Brain Tumor

A brain tumor can be either a benign or malignant neoplasm that grows within the skull bone. It can develop in the brain tissue itself (primary) or migrate through metastases from other tissues (secondary).
Due to the limited space available in the skull, the tumor displaces healthy nerve tissue and triggers a wide variety of symptoms.

The treatment of brain tumors depends largely on the type of tumor, individual needs and its proximity to vital structures.

The symptoms of a brain tumor depend on its location and the tissue that is affected.

There may be mild symptoms such as diffuse headaches, nausea and vomiting or dizziness, but also more dangerous manifestations such as sudden seizures, paralysis, speech disorders or loss of vision and hearing.
Other possible symptoms include impaired memory and concentration and changes in personality.

Brain tumors can be divided into two categories: benign and malignant tumors.

Benign brain tumors grow slowly, do not spread to surrounding tissue and are therefore easier to treat. Nevertheless, they pose a serious health risk and must be treated accordingly.

Malignant brain tumors usually grow quickly, spread to surrounding tissue and have a much poorer prognosis for treatment. They can also metastasise and affect tissues throughout the body.

Below we take a closer look at the most important types of tumor.

The most common malignant tumor that arises from brain tissue is glioblastoma. It forms from glial cells, or more precisely astrocytes, and is characterised by very aggressive growth and a correspondingly poor prognosis.
Symptoms overlap with those of other brain tumors, although the perifocal oedema (swelling in the surrounding tissue) caused by the tumor also worsen the symptoms.

The typical age of onset of a glioblastoma is between 45 and 60 years. Known risk factors to date include the rare inherited Lynch syndrome and Li-Fraumeni syndrome, which are herefore called tumour 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, they often cause visual field loss, epileptic seizures or headaches.

Once the diagnosis has been confirmed, the aim is to surgically remove the tumor, which has a good to moderate prognosis depending on the tumor grade.

Astrocytoma is a generic term for various tumors of the astrocytes, both benign and malignant, which affect all age groups.
Symptoms can vary depending on the size, location and grade of the tumor.
The prognosis depends on many factors, including the stage of the tumor, its location and the treatment selected.

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

Typical symptoms are epileptic seizures and strokes, as the tumors often tend to bleed into the brain, which makes acute action essential. However, classic symptoms of a brain tumor are also common.
The survival prognosis varies depending on the malignancy, location and size of the tumor.

Ependymoma is a tumor that originates from the 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 restricted in their function by the tumor.

If the tumor obstructs the outflow of cerebrospinal fluid, signs of intracranial pressure such as nausea, vomiting and restlessness occur. If the outflow is not obstructed, the tumour remains symptom-free for a long time.

Pituitary adenomas are benign tumors of the pituitary gland. The gland plays a central role in hormonal control circuits, which is why a tumor manifests itself in the dysregulation of these hormones.
Possible symptoms include growth disorders, energy balance disorders, exhaustion and much more.
Moreover, if surrounding structures are compressed, loss of vision is also possible.

An acoustic neuroma is a benign neoplasm on the 8th cranial nerve, the auditory and vestibular nerve. Accordingly, the symptoms are hearing and, more rarely, balance disorders and tinnitus.

The treatment of choice is surgical removal. If the neurinoma is recognised early, it is possible to remove it while retaining hearing function.

Dermoid cysts are benign tumors that arise from embryonic tissue. They can occur in the brain, among other places, and often cause hearing disorders, paralysis of the facial muscles or nerve pain.

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

Prolactinoma is a benign, endocrine-active, i.e. hormone-producing tumors of the anterior lobe of the pituitary gland.

In terms of symptoms, a distinction must be made between the consequences of increased prolactin production and the symptoms caused by displacement of the surrounding tissue.
In women, the increased prolactin levels lead to missed periods and ovulation, while in men it leads to impotence and loss of libido.

In addition, the tumor can press on the optic nerve and lead to reduced hormone secretion in the rest of the pituitary gland, which then results in corresponding symptoms.

Once the diagnosis has been confirmed, the tumor is usually treated with medication to reduce the prolactin level. In some cases, surgery may be necessary.

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

Classic symptoms are nausea, coordination disorders, visual disturbances and drowsiness, which usually become apparent early due to rapid growth.

Conventional treatment involves surgical removal followed by radiotherapy to prevent recurrence.
As a result, almost 80% of tumors can be removed and the children completely cured.

A Rathke cyst is a benign remnant from early childhood brain development which, if large enough, can exert pressure on surrounding structures and necessitate removal.

If the cyst is large enough, it can cause headaches, visual disturbances and hormonal imbalances.

Firstly, it should be ensured that the cyst is a cyst and that no growth can be observed over a longer period of time. The cyst is then surgically removed and the symptoms disappear.

Brain metastases are cancer cells that have detached from their original tumor elsewhere in the body and have settled in the brain. They often develop as a result of advanced cancer in other organs such as the lungs, breast, intestines or skin.
Once these metastases settle in the brain, they can exert pressure on the surrounding tissue and lead to various neurological symptoms such as headaches, visual disturbances, seizures, motor problems or changes in thinking and behavior.

Treatment always depends on the location, the type of tumor and the patient’s needs.

Diagnosis is based on a variety of procedures, including anamnesis interviews, imaging, physical examination and the determination of tumor markers in the blood and cerebrospinal fluid.

Depending on the type of tumor, different procedures are suitable for identifying both the localisation and possible spread to surrounding structures and consequently planning the appropriate therapy.

Magnetic resonance imaging (MRI) is the method of choice when it comes to detecting changes in brain tissue, calculating volumes and measuring the blood flow to suspicious structures.

It also has the advantage that the patient is not exposed to radiation and even the smallest changes can be detected more reliably than with CT.

CT, a procedure in which a large number of X-ray images of the brain are taken, also makes it possible to detect tumors in the brain tissue and has the advantage that calcifications of tumors are better detected than in MRI. It is therefore generally used in addition to an MRI, even though the patient is exposed to radiation.

PET is another imaging technique in which radioactive tracers are administered. These are distributed in the brain and accumulate more in some structures than in others. This makes it possible to locate tumors, but also to make statements about the metabolism and malignancy of the tumor.

It is less widely available and is therefore generally used in cases of concrete suspicion.

Angiography is a diagnostic procedure that allows the vessels to be visualised. This allows important information to be gathered about the blood supply to the tumor for surgical planning.

However, the examination is associated with radiation exposure and a risk of complications due to the administration of contrast medium. Therefore, it is only used if there is a special indication.

CSF diagnostics is an invasive procedure in which cerebrospinal fluid is extracted by means of a puncture and analysed in the laboratory for changes in its composition.

CSF diagnostics can be used to diagnose tumor markers, cells or blood in the CSF and increased CSF pressure. This allows specific statements to be made about the type of tumor, metabolism or malignancy.

It is also used to differentiate between 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 the case of brain tumors, the EEG can reveal 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 carried out in combination with other tests.

The treatment strategy for brain tumors depends largely on the type of tumor, its location and the patient’s state of health.

The basic aim is to remove the tumor as quickly and completely as possible in order to minimise compression of surrounding structures and thus avoid long-term damage.

Classic procedures include surgical removal, radiotherapy and chemotherapy, but hyperthermia and photodynamic procedures can also be used.

Below we take a closer look at the various procedures.
It is recommended that the possible treatment options are discussed as part of a comprehensive disciplinary collaboration between neurologists, oncologists, surgeons and holistic physicians. This ensures an integrative approach that is tailored to the individual needs of the patient.

The removal of a brain tumor by neurosurgeons requires precise knowledge of the size and type of tumor, surrounding structures and supplying vessels.

If surgery is indicated, the tumor can be resected quickly while sparing the surrounding tissue.

The aim of radiotherapy is to provoke mutations in the tumor tissue that lead to the death of the tissue.
It is used either as a primary treatment or prior to surgery to shrink the tumor and make the operation easier.

Depending on the type of tumor and its location, the radiation source can be used to a greater or lesser extent and may require several sessions over a longer period of time. The side effects should always be taken into account when making a decision.

Chemotherapy is another procedure that is often used in combination with surgery or radiotherapy to improve the prognosis and combat metastases.

Depending on the tumor, different chemotherapeutic agents are used, which can achieve very different successes and side effects depending on the individual.

Photodynamic therapy is a procedure in which a drug is administered that accumulates in the tumor tissue and can be activated by laser light. In its activated form, it is toxic to the tumor tissue and causes the tumor to die.

The advantages are the targeted cell destruction and the low side effects. Before use, it must be carefully checked whether the application is effective for the brain tumor in question.

Hyperthermia involves exposing the tumor tissue to elevated temperatures up to 113°F . This damages and kills cancer cells with little or no harm to normal tissue. Hyperthermia is used in combination with other cancer treatments, such as chemotherapy and radiation therapy, to optimise the prognosis.
It is crucial that hyperthermia is embedded in an individually customised treatment concept in order to achieve the best possible effect.

The development of a brain tumor can also be caused by a deep physical imbalance. These causal factors can also be included in the therapy.
For example, hidden metabolic disorders and micronutrient deficiencies (e.g. omega-3 fatty acids or vitamin D3) may be present and weaken the body. Hidden inflammations (silent inflammation), immune disorders and intestinal diseases can also be causal factors.
Methods such as orthomolecular medicine, intestinal cleansing and normalisation of the immune system can also support treatment.

Life expectancy and chances of recovery cannot be predicted, as they vary considerably depending on the type of tumor and depend heavily on the treatment measures selected.

In addition, brain tumors are usually detected late and have already grown into the surrounding tissue, making complete removal impossible.

Nevertheless, there are also benign brain tumors that are completely curable and leave no symptoms after treatment.

In order to make a more accurate prediction, the attending physician must further narrow down the type of tumor and rule out possible metastasis.

Brain tumors can be a considerable burden for those affected, not least because of the great uncertainty and unanswered questions they face.

In the following, we will address the most frequently asked questions about brain tumors.

If you have any further questions, you should contact your doctor.

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