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diagnosing and treatment of primary brain tumor like glioblastoma and brain metastases
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Brain Tumors
Brain metastases or primary brain tumors (glioma)
Treatment options Side effects of treatment
Brain metastases: cancer that started elsewhere in the body (e.g. lung or breast) and spread to the brain
Brain primary: a normal brain cell (glial cell) becomes malignant and is called a glioma
Brain Function
The most common causes of brain metastases in adults with their approximate frequency are:
Lung — 50 percent Breast — 15 to 20 percent Unknown primary 10 percent Melanoma — 10 percent Colon and rectum 5 percent
The distribution of metastases roughly follows the relative weight of and blood flow to each area.
Cerebral hemispheres — 80 percent Cerebellum — 15 percent Brain stem — 5 percent
SYMPTOMS OF BRAIN METASTASES
Symptom Patients % Headache 42 Focal weakness 27 Mental change 31 Seizure 20 Gait ataxia 17 Sensory disturbance 6 Speech problems 10
Brain Imaging
Whole brain irradiation
Whole brain radiation
The response or benefit from whole brain radiation takes several weeks to months
Typical response for whole brain radiation
Typical response for whole brain radiation
Typical response for whole brain radiation
Small tumors may be gone completely by two months
Radio resistant cancer (renal cell) MRI appearance two months after whole brain radiation (small lesions gone and large lesion much
smaller)
Cyberknife Radiosurgery for Brain Metastases
Typical time interval to regression after radiosurgery Cyberknife or Gamma Knife)
How often does brain radiation help?
• 70 -90% initial response • > 50% of symptoms of headache, CSF pressure have complete response • 50 -60% have functional improvement
moderate dysfunction: 1/3 near normal at median time of 3 weeks severe dysfunction: 2/3 improve at median of 1-2 weeks
Side Effects of Brain Radiation
1. Hair loss (usually takes two or three weeks to happen)
2. Mild skin itching or irritation
3. Short term more fatigue or slightly more confusion or memory problems
4. Mild headache or nausea is uncommon but may require medication (Decadron)
5. Occasionally hearing problems (fluid behind the ear drums)
Radiation prescription for #
Diagnosis: #
External radiation: #
Internal radiation: #