Brain tumors (First of two parts)

Article Abstract:

In a review of the current state of knowledge about brain tumors, the epidemiology, laboratory research, and care and treatment of brain tumors are discussed. About 35,000 new cases of brain tumors occur in adult Americans each year. Nevertheless, little is known about what causes brain tumors. Many brain tumors are secondary, that is, they are metastatic tumors that have spread from a primary tumor located elsewhere, such as breast cancer or lung cancer. Primary brain tumors that arise within the brain are not associated with tobacco use or dietary patterns; in about 16 percent of cases of primary brain tumor there is, however, a family history of cancer. Surgery is an important part of the treatment of brain tumors for two reasons. Obtaining a sample of the tumor for microscopic examination is often the only conclusive method of diagnosis. Furthermore, many of the ill effects resulting from a brain tumor result from the pressure caused by the growing mass within an enclosed space (the skull). Surgery can relieve this effect. In general, the hope for successful treatment relies upon following the surgical treatment with radiation therapy. It is common to treat malignant gliomas, a common form of brain tumor in adults, with about 5,000 to 6,000 cGy of radiation. (A Gy, or Gray, is a dose of radiation equivalent to one joule of energy absorbed per kilogram of tissue. It is equal to 100 rads.) This dose is usually delivered to an area focused as narrowly to the location of the tumor as is practical. Chemotherapy has met with only limited success in the treatment of brain tumors. Many chemotherapeutic agents do not enter the brain with great efficiency; the barrier of cells designed to protect the brain from chemicals in the blood keeps out chemotherapeutic drugs as well. New methods of breaching the blood-brain barrier may improve the effectiveness of some forms of chemotherapy. However, there is evidence that malignant gliomas may have enzymes that make them particularly effective at repairing damage caused by chemotherapeutic agents. In some cases, malignant glioma cells can survive doses of chemotherapy that will kill most normal healthy cells in the body. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Hypothalamic-pituitary dysfunction after radiation for brain tumors

Article Abstract:

Radiation therapy for brain tumors may frequently cause hypothalamic-pituitary dysfunction. Growth hormone, which is secreted by the pituitary gland, is known to be deficient in patients treated with radiation, but other other neuroendocrine abnormalities associated with radiation were previously thought to be uncommon. Of 32 patients studied two to 13 years after receiving radiation for brain tumors, only three had no endocrine abnormalities. Nine patients had signs or symptoms of thyroid deficiency. Of the 23 patients who underwent radiation only to the head, 15 (65%) had either hypothalamic or pituitary hypothyroidism. Fourteen of the 23 postpubertal patients had signs of abnormal sexual development, including diminished or absent menstrual flow in women and low testosterone levels in men. The higher than expected incidence of neuroendocrine, particularly hypothalamic, abnormalities indicates brain tumor patients undergoing radiation therapy should be routinely checked and treated for these disorders.

Causes of, Complications and side effects, Physiological aspects, Radiotherapy, Hypothyroidism, Hypothalamo-hypophyseal system

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Brain tumors

Article Abstract:

The diagnosis and treatment of brain tumors is reviewed. The tumors discussed include astrocytic tumors, oligodendroglial tumors, meningioma, and primary central nervous system lymphoma. Brain tumors are especially difficult to treat because drugs must cross the blood-brain barrier and many drugs can damage the brain.

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