About Brain Tumors

The brain is the center of thought, memory, emotion, speech, sensation and motor function. The spinal cord and special nerves in the head called cranial nerves carry and receive messages between the brain and the rest of the body.

• There are two types of brain tumors:
  • Primary — a tumor that starts in the brain. Primary brain tumors can be benign (noncancerous) or malignant.
  • Metastatic — a tumor caused by cancer elsewhere in the body that spreads to the brain. Metastatic brain tumors are always cancerous.
• Primary tumors in the brain or spinal cord rarely spread to distant organs.
• Brain tumors cause damage because as they grow they can interfere with surrounding cells that serve vital roles in our everyday life.

General Risk Factors for Brain Tumors

Most brain and spinal cord tumors have no known risk factors and occur for no apparent reason. There are no known proven ways to prevent these tumors.

Facts about Brain Tumors

• The Central Brain Tumor Registry of the United States estimates that more than 40,000 Americans will be diagnosed with a primary brain tumor this year.
• This year, an estimated 170,000 Americans will be diagnosed with a brain or spinal cord tumor that has spread from another part of the body.

Signs of Brain Tumors

No blood test or other screening exam can detect brain tumors, but there are often some outward signs. While tumors in different parts of the central nervous system disrupt different functions, some symptoms include:

• Headaches.
• Nausea/vomiting.
• Seizures.
• Weakness or numbness on one side of the body.
• Changes in vision, hearing or sensation.
• Difficulty with speech.
• Lack of coordination.
• A change in mood or personality.
• Memory loss.

Diagnosing Brain Tumors

If you suffer from any of the initial signs of a brain tumor, your doctor will likely conduct some or all of the following tests:

• A physical exam to determine your overall health.
• A neurologic exam to evaluate brain and spinal cord function.
• Imaging studies, such as CT, MRI or PET scans, to look for signs of a brain tumor.
• If studies or scans indicate you might have a brain tumor, some tissue may be taken from the tumor to make an exact diagnosis. This test is called a biopsy.
• A spinal tap may also be performed to look for tumor cells. During this test, a needle is placed in the lower back to obtain a sample of cerebrospinal fluid. This fluid is then examined to see if tumor cells are present.

Treating Brain Tumors

If doctors determine that you have a tumor, the treatment options and prognosis are based on the following factors:

• Tumor type.
• Location and size of tumor.
• Tumor grade (how abnormal the cells are).
• Your age, medical history and general health.

Understanding Radiation Therapy

Radiation therapy, sometimes called radiotherapy, is the careful use of radiation to safely and effectively treat many different kinds of tumors.

• Doctors called radiation oncologists use radiation therapy to try to kill tumors, to control tumor growth or to relieve symptoms.
• Radiation therapy works within tumor cells by damaging their ability to multiply. When these cells die, the body naturally eliminates them.
• Healthy cells near the tumor may be affected by radiation, but they are able to repair themselves in a way tumor cells cannot.

Radiation Therapy Options for Brain Tumors

People with brain tumors should discuss treatment options with several cancer specialists, including a radiation oncologist. A radiation oncologist is a doctor who will help you understand the types of radiation therapy available to treat your tumor. Conventional radiation therapy treatment options for brain tumors include:

• External beam radiation therapy.
• Brachytherapy or internal radiation therapy.

Facts About Breast Cancer

Breast cancer is the most common type of cancer in American women, according to the American Cancer Society.

• Each year, nearly 216,000 women and 1,500 men learn they have breast cancer.
• Another 59,000 women learn they have in situ or noninvasive breast cancer.
• Nearly 40,000 women will die from breast cancer each year.

Risk Factors for Breast Cancer

Most women who develop breast cancer do not have known risk factors, but some factors may increase the chance of developing this disease. One of these risk factors is age — more than 75 percent of women diagnosed with breast cancer are over age 50. Other factors include:

• Early onset of menstruation.
• Family history of breast cancer in your mother or sister.
• Hormone replacement therapy with estrogen and progesterone.
• Alcohol consumption.
• A personal history of breast cancer or prior breast biopsy for benign disease.

Diagnosing Breast Cancer

Breast tumors are typically, but not always, painless, so it is important to have any breast or underarm lump checked. Swelling, discoloration, thickening of the skin or nipple discharge also should be checked immediately.

• In some cases, a biopsy to determine if you have breast cancer will be done in an office setting using a needle to remove cells from the lump.
• A stereotactic biopsy uses mammography targeting to pinpoint smaller tumors and permit a small amount of tissue to be removed by a needle for diagnosis.
• Your surgeon may suggest removing the lump to see if you have cancer.

Types of Breast Cancer

The breast is made up of ducts and lobules surrounded by fatty tissue.

• Cancer confined within a duct is called ductal carcinoma in situ (DCIS). Lobular carcinoma in situ (LCIS) is cells confined to a lobule.
• Tumors that break through the wall of the duct or lobule are called infiltrating ductal or infiltrating lobular carcinomas.
• Inflammatory breast cancer may involve the entire breast with specific skin changes and swelling.

Breast-conserving Surgery

Studies have shown that women with early-stage breast cancer who have a lumpectomy to remove the cancer followed by radiation live just as long as women who have a mastectomy and may be preferred by many women. The standard of care after breast-conserving surgery is external beam radiation therapy. Often, this follows chemotherapy.

• Your surgeon will perform an operation called a lumpectomy, also called a partial mastectomy, excisional biopsy or tylectomy, to remove the tumor. In some cases, a second operation called a re-excision may be needed if microscopic examination finds tumor cells at or near the edge of the tissue that was removed (called a positive or close margin).
• To see if your cancer has spread, your doctor may remove several lymph nodes from under your arm (axilla). If any of these nodes contain cancer cells, more nodes may be removed.
• Breast-conserving surgery is not suitable for all breast cancer patients. Talk with your surgeon to see if this is the best procedure for you.

After Mastectomy Radiation

In cases where the breast is surgically removed, your doctor may suggest radiation therapy for the chest wall and nearby lymph node areas.

• Whether or not radiation therapy should be used after removal of the breast depends on several factors, including the number of lymph nodes involved, tumor size and surgical margins.