Malignant Brain Tumors

Malignant brain tumors are cancerous growths that develop in the brain and require swift medical intervention. These aggressive tumors can grow quickly and invade healthy brain tissue, affecting thousands of lives each year.

Table of contents

• What is a Malignant Brain Tumor?
• Types of Malignant Brain Tumors
• Who is Affected?
• Signs and Symptoms
• How Doctors Diagnose Brain Tumors
• Treatment Options
• Living with a Malignant Brain Tumor

What is a Malignant Brain Tumor?

A malignant brain tumor is a cancerous growth of cells in the brain. The word “malignant” indicates that the tumor is cancerous, while “neoplasm” is a medical term that simply means tumor^[1][2]. These tumors are different from benign (noncancerous) brain tumors because they grow more aggressively.

Malignant brain tumors typically grow rapidly and invade surrounding healthy brain tissue. Unlike benign tumors that may push on brain tissue, malignant tumors can actually destroy brain cells as they spread^[2][3]. Whether cancerous or not, brain tumors can impact your brain function if they grow large enough to press on surrounding nerves, blood vessels, and tissue^[3].

A brain tumor can begin in the brain itself, which doctors call a primary brain tumor. Sometimes cancer spreads to the brain from other parts of the body, such as the lungs or breasts. These are called secondary or metastatic brain tumors^[1][3].

• Brain
• Central nervous system
• Spinal cord

Types of Malignant Brain Tumors

There are many different types of malignant brain tumors. The most common types are called gliomas, which form in the glial cells that support and protect the brain’s nerve cells. Approximately 78% of cancerous primary brain tumors are gliomas^[3].

Common types of malignant brain tumors include:

• Glioblastoma: These are the fastest-growing and most aggressive brain tumors. They form in glial cells called astrocytes. Glioblastomas are malignant grade 4 tumors that contain a mix of different cell types and areas of dead cells. They can invade nearby regions of the brain and sometimes spread to the opposite side^[3][7][12].
• Astrocytoma: These tumors form in star-shaped glial cells called astrocytes. They can form in many parts of the brain but most commonly occur in the cerebrum, the largest part of your brain^[3].
• Ependymomas: These tumors often occur near the ventricles in the brain, which are spaces filled with fluid. They develop from ependymal cells^[3].

Researchers have identified more than 150 different brain tumors^[3]. There are more than 100 distinct types of primary brain tumors, each with its own spectrum of presentations, treatments, and outcomes^[6].

Who is Affected?

Malignant brain tumors can affect people of any age, but they are more common in adults, especially those over 60 years old^[2]. Different types of brain tumors have varying age patterns. For instance, glioblastomas appear more often in older adults, while other brain tumor types can occur in children and young adults^[2].

Brain tumors account for 85% to 90% of all primary central nervous system tumors. Data shows that the combined incidence of brain and other central nervous system tumors in the United States is 6.2 cases per 100,000 people per year. The mortality rate is 4.4 deaths per 100,000 people per year^[13].

In general, the incidence of primary brain tumors is higher in White individuals than in Black individuals, and the incidence is slightly higher in men than women^[2][13].

Only about one-third of brain tumors are cancerous. Primary brain tumors rarely spread to other areas of the body, but they can spread to other parts of the brain and to the spinal cord^[3][13].

Signs and Symptoms

The signs of a malignant brain tumor can differ based on where the tumor is located in the brain. Some people notice changes over time, while others may experience sudden symptoms^[2]. Some parts of the brain are less active than others, so if a brain tumor starts in a less active part, it might not cause symptoms right away. The tumor could become quite large before it is found^[1].

As the tumor grows, it creates pressure on and changes the function of surrounding brain tissue^[1]. Common signs to watch for include:

• Ongoing severe headaches or pressure in the head, which may worsen in the morning or with physical activity
• Seizures or convulsions (sudden, uncontrolled movements or loss of consciousness)
• Nausea and vomiting, especially in the morning
• Weakness or numbness in parts of the body, often on one side
• Difficulty with balance or coordination
• Dizziness or vertigo (feeling like the room is spinning)
• Changes in vision, such as blurry or double vision
• Changes in thinking or personality, including memory issues or feeling confused
• Difficulty speaking or understanding others
• Loss of appetite or unintended weight loss^[2]

If you notice any of these signs in yourself or someone else, it is important to see a doctor as soon as possible. Early detection can lead to quicker and more effective treatment^[2].

How Doctors Diagnose Brain Tumors

If your doctor thinks you might have a brain tumor, you will need a number of tests and procedures to get a diagnosis^[8].

A neurological exam tests different parts of your brain to see how they are working. This exam may include checking your vision, hearing, balance, coordination, strength, and reflexes. If you have trouble in one or more areas, this gives your doctor clues about what part of your brain might be causing your symptoms^[8].

Imaging tests help doctors see inside your brain:

• CT scan: This test uses X-rays to make pictures of your brain. It is widely available and results come back quickly^[8].
• Brain MRI: MRI uses strong magnets to create pictures of the inside of the body. MRI is often used to detect brain tumors because it shows the brain more clearly than other imaging tests. Often a dye is injected into a vein in your arm before an MRI to make certain details more clear and help see smaller tumors^[8].

A biopsy involves taking a small sample of the tumor tissue to examine under a microscope. This helps doctors determine what type of tumor you have and whether it is cancerous^[8].

Treatment Options

The main treatments for brain tumors are surgery, radiotherapy (radiation treatment), and chemotherapy (drugs to destroy cancer cells). Your treatment depends on the type of tumor you have, where it is located, and your general health^[9][14].

Surgery

Surgery is often the first step in treating a malignant brain tumor. The goal is to remove as much of the tumor as possible while leaving the surrounding healthy brain tissue intact. Neurosurgeons use imaging and mapping tools and delicate instruments to carefully remove the tumor^[14].

Surgery helps doctors confirm the diagnosis and informs what treatment will come next. Even after surgery, most malignant brain tumors can return, which is why additional treatment is usually needed^[12].

Radiation Therapy

Radiation therapy uses high-energy beams to destroy cancer cells in malignant tumors or slow down tumor growth. This treatment can target the tumor itself, nearby brain tissue, or in some cases, the whole brain^[9][14].

Chemotherapy

Chemotherapy uses drugs to destroy cancer cells. You might have chemotherapy for some types of brain tumors. These drugs work by stopping cancer cells from growing and dividing^[9][14].

Current treatment options at diagnosis are multimodal and include surgical removal of the tumor, radiation, and chemotherapy. Despite aggressive treatment, most malignant brain tumors recur^[12].

Living with a Malignant Brain Tumor

A brain tumor diagnosis is a life-altering event. There is no “right” way to feel. You may have days when you feel upbeat and positive, and other days when you feel that your world has caved in^[16].

Emotional Impact

Many people with a brain tumor report going through different emotional phases. All of these feelings are common and normal^[16][17]:

• Shock and feeling numb or confused
• Denial, acting as if nothing happened
• Anger and feeling that things are unfair
• Guilt, questioning past choices
• Anxiety and depression about the future
• Acceptance of the new reality^[16]

All sorts of feelings are likely to come and go. This is a natural part of coming to terms with the disease^[17]. Counseling can help reduce stress and improve your quality of life^[17].

Getting Support

Talking to your friends and relatives about your brain tumor can help and support you. However, some people are scared of the emotions this could bring up and won’t want to talk. Help your family and friends by letting them know if you would like to talk about what’s happening and how you feel^[17].

You might find it easier to talk to someone outside your own friends and family, such as your specialist nurse or other people in a similar situation. Support groups can be very helpful^[17][18].

Managing Physical Symptoms

Brain tumor treatment can cause a variety of symptoms that impact the way you feel and function. You may experience fatigue (a persistent sense of exhaustion that is different from ordinary tiredness), pain, difficulty communicating, thinking problems, and other challenges^[15][18].

Movement and activity are important for recovery, though more is not always better. Some people find that physical therapy helps them maintain independence and strengthen their body. Wellness activities like yoga, mindfulness, massage, and maintaining good nutrition can help release stress and make your body feel better^[18].

Despite the challenges, many individuals dealing with a brain tumor diagnosis can still maintain a good quality of life. Personalized supportive care and treatments, clear communication with your healthcare team, and a solid framework of emotional support from loved ones are key to living with this disease^[19].