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What is brain cancer?

Brain cancers include primary brain tumours, which start in the brain and almost never spread to other parts of the body, and secondary tumours (or metastases), which are caused by cancers that began in another part of the body.

There are more than 40 major types of brain tumours, which are grouped into two main types:

  • benign - slow-growing and unlikely to spread. Common types are meningiomas, neuromas, pituitary tumours and craniopharyngiomas.
  • malignant - cancerous and able to spread into other parts of the brain or spinal cord. Common types include astrocytomas, oligodendrogliomas, glioblastomas and mixed gliomas.

In 2016, 1418 brain cancers were diagnosed in Australia. The risk of being diagnosed with a brain cancer by age 85 is estimated at 1 in 102 for men and 1 in 157 for women.

In 2018, there were 1410 deaths in Australia caused by brain cancer. 

The five year survival rate for brain cancer is 22%.



Brain cancer symptoms

Headaches are often the first symptom of a brain tumour. The headaches can be mild, severe, persistent, or come and go. A headache isn't always a brain tumour but if you're worried, be sure to see your GP.

Other symptoms include:

  • seizures: severe (e.g. a convulsion) or mild (a fleeting disturbance of awareness, sensation or jerking muscles)

  • weakness or paralysis in part of the body

  • loss of balance

  • general irritability, drowsiness or a change in personality

  • nausea and vomiting

  • disturbed vision, hearing, smell or taste



Causes of brain cancer

Some factors that can increase your risk of brain cancer include:

  • some brain and spinal cord tumours are more common in people with certain inherited or genetic conditions

  • people exposed to very high doses of radiation to the head



Diagnosis of brain cancer

If a brain tumour is suspected, the doctor may check how different parts of the brain are functioning by checking your reflexes, muscle strength, balance and coordination, ability to feel pin-pricks and to distinguish between hot and cold. An opthalmoscope is used to view the optic nerve, which may bulge if the pressure in the skull is raised, for example by a tumour.

The main tests for brain cancer diagnosis are:

CT scan

A CT (computerised tomography) scan uses x-rays to take multiple pictures of the inside of the body.

MRI scan

A MRI (magnetic resonance imaging) scan uses a computer and a powerful magnet to make cross-sectional pictures of your body.

MRS (magnetic resonance spectroscopy)

A MRS (magnetic resonance spectroscopy) scan looks for changes in the chemical make-up of the brain and can be done at the same time as an MRI.

PET scan

A PET (positron emission tomography) scan injects a small amount of radioactive solution to show up cancer cells as they absorb the solution faster than normal cells.

SPECT (single proton emission computerised tomography)

A single photon emission CT (SPECT) scan takes three-dimensional images of blood flow in the brain and areas with higher blood flow, such as a tumour, will be brighter on the scan.

Lumbar puncture

A lumbar puncture (also known as spinal tap) uses a needle to collect cerebrospinal fluid which will be sent to a laboratory to test for cancer cells.



Treatment for brain cancer

Brain tumours may be treated with surgeryradiation therapychemotherapy or steroid therapy, or a combination of these treatments.

Some tumours can be removed completely by surgery (craniotomy). Post-operative radiotherapy improves local control and survival. For glioblastomas, temozolomide may be added during or after radiotherapy to further improve outcomes.

If a tumour cannot be removed, the aim of treatment is to slow growth and relieve symptoms by shrinking the tumour and any swelling around it. Treatment options include radiation therapy with or without temozolomide.

Staging

Based on the results of MRI, CT scans and other tests, your doctor will tell you the stage of the cancer. Staging describes the size of the cancer and if and how far it has spread beyond the brain.

Brain tumours are usually graded on a scale of 1 to 4, based on how quickly they are growing and their ability to invade nearby tissue: grades 1 and 2 are the slowest growing and are called low-grade tumours; grade 4 is the fastest growing.

Palliative care

In some cases of brain cancer, your medical team may talk to you about palliative care. Palliative care aims to improve your quality of life by alleviating symptoms of cancer. 

 As well as slowing the spread of brain cancer, palliative treatment can relieve pain and help manage other symptoms. Treatment may include radiotherapy, chemotherapy or other drug therapies. 

Treatment Team

Depending on your treatment, your treatment team may consist of a number of different health professionals, such as:
  • GP (General Practitioner)- looks after your general health and works with your specialiststo coordinate treatment.
  • neurologist- diagnoses and treats diseases of thebrainand nervous system.
  • neurosurgeon- uses surgery to treatbraindiseases and injuries.
  • Cancer nurses- assist with treatment and provide information and support throughout your treatment.
  • Medical oncologist- prescribes and coordinates the course of chemotherapy.
  • Radiation oncologist- prescribes and coordinates radiation therapy treatment.
  • Other allied health professionals- such as social workers, pharmacists and counsellors.


Screening for brain cancer

There is currently no screening for brain cancer available in Australia.



Preventing brain cancer

There are no proven measures to prevent brain cancer.



Prognosis for brain cancer

Prognosis means the expected outcome of a disease. An individual's prognosis depends on the type and stage of cancer, as well as their age and general health at the time of diagnosis.

For benign tumours that can be completely removed, cure is likely. For malignant tumours, outcomes depend on how slowly or quickly the tumour develops and responds to treatment.

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