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| Subscribe to Clinical Compass™ | VOLUME 3, ISSUE 10 - MAY 6, 2008 | ||||||||||||||||||||||||
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Brain Tumor Action Week by Kara Gobron, PhD May 4-10th is Brain Tumor Action Week. During this week, the North American Brain Tumor Coalition (NABTC) will convene in Washington, DC, to press Congress for increased funding to support greater brain tumor research and care. The NABTC’s efforts in Washington will focus on fighting for more federal dollars to support translational and clinical brain tumor research programs and enhanced collaboration among brain tumor researchers. The NABTC will also be working to remove barriers to quality care through the elimination of the Medicare waiting period.(1) Each year, more than 44,500 people in the United States are diagnosed with a primary brain tumor (originating in the central nervous system),(2) and just under half of these tumors are malignant.(3) Primary brain tumors are classified into four grades determined by the microscopic appearance of the tumor cells (I = benign, slow growing, tumor cells look very similar in appearance to normal cells, II, III, and IV = malignant and highly aggressive, tumor cells look very different from normal cells) based on a system established by the World Health Organization(4) and the response to treatment depends in part on the grade of the tumor. The outlook for brain tumor patients has not improved significantly in the last 20 years.(1) Only 33 percent of males and 32 percent of females survive five years following the diagnosis of a primary brain tumor.(3) The incidence of metastatic brain tumors (cancer that spreads to the central nervous system from another part of the body) is not as well documented, but it is estimated that 140,000 metastatic brain tumors are diagnosed every year. Metastatic brain tumors are by definition, malignant. Metastatic brain tumors occur in roughly 25 percent of all cancers that metastasize and approximately 10 percent to 30 percent of people with cancer will have brain tumor metastases, particularly those with lung or breast cancer.(5) Symptoms of a metastatic brain tumor may be the initial cause for a patient to see their physician, oftentimes before symptoms of the primary cancer are even evident. Common symptoms of a brain tumor include headaches, seizures, memory loss, and behavioral changes. Brain tumor should be included in the differential diagnosis of patients presenting with one or more of these symptoms who do not respond to conventional symptomatic treatment. Since the symptoms of a brain tumor can affect a number of systems, patients commonly present first to their primary care doctor, a psychiatrist, or a neurologist. Early referral and treatment are critical in patients with a brain tumor, so physicians in a number of disciplines need to have an appropriate index of suspicion regarding the possibility of a brain tumor. An ongoing survey of patients with brain tumors found that in almost 68 percent of cases, the brain tumor was misdiagnosed at initial presentation and for 23 percent of patients, it took over a year for the correct diagnosis to be made.(6) The treatment of a patient with a brain tumor requires a multidisciplinary approach and the treatment team usually consists of a neurosurgeon, a radiation oncologist, and an oncologist and/or neuro-oncologist. The patient’s primary care doctor and a neurologist are also likely to be involved in the care team.(7) Treatment for brain tumors can include surgery, radiation, and chemotherapy as well as investigational agents, and must be individualized for each patient based on the grade and location of the brain tumor, and the patients’ age and health at the time of diagnosis, etc.(8) The cause of brain tumors remains unknown. Environmental, occupational, and genetic factors continue to be investigated in the hopes of someday curing or even preventing the occurrence of these tumors.(9) The Brain Tumor Epidemiology Consortium(10) has been founded to look for common risk factors and to develop ways to prevent these devastating tumors from ever occurring. Until the time that prevention is possible, patients need access to the best possible treatments, and physicians need to increase their awareness of the symptoms, diagnosis, and management of brain tumors. With over 120 different types of brain tumors, recognition, diagnosis and treatment can be complicated. Mortality rates for patients with brain tumors have remained unchanged in the last decade,(11) and the incidence of brain tumors is increasing as people live longer.(12) Developing new technologies, improving techniques for classification, increasing use of molecular markers, and developing a database for tracking diagnosis and prognosis will help to advance our understanding of brain tumors, their causes, prevention, and treatment. This knowledge could lead to identification of predictors of risk/susceptibility and/or response to treatment, and ultimately to improved survival rates of people diagnosed with brain tumors. For further information, please visit www.nabraintumor.org Do you have feedback for the author? Click here to send us an email. References
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