Brain cancer is perhaps one of the more emotionally charged diseases of man. This is not only because of the realization that cancer often shortens a person’s life, but at the same time it changes the personality of the patient.
This can be very upsetting and emotionally draining for the family members . Sometimes the person gets diagnosed in the work-up of a seizure or because of headaches, and the patient may suddenly die within only a few days or weeks as a result of a rapidly growing brain tumor.
At other times the patient may be alive for several years, but needs several surgeries or treatments for a recurrent brain cancer. In that case the personality, mentation and energy level tends to deteriorate as the cancer slowly spreads within the brain.
Often there has been a cancer elsewhere in the body (breast, prostate, lungs or melanoma of the skin) and brain metastases are part of that cancer spreading throughout the body. An x-ray or MRI scan needs to be done very quickly in that situation, as the neurosurgeon can often intervene in an early stage and the surgery will extend the patient’s lifetime to a certain degree. In about 2% of routine autopsies brain cancer is found by the pathologist as a surprise finding.
The following outline can only give a global overview of this very complex topic. There are about 15 primary cancers of the brain and spinal cord from a histological point of view and I will only mention the most common ones here.
The following references were used apart from my own clinical experience:
1. Cancer: Principles &Practice of Oncology, 4th edition, by V.T. De Vita,Jr.,et. al J.B. LippincottCo.,Philadelphia, 1993.Chapter 48.
2. Cancer: Principles&Practice of Oncology. 5th edition, volume 2. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter 42, page 2013: Neoplasms of the Central Nervous System.
3. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 177.
4. T Kilic et al. Cancer Res 2000 Sep 15;60(18):5143-5150.
5. Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
6. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc