The Brain tumors Y Medullar Are a type of pathology characterized by abnormal tissue formation in both the brain and spinal cord (National Institute of Cancer, 2015).
Although the body of knowledge about this type of neoplasia has progressed considerably in recent decades and therefore the survival of patients has increased, the prognosis has not changed significantly.
Therefore, in their treatment, traditional approaches continue to be used: surgery, radiotherapy , chemotherapy And introduction of new drugs (Lafuente-Sánchez, 2002).
What is a brain or spinal tumor?
A tumor is an abnormal accumulation of cells that form a mass (National Institute of Neurological Disorders and Stroke, 2016).
Cells are the basic structural and functional units for humans. When our body functions in a coordinated way and Normalized, the normal development path is the formation of new cells that replace old or damaged cells. However, the cells also Can begin to grow abnormally, forming a tumor (Johns Hopkins Medicine, 2016).
This uncontrolled development of cells is due to a mutation or injury of genes responsible for the regulation of cell growth and death (National Institute of Neurological Disorders and Stroke, 2016).
When genetic regulatory mechanisms do not work optimally, cells can begin to grow and divide uncontrollably and for Both to form tumors in any body zone (National Institute of Neurological Disorders and Stroke, 2016).
These masses or tumors will cause damage at the neurological level, both because of the pressure they can exert on other brain and spinal structures By the propagation of this one through the different areas (Johns Hopkins Medicine, 2016).
Are all brain and spinal tumors going to cause neurological damage?
In general, all tumors regardless of where they are located may be classified as benign or malignant (Johns Hopkins Medicine, 2016):
- Benign tumor : It is a non-cancerous cell mass that grows slowly and localized, does not expand towards other areas. The cells that make up this tumor are similar to the non-pathological ones and are usually removed surgically without ever reappearing. It can damage and compress brain areas, when located in vital areas they can be life-threatening Johns Hopkins Medicine, 2016).
- Malignant tumor : It is a mass composed of cancer cells, they usually grow faster and more globally and expand To other areas. In addition to the use of surgery, chemotherapy and radiation therapy are often used. In general, malignant tumors Seriously threaten the life of the person who has Johns Hopkins Medicine, 2016).
Regardless of whether it is a benign or malignant tumor, all masses that grow in or invade brain tissue are potentially capable of damaging The different neurological functions.
Although some of the brain tumors can spread to other areas of the body, most of them have to propagate between neural tissue, both Malignant as benign tumors (Johns Hopkins Medicine, 2016).
Depending on the type, tumors can cause different events at the brain and spinal (National Institute of Neurological Disorders and Stroke, 2016):
- Damage or destroy healthy cells.
- Harm or disrupt the function of healthy cells.
- You can move or push the surrounding tissue.
- They can block the blood flow causing inflammation, obstruction, hypoxia, among others.
- It can block the flow of neural information by damaging entry or exit pathways.
Although the most frequent is the appearance of a broad symptomatology, cases have also been documented in which the presence of a brain tumor or Medullary is asymptomatic.
Types of Brain and Spinal Tumors
Clinical and experimental reports have identified more than 120 types of brain and spinal tumors. All these types can be classified by Place of origin and expression; By the type of cells that originate them and / or by the specific location in which they are found (National Institute of Neurological Disorders and Stroke, 2016).
Normally in the scientific literature depending on the origin and expansion of this type of tumors, we speak of primary or metastatic tumors:
Primary tumor
The cells begin to grow locally in the SNC . They can be benign or malignant and are given Preferably in adults (National Institute of Neurological Disorders and Stroke, 2016). The most prevalent are Meningiomas and the Gliomas Johns Hopkins Medicine, 2016).
Metastatic tumor
The cancerous or malignant primary tumor is generated in another part of the body and expands into regions Of the central nervous system (National Institute of Neurological Disorders and Stroke, 2016).
Approximately 50% of metastatic brain and spinal tumors are Lung cancer , Although they can also be derived from (National Institute of Cancer, 2015): Melanomas , Breast cancer , kidney cancer Y Nasopharyngeal cancer .
Depending on the type of original cell or part of the brain or marrow where the National Institute of Neurological Disorders (2016) Highlights some of the most prevalent types both in children and adults:
Gliomas
Tumors are derived from Glial cells (Cells that support the different neuronal functions). They usually appear in Cerebral hemispheres and in other areas such as optic nerve , he Brain stem Or in the cerebellum . We can perform a classification of gliomas in Function of which type of glial cell is affected:
- Astrocytomas : They develop from the astrocytes. They are the cause of approximately 50% of CNS tumors. The most Common are: anaplastic astrocytoma, polycytic astrocytoma, glioblastoma multiforme.
- Ependymomas : They develop from the cells that line the aqueducts and cerebral cavities and the spinal canal, where Produces and stores the cerebrospinal fluid. It is usually benign.
Other tumors that may appear include:
Chordomas
It is developed in the spine , Are usually congenital and can invade both the spinal canal and the brain.
Choroid plexus papillomas
It essentially affects the production of cerebrospinal fluid, increasing its production or blocking Normal flow.
Craniopharyngiomas
They usually grow in the brain base, in regions close to the pituitary gland , optic nerve And weaving surrounding. It is usually of the congenital type.
Neuroepithelial Neoepithelial Tumors
They usually develop in the upper half brain, although they are usually beningos, Cause a significant number of seizures.
Germ cell tumors
They develop from cells that do not migrate during the development of the CNS to differentiate into a Specific body. Generally they are to be formed in the interior of the encephalon, near the Pineal gland And may expand into other brain areas And medullar. Depending on the type of germ cell that originates, we can find Teratomas , Embryonic carcinomas and Germinomas .
Meningiomas
They develop in the membranes that protect the brain and spinal cord , the Meninges . Generally benign and not Usually invade adjacent tissues.
Neuroectodermal primitive tumors
They usually develop from primitive or immature cells that are present during the Development of NS. It can spread throughout the brain and spinal cord irregularly. There are two very common types:
- Medulloblastomas : Present in more than 25% of childhood brain tumors. They are normally generated in the brain and can Spread throughout the entire spinal cord.
- Neuroblastomas : Tend to develop above the Kidney glands , But can be located in other brain areas and Medullar
Vascular Tumors
They develop in the blood vessels that supply the brain and spinal cord.
Symptoms of brain and spinal tumors
As we have seen there is a wide variety of tumors, therefore the symptoms will vary depending on the location of the tumor. In addition, the size And the rate of growth will also determine the clinical course of symptomatology (Johns Hopkins Medicine, 2016).
Some of the most common symptoms that may appear are (Johns Hopkins Medicine, 2016):
- Headache or headache .
- Episodes of seizures.
- Difficult to focus Or talk.
- Changes in personality.
- Behavioral changes.
- Weakness or paralysis of a particular part of the body or of a complete side.
- Hearing loss.
- Loss of vision
- Confusion and disorientation.
- Forgetfulness and memory loss.
Often these symptoms are classified depending on whether the origin is in a brain or spinal tumor (National Institute of Cancer, 2015):
- Symptoms of brain tumors: D Morning head odor that is relieved by vomiting; convulsive crisis; Problems or difficulties of vision, hearing or speech; Loss of appetite; sickness And recurrent vomiting; Changes in personality, State of mind , Behavior or ability to concentrate; Loss of balance or difficulty in walk; Weakness and exaggerated sleepiness (National Institute of Cancer, 2015).
- Symptoms of spinal tumors Pain in the back that expands towards the extremities; Change in bowel habits or difficulty urinating; Weakness and numbness of legs and arms; Difficulty walking (National Institute of Cancer, 2015).
Causes of brain and spinal tumors
Current clinical research does not yet know the causes of the development of primary brain and spinal tumors. Some of the causes that are Investigated are: viruses, genetic mutations, exposure to chemicals or hazardous materials and disorders of the immune system (National Institute of Neurological Disorders and Stroke, 2016).
On the other hand, it is known that the consumption of alcohol and tobacco or different unhealthy dietary habits if they are associated with some types of cancer, But none of them has been associated with the presence of primary tumors in the central nervous system (National Institute of Neurological Disorders And Stroke, 2016).
There are a small number of patients in which some specific genetic causes have been identified: Neurofibromatosis Y Tuberous sclerosis (National Institute of Neurological Disorders and Stroke, 2016).
Who has brain or spinal tumors?
Statistical estimates estimate that there may be more than 359,000 people in the US living with a diagnosis of CNS tumor. In addition, each Year is diagnosed more than 195,000 new cases (National Institute of Neurological Disorders and Stroke, 2016)
In general, brain tumors are more common than spinal ones. They can occur at any age; However, they are more common in adults of Middle age and young people (National Institute of Neurological Disorders and Stroke, 2016)
Despite this, approximately 3,200 central nervous system tumors in children are diagnosed per year (National Institute of Neurological Disorders and Stroke, 2016).
Are there risk factors for central nervous system tumors?
Some studies have shown that there are some conditions that may increase the risk of this type of tumor (Cancer Support Communnity, 2016):
- Exposure to vinyl chloride .
- Radiation.
- Infection by Epstein-Barr virus .
- HIV -positive.
- Transplantation of organs.
- Primary lymphoma SNC.
In addition, some genetic factors have also been identified (Cancer Support Communnity, 2016):
- Neurofibromatosis of type 1 or 2.
- Hippel-Lindau .
- Tuberous sclerosis .
- Li-Fraumeni syndrome .
- Turcot's Syndrome Type 1 and type 2.
- Klinefelter's syndrome .
- Basal Cell Carcinoma Syndrome .
Treatments
Treatments of tumors of the central nervous system will depend on several factors: size, location, symptoms, general health and Treatment preferences. Some of the most used treatments are:
- Surgery.
- Radiotherapy.
- Chemotherapy.
In some patients the combined use of these therapies is possible, while in others the exclusive use of one of them is beneficial.
CONCLUSIONS
Tumors of the brain and spinal cord are really heterogeneous both in form and in clinical course. They are priority pathologies In the health systems since they put in serious risk the life of the patients.
Despite the fact that research is usually of an evolutionary nature Currently is making important advances in the clarification of the biological bases as in its various treatments.
References
- ACS. (2016). Brain and Spinal Cord tumors in Adults . Retrieved from the American Cancer Society: http://www.cancer.org/.
- CSC. (2016). Brain and Spinal Cord Tumors . Obtained from Cancer Support Community:
- NHI. (2016). Adult Central Nervous System Tumors Treatment . Retrieved from the National Cancer Institute: http://www.cancer.gov/.
- The Johns Hopkins University. (2016). About Brain Tumors . Retrieved from Jhons Hopkins Medicine: http://www.hopkinsmedicine.org/.