Brain Tumor

A brain tumor is an abnormal cell growth in the brain that can originate either directly from brain tissue or from cells of surrounding structures, such as blood vessels or the meninges. Brain tumors are generally divided into two main categories: benign and malignant tumors. Benign brain tumors often grow more slowly compared to malignant tumors and usually remain locally confined. However, due to their growth, they can exert pressure on adjacent brain tissue, leading to neurological abnormalities such as headaches, nausea, vision problems, or motor issues. In some cases, a benign tumor can be surgically removed without an increased risk of recurrence. Malignant brain tumors, on the other hand, those also referred to as brain cancer, are more aggressive and grow significantly faster. These tumors can invade surrounding tissue and cause damage to brain tissue, making treatment more difficult. They can also form metastases, easily spreading to other parts of the brain or body through the blood or lymphatic system.

Brain tumors can also be classified as primary or secondary tumors. Primary brain tumors originate directly in the brain, from different cell types. Examples of primary tumors include gliomas, meningiomas, or acoustic neuromas. Secondary tumors, on the other hand, are metastases that develop from the spread of other cancers. Common primary cancers that form metastases in the brain include breast, lung, and kidney cancer.

The incidence of brain tumors varies depending on age group and gender. In adults, brain tumors are more commonly a disease of middle and older age, with the diagnosis of malignant tumors like glioblastoma becoming more frequent nowadays. There are also gender-specific differences. Men are generally more often affected by certain tumors, while in women, tumors such as meningiomas occur more frequently. Early detection of the tumor is crucial, as it can significantly improve the prognosis of the disease. A tumor detected early can often be treated more effectively and offers the patient better chances of survival.

Brain tumors can be categorized into two types: Benign and malignant tumors.
Benign brain tumors grow slowly, do not spread to surrounding tissue, and are consequently easier to treat. Nevertheless, they pose a serious health risk and must be treated accordingly.
Malignant brain tumors typically grow quickly, spread to surrounding tissue, and have a significantly worse treatment prognosis. Additionally, they can metastasize and affect structures throughout the entire body.
In the following, we will examine the most important types of tumors in more detail.

Benign brain tumors are typically slow-growing cell formations in the brain or adjacent structures that, unlike malignant tumors, do not form metastases and rarely spread to surrounding tissue. They are often less life-threatening and can frequently be surgically removed. Nevertheless, their risk for complications strongly depends on their location. Even a benign tumor can lead to unpleasant symptoms by pressing on sensitive brain structures, nerves, or blood vessels. This can cause various symptoms such as headaches, vision problems, or neurological deficits. Typically, benign brain tumors grow very slowly over extended periods and often remain symptom-free for a long time. Since they do not spread throughout the body, they are often treatable and have a good prognosis. In many cases, complete recovery is possible, especially if the tumor can be surgically removed. Some benign tumors, however, do not require immediate treatment and are instead regularly monitored.

A commonly occurring benign brain tumor is the meningioma, which originates from the meninges, also called the brain membranes. Characteristic of meningiomas is their slow growth, which often allows them to remain undetected for a long time. Many affected individuals have no symptoms whatsoever, so the diagnosis is frequently made by chance. Only when the meningioma grows larger and presses on surrounding brain areas can symptoms appear. In such cases, surgery or radiation therapy is possible, particularly if the tumor is located in a surgically accessible area.

Another example is pituitary adenomas, which develop from the tissue of the pituitary gland. These tumors can influence hormone production and thereby cause diverse symptoms. Many affected individuals often experience vision problems, as the pituitary gland is located near the optic nerve. Depending on the type of adenoma, hormonal changes may also become noticeable. Classic hormonal changes can include weight gain, menstrual disorders, or excessive thirst. Treatment for pituitary adenomas often consists of endoscopic surgery performed through the nose. In some cases, however, medication therapy may be sufficient.

Another benign tumor is the acoustic neuroma, which develops from the sheath cells of the auditory and vestibular nerve. Although it is a benign tumor, it can cause significant problems due to its location. Early signs are often unilateral hearing loss or tinnitus, accompanied by dizziness and balance disorders. Depending on the size of the tumor, either regular monitoring, targeted radiation, or surgical removal of the tumor may be necessary.

In summary, benign brain tumors are often treatable and generally have a favorable prognosis. Life expectancy is not limited in most cases, as long as the tumor does not cause severe neurological problems.

Malignant brain tumors are particularly aggressive growths in the brain that develop rapidly, invade surrounding tissue, and are typically more difficult to treat. Unlike benign tumors, they don’t merely displace adjacent structures but infiltrate them. This often makes complete surgical removal of malignant tumors impossible. Many malignant brain tumors either originate from the brain itself or develop as metastases from other cancers. Due to their rapid and aggressive growth, symptoms frequently worsen very quickly. Depending on the tumor type and location, patients may suffer from persistent headaches, nausea, speech disorders, paralysis, or epileptic seizures. In many cases, the prognosis is unfavorable, as tumor cells often remain and continue to grow even after a combination treatment of surgery, radiation, and chemotherapy.

Glioblastoma is the most malignant and common primary brain tumor. It grows extremely fast and spreads into brain tissue like finger-shaped extensions, making complete removal nearly impossible in most cases. Glioblastomas are particularly treatment-resistant and usually recur despite intensive therapy. Life expectancy is therefore typically severely limited, as even with optimal treatment, most patients survive only a few months to years.

Another example is high-grade astrocytomas, which develop from neuronal support cells called astrocytes. While lower-grade astrocytomas grow relatively slowly, highly invasive forms are difficult to treat. They destroy healthy brain tissue, causing neurological deficits.

Medulloblastoma is another malignant tumor that primarily affects children. It originates from cellular structures in the cerebellum and can spread throughout the central nervous system via cerebrospinal fluid. Although medulloblastomas often respond well to intensive treatment, the therapy is extremely rigorous and frequently associated with significant long-term consequences.

Overall, malignant brain tumors often have a poor prognosis. Even with intensive treatment, many tumors recur, and life expectancy largely depends on the type, grade, and location of the tumor. Nevertheless, ongoing research advances may enable better therapeutic options in the long term.

Brain tumors comprise a diverse group of neoplasms in the brain that differ in their origin, location, and biological properties. In the following sections, we will explain in more detail the differences between benign and malignant brain tumors and which tumor types are typically represented in each category:

The most common malignant tumor originating from brain tissue is glioblastoma. It forms from glial cells, specifically astrocytes, and exhibits very aggressive growth with a correspondingly poorer prognosis.

Symptoms overlap with those of other brain tumors, with the perifocal edema (swelling in surrounding tissue) caused by the tumor further intensifying the symptoms.

The typical age of onset for glioblastoma is between 45 and 60 years.
Known risk factors include the rare inherited Lynch syndrome and Li-Fraumeni syndrome, which are also referred to as tumor predisposition syndromes.

Meningiomas are tumors that originate from the soft meninges and account for 15% of all brain tumors. The usual age of onset is between 40 and 60 years.

They grow slowly and remain asymptomatic for a long time, which can make diagnosis difficult. When meningiomas become symptomatic, visual field defects, epileptic seizures, or headaches are common signs.

After confirmed diagnosis, surgical removal is sought, which provides good to moderate prognoses depending on the tumor grade.

Astrocytoma is an umbrella term for various benign and malignant tumors of astrocytes that affect all age groups.

Symptoms can vary depending on the size, location, and grade of the tumor.
The prognosis depends on many factors, including tumor stage, location, and the selected treatment.

Oligodendroglioma is a primary tumor that originates from oligodendrocytes. Growth is often slow and locally confined, but there are also forms that grow rapidly and are highly malignant.

Typical symptoms are epileptic seizures and stroke, as the tumors often tend to hemorrhage, making immediate action essential. Classic symptoms of a brain tumor are also common.

Depending on malignancy, location, and size, survival prognoses vary.

Ependymoma is a tumor that originates from ependymal cells. These line the fluid-filled cavities of the brain, which play an important role in supplying nutrients to the brain and can be functionally impaired by the tumor.

If the tumor obstructs the flow of cerebrospinal fluid, it leads to signs of increased intracranial pressure such as nausea, vomiting, and restlessness. If the flow is not obstructed, the tumor remains asymptomatic for a long time.

Pituitary adenomas are benign tumors of the pituitary gland. The pituitary gland plays a central role in hormonal regulation circuits, which is why a tumor manifests in the dysregulation of these hormones.

Possible symptoms include growth disorders, disruptions in energy metabolism, exhaustion, and much more.

Compression of surrounding structures can also cause visual impairment.

Acoustic neuroma is a benign neoplasm on the 8th cranial nerve, the auditory and vestibular nerve. Correspondingly, the symptoms are hearing and, less frequently, balance disorders, as well as tinnitus.

The treatment of choice is surgical removal. If the neuroma is detected early, removal with preservation of hearing function is possible.

Dermoid cysts are benign tumors that originate from embryonic tissue. They can occur in the brain and frequently cause hearing disorders, facial muscle paralysis, or nerve pain.

After successful diagnostic differentiation from other tumors, complete surgical resection usually follows.

A prolactinoma is a benign, endocrine-active tumor of the anterior pituitary gland that produces hormones.

When considering symptoms, a distinction must be made between the consequences of increased prolactin production and symptoms caused by compression of surrounding tissues.

Elevated prolactin levels in women lead to absence of menstruation and ovulation, while in men they cause erectile dysfunction and loss of libido.
Additionally, the tumor can press on the optic nerve and lead to decreased hormone secretion in the rest of the pituitary gland, resulting in corresponding symptoms.

After confirming the diagnosis, treatment is usually medication-based to lower prolactin levels. In some cases, surgery may be necessary.

Medulloblastomas are the most common primary malignant brain tumors in children. They arise from embryonic cells of the central nervous system and in most cases affect the cerebellum.

Classic symptoms include nausea, coordination problems, vision disturbances, and drowsiness, which typically appear early due to rapid growth.

Conventional treatment involves surgical removal followed by radiation to prevent recurrence.

As a result, nearly 80% of tumors can be removed and children completely cured.

A Rathke’s cleft cyst is a benign remnant from early brain development that, when sufficiently large, can exert pressure on surrounding structures and necessitate removal.

When pronounced, the cyst can cause headaches, vision problems, and hormonal imbalances.

First, it should be confirmed that it is indeed a cyst and that no growth is observed over an extended period. Subsequently, the cyst is surgically removed, and symptoms disappear.

A schwannoma is a benign tumor that develops from Schwann cells in the brain. Schwann cells surround nerves and are critical for nerve signal transmission. The auditory and vestibular nerves are frequently affected by schwannomas, referred to as acoustic neuromas. Therefore, symptoms such as hearing loss, dizziness, and balance disorders often occur. Depending on the location, other nerves may also be affected, leading to numbness or pain. Treatment typically consists of surgery or targeted radiation therapy.

A CNS lymphoma is a malignant tumor that develops in the central nervous system, specifically in the brain or spinal cord. It develops from specialized immune cells called lymphocytes. Affected patients often suffer from symptoms such as headaches, vision problems, mental confusion, or in severe cases, paralysis. Lymphomas are particularly dangerous for people with weakened immune systems. Conventional therapy for CNS lymphoma consists of a combination of radiation and chemotherapy.

A hemangioblastoma is a relatively rare, benign tumor that develops from the blood vessels of the central nervous system. Most commonly, it affects the cerebellum or spinal cord. Therefore, typical symptoms often include headaches, coordination problems, and in some cases, fluid accumulation in the brain. Hemangioblastomas frequently occur as part of von Hippel-Lindau disease, making a thorough assessment essential. Treatment typically consists of surgical removal of the tumor, as its growth can displace adjacent brain structures and lead to severe neurological deficits.

A craniopharyngioma is a benign brain tumor that grows near the pituitary gland and therefore often leads to hormonal disorders. In addition to hormonal symptoms such as growth disorders, visual disturbances and headaches may also occur. Due to the tumor’s proximity to important structures, treatment can often be challenging and usually consists of surgery, frequently combined with additional radiation therapy. Despite its benign nature, craniopharyngioma can have long-term consequences for hormonal regulation.

Brain metastases are cancer cells that have detached from their original tumor elsewhere in the body and settled in the brain. They commonly occur as a consequence of advanced cancers in other organs such as the lungs, breast, colon, or skin.

Once these metastases establish themselves in the brain, they can exert pressure on the surrounding tissue and lead to various neurological symptoms, including headaches, visual disturbances, seizures, motor problems, or changes in thinking and behavior.

Treatment always depends on the specific location, tumor type, and patient needs.

In most cases, brain tumors develop from a combination of various factors that promote the growth of abnormal cells in the brain. The exact causes of cancer can therefore be very diverse and attributed to several typical factors:

A brain tumor can cause a variety of symptoms, ranging from non-specific complaints such as headaches and dizziness to neurological deficits. The type and intensity of symptoms usually depend on the size, growth rate, and exact location of the tumor in the brain. Since the brain controls various important functions such as movement, speech, perception, and emotions, tumors can cause different symptoms depending on the affected area.

Since many of these symptoms can have other underlying causes, early medical evaluation is particularly crucial. Especially when symptoms persist or worsen, a thorough neurological examination should be performed.

The diagnosis of a brain tumor is built upon a thorough medical examination, as symptoms are often non-specific and can also occur in other diseases. To provide clarity, various diagnostic procedures are used to identify a tumor, precisely determine its location, and plan the best possible therapy. Modern imaging techniques play a central role in the diagnosis of brain tumors. They enable a detailed visualization of the brain to better assess the size, location, and possible effects of the tumor on adjacent structures.

MRI is the most important procedure for diagnosing a brain tumor. The so-called contrast-enhanced MRI is particularly sensitive, making differences between healthy and pathological tissue more visible. MRIs are generally especially helpful in visualizing soft tissue, such as the brain.

CT scans are often used as the first examination, particularly in emergencies or when a quick diagnosis is needed. A CT can show calcifications, bleeding, or larger tumors, but is less detailed than an MRI. By administering contrast agents in CT scans, the blood flow of a tumor can be assessed and determined in more detail. This allows doctors to evaluate whether important blood vessels are affected.

Positron emission tomography (PET scan) is also very frequently used in cancer diagnostics. This method measures the precise metabolism of cells and, due to the high metabolic rate of cancer cells, can particularly well identify active tumor cells. It is mainly used to differentiate between benign and malignant tumors and for monitoring after therapy.

To determine the type of tumor, a tissue biopsy is often taken. The biopsy can be performed either during surgery or using a thin drill hole in the skull. Microscopic examination of the tissue can provide important information about the cell type, tumor grade, and possible genetic changes. All this information is crucial for adjusting the right therapy.

Although there are no classic tumor markers in the blood for brain tumors, certain laboratory values can provide more precise indications of the disease:

In addition to general diagnostic methods, there are also other special tumor markers that can be detected in tissue examination. One such marker is often synaptophysin, which is particularly detected in neuroendocrine and neuronal tumors such as medulloblastomas and neurocytomas.

While classic blood tests can provide only limited information about brain tumors, neurological examinations play a crucial role in precise classification and therapy planning, along with special tumor markers in the biopsy. Therefore, in addition to imaging techniques, neurological tests are also performed to identify possible impairments of brain function:

These tests help to more precisely localize the affected brain areas and can provide clues about the possible location of a tumor.

Through the combination of these diagnostic procedures, a good foundation is established for early detection of a brain tumor, determining its exact location, and assessing its aggressiveness.

Magnetic Resonance Imaging (MRI) is the method of choice when it comes to detecting changes in brain tissue, calculating volumes, and measurably assessing the blood flow of suspicious structures.
Additionally, it has the advantage of not exposing the patient to radiation and can reliably detect even the smallest changes more effectively than CT scans.

CT scanning, a procedure in which multiple X-ray images of the brain are taken, also provides the ability to detect tumors in brain tissue and has the advantage of better identifying calcifications in tumors compared to MRI. Therefore, it is typically used in addition to MRI, although it does involve radiation exposure for the patient.

PET is another imaging technique in which radioactive tracers are administered that distribute throughout the brain and accumulate more strongly in some structures than others. This makes it possible to detect tumors and also make assessments about the metabolism and malignancy of the tumor.
It is less widely available and is therefore usually employed when there is a specific suspicion.

Angiography is a diagnostic procedure that enables visualization of blood vessels. This allows for assessments about the blood supply to the tumor and gathering important information for surgical planning.
However, since the examination involves radiation exposure and also carries a risk of complications due to the administration of contrast agents, it is only used when there is a specific indication.

Cerebrospinal fluid diagnostics is an invasive procedure in which cerebrospinal fluid is extracted via puncture and examined in the laboratory for changes in composition.
This diagnostic method can be used to detect tumor markers, cells, or blood in the cerebrospinal fluid and increased cerebrospinal fluid pressure. This allows for specific statements about the type of tumor, metabolism, or malignancy.
It also serves to differentiate from inflammatory brain diseases, which can sometimes cause similar symptoms.

The electroencephalogram (EEG) is an important examination method for assessing the electrical activity of the brain. In brain tumors, the EEG can show certain changes in brain activity that may indicate the presence of a tumor or associated epileptic seizures.
However, it is not sufficient to make a definitive diagnosis and is always performed in combination with other examinations.

The treatment of a brain tumor often requires an interdisciplinary approach that is tailored to the individual type of tumor, its location, size, and the patient’s overall health. Treatment methods are divided into conventional and complementary medical approaches, which can sometimes be applied in parallel or as supplements to each other in order to achieve the best possible results.

Conventional treatments for brain tumors primarily consist of surgical interventions, radiation therapy, and chemotherapy. One of the most common treatment options for brain tumors is surgical removal of the tumor. The goal here is to completely remove the tumor when possible. However, the decision for surgery depends on factors such as the location of the tumor, its accessibility, and the potential impairment of adjacent brain structures. In some cases, it may only be possible to remove part of the tumor to relieve symptoms through decompression or to reduce the tumor size. However, brain surgeries always carry risks such as infections, bleeding, or neurological deficits.

When a tumor is classified as inoperable, radiation therapy is often used as the primary therapy. This involves using high-energy radiation to destroy tumor cells or inhibit their growth. Radiation therapy is particularly helpful for tumors located in difficult-to-access areas of the brain or where surgery is deemed too risky. In some cases, it is also used as a supplementary treatment after surgery to treat remaining tumor cells and thus reduce the risk of recurrence.

For certain tumors, such as glioblastomas or other malignant brain tumors, chemotherapy is frequently used. This treatment utilizes medications that destroy tumor cells through various mechanisms or inhibit their proliferation. Chemotherapy can be administered systemically so that the medications reach the entire body and can also treat metastases. For brain tumors, chemotherapy is particularly challenging due to the blood-brain barrier, which makes it difficult for many medications to access the tumor.

In addition to classical treatment methods, there is a range of complementary medicine approaches that can effectively support tumor therapy and improve patients’ quality of life.

Hyperthermia and Active Fever Therapy: In hyperthermia, tumor tissue is damaged through a controlled increase in body temperature, which can significantly enhance the effect of conventional therapy, especially radiotherapy and chemotherapy. It can be differentiated into:

Active fever therapy, on the other hand, deliberately employs higher temperatures to activate the body’s own immune system and weaken tumor cells. Both methods aim to support the body in fighting the tumor.

Mistletoe Therapy: Mistletoe therapy is among the most frequently used complementary methods in cancer treatment. The goal of mistletoe therapy is to stimulate the immune system, influence inflammatory responses, and potentially promote programmed cell death of tumor cells. Mistletoe therapy is generally used as a supportive adjunctive therapy. Studies suggest that it can help improve the quality of life for cancer patients by alleviating fatigue, nausea, and pain, as well as enhancing overall well-being.

Photodynamic therapy is a procedure in which a medication is administered that accumulates in tumor tissue and can be activated by laser light. In its activated form, it becomes toxic to tumor tissue and causes the tumor to die off.
Advantages include targeted cell destruction and minimal side effects. Before application, it must be carefully assessed whether this approach is effective for the specific brain tumor.

Another important approach in complementary therapy is immune stimulation, which aims to strengthen the body’s immune system to more effectively combat tumor cells. Common methods include mistletoe therapy, which uses substances from the mistletoe plant, and ozone therapy, which stimulates the immune system through the formation of ozone. Both therapies have shown positive effects on patient well-being in practice and are used as supportive treatments.

Acupuncture has proven to be a helpful method for alleviating pain, improving quality of life, and enhancing the general well-being of tumor patients. By placing needles at specific points on the body, acupuncture can restore balance and address symptoms such as nausea, sleep disorders, or fatigue.

Adapted nutrition plays a central role in the treatment of brain tumors. Orthomolecular medicine focuses on the targeted intake of vitamins, minerals, and other nutrients that can support the body and immune system. Studies indicate that a diet rich in antioxidative nutrients such as vitamin C, vitamin E, selenium, anti-inflammatory omega-3 fatty acids, and sufficient protein can promote better recovery after cancer therapy. Particularly important is vitamin D, which demonstrably supports the immune system and may potentially slow cancer progression.

The combined application of conventional and complementary medical approaches offers an integrative approach to treating brain tumors. It is therefore of great importance that patients and physicians jointly select individually appropriate therapies.

Psycho-oncological care plays a significant role in dealing with the diagnosis and treatment of a brain tumor. It helps patients cope with emotional and psychological burdens such as anxiety, depression, and uncertainty, and improves quality of life during therapy. Psychological support can also have positive effects on the course of the disease as it encourages participation in treatments and reduces stress. Possible forms of care include individual therapy, group therapy for exchange with other affected individuals, and relaxation techniques for stress management. Family counseling and psychosocial counseling are also important to support both patients and their relatives and to help manage the challenges of everyday life.

The prognosis and chances of recovery for a brain tumor depend on various factors, such as the tumor stage, tumor type, and time of diagnosis. Tumors diagnosed early often have a better prognosis as they can be treated sooner. Benign tumors generally have better chances of recovery as they grow more slowly and can often be completely removed. Malignant tumors, on the other hand, are often more aggressive and difficult to treat, which can significantly limit the chances of recovery. Tumors in the end stage, such as glioblastoma (grade 4), have a significantly lower life expectancy, even though therapies such as surgery, radiation therapy, and chemotherapy are still used to slow growth and alleviate symptoms.

In the end stage of a brain tumor, treatment usually focuses on relieving symptoms and improving quality of life. Pain therapy, palliative medicine, and psychosocial support are therefore used to make the patient’s continued life as comfortable as possible. Although a cure is generally no longer possible in advanced stages, palliative treatment can help reduce pain and discomfort and give patients more quality of life.

In the following, we want to address your questions about brain tumors in more detail.

The information listed contains relevant topics and serves to improve understanding.