radiation Therapy
External beam radiotherapy after surgery
Stereotactic radiosurgery (Gamma Knife / CyberKnife)
Whole brain radiotherapy for selected metastatic cases
Systemic Therapy
Chemotherapy such as temozolomide
Targeted therapy for selected molecular alterations
Immunotherapy in selected tumors
Participation in clinical trials
Supportive Care
Steroids to reduce brain swelling
Anti-epileptic drugs for seizure control
Pain management
Neuro-rehabilitation therapies
Do's and Don'ts
Dos
Seek immediate care for new seizures or worsening neurological symptoms
Follow medication schedules strictly
Attend regular follow-up imaging
Participate in rehabilitation programs
Seek emotional and psychological support
Donts
Do not ignore severe headaches with vomiting
Do not stop seizure or steroid medications abruptly
Avoid driving if seizures are not controlled
Do not rely on unproven alternative therapies