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Brain Cancer and Metastases


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diagnosing and treatment of primary brain tumor like glioblastoma and brain metastases

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Brain Cancer and Metastases

  1. 1. Brain Tumors <ul><li>Brain metastases or primary brain tumors (glioma) </li></ul><ul><li>Treatment options </li></ul><ul><li>Side effects of treatment </li></ul>
  2. 2. 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
  3. 3. Brain Function
  4. 9. 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
  5. 10. 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
  6. 11. Brain Imaging
  7. 12. Whole brain irradiation
  8. 13. Whole brain radiation
  9. 14. The response or benefit from whole brain radiation takes several weeks to months
  10. 15. Typical response for whole brain radiation
  11. 16. Typical response for whole brain radiation
  12. 17. Typical response for whole brain radiation Small tumors may be gone completely by two months
  13. 18. Radio resistant cancer (renal cell) MRI appearance two months after whole brain radiation (small lesions gone and large lesion much smaller)
  14. 19. Cyberknife Radiosurgery for Brain Metastases
  15. 21. Typical time interval to regression after radiosurgery Cyberknife or Gamma Knife)
  16. 22. <ul><li>How often does brain radiation help? </li></ul><ul><li>70 -90% initial response </li></ul><ul><li>> 50% of symptoms of headache, CSF pressure have complete response </li></ul><ul><li>50 -60% have functional improvement </li></ul><ul><li>moderate dysfunction: 1/3 near normal at median time of 3 weeks </li></ul><ul><li>severe dysfunction: 2/3 improve at median of 1-2 weeks </li></ul>
  17. 23. Side Effects of Brain Radiation <ul><li>Hair loss (usually takes two or three weeks to happen) </li></ul><ul><li>Mild skin itching or irritation </li></ul><ul><li>Short term more fatigue or slightly more confusion or memory problems </li></ul><ul><li>Mild headache or nausea is uncommon but may require medication (Decadron) </li></ul><ul><li>Occasionally hearing problems (fluid behind the ear drums) </li></ul>
  18. 24. Radiation prescription for # Diagnosis: # External radiation: # Internal radiation: #