Brain Tumors

Those two words scare me to death. This is the worst thing to hear. I guess it all stems from my early childhood. You see, I would be 9 years of age on May 30, 1958.

My Daddy worked for McDonnell Aircraft in Tulsa, OK. He just had his 35th birthday March 4, 1958..

After he and my mother divorced, he got custody of my little brother and I.

It had been almost 4 years with just me, Daddy, and Kevin, and of course my paternal grandparents.

Then, Daddy got married again when I was 6. They had a little girl shortly thereafter.

Daddy worked ever so hard to take care of his family. He never missed any time at work.

Then, one day in late March, 1958, Daddy didn't come home. When I asked why with my inquisitive-self, I was told Daddy had a black-out at work, and they took him to the hospital, and that was where he was.

Little did I realize what the next 2 1/2 months had in store for my family.

The doctors found a brain tumor in Daddy's brain. They did surgery, some cobalt treatments. They knew little about this disease back in 1958.

The didn't have all the new technology they do now.

Daddy was so sick. But you know, even in his condition, he never let his children know just how bad he really was or how much he was hurting.

He went through another surgery procedure in the middle of May, 1958.

he came home to stay then. He never was able to get out of bed, so we would go down the hall from our rooms to visit with him.

I loved my Daddy more than anything in the world. I guess I was thinking he was all I had to love and love me in the whole world.

Then, early the morning of May 29, 1958, he silently passed from this world. I knew he wouldn't be back, but I kept hoping. This was the day before my 9th birthday, and this disease forever changed my life, and took my most precious treasure, my Daddy.

Brain tumors -- the very words strike fear in the heart of anyone threatened by one. It once was considered one of the most frightful events that could occur. Today, however, with improving technology and the gradual unfolding of scientific understanding of the basic biology of brain tumors, patients and families can look to the future with considerably more hope.

Scientists, physicians and researchers ponder the limitless questions concerning brain tumors: What does a brain tumor eat for breakfast? How does it really function? Why can't we get rid of this thing now? Why did person A get a brain tumor and not B? What causes brain tumors? These are just a few of the hundreds of questions plaguing scientists, researchers, as well as patients, their families and their physicians.

Firstly, the brain is an incredibly complex organ. Like a true resident in an Ivory Tower, the brain lives apart from, and quite differently than, the rest of the body. The brain contains about 10 Billion (10,000,000,000) working brain cells. They are called neurons and make over 13 Trillion (13,000,000,000,000) connections with each other to form the most sophisticated organic computer on the planet -- maybe even the universe. By today's computer standards, the brain far exceeds any network of linked state-of-the-art computers.

Despite such complexity, most of the brain is made up of supporting cells. The vast majority of these are called astrocytes. These cells are the support "stuff" of the brain, and serve as a scaffold for the working brain cells and other structures. Oligodendrocytes, another type of brain cell, are much fewer in number; they are primarily responsible for making the covers (called myelin) for the vast wiring system of the brain. The ependymal cells are fewest in number; they simply cover the inner surfaces of the brain called ventricles.

The entire brain floats in a self contained sort of womb, and like a fetus, is surrounded by and filled with a watery fluid known as cerebrospinal fluid (CSF). These fluid spaces, when obstructed by a tumor, may enlarge and cause pressure within the closed box of the hard skull to increase dangerously. This is referred to as hydrocephalus or water-on-the-brain.

The brain has various coverings (meninges or dura), just like a wet football with its inner bladder and outer pigskin shell. They hold things securely in their proper place. The cells of the meninges are unique, and some of them are capable of filtering the brain fluid (CSF) back into the bloodstream by a sort of one way valve system. They are called arachnoid cap cells.

Also, attached to the brain are a couple of hangers on. Literally, hanging beneath the brain is the Pituitary Gland, a kind of Wizard of Oz box of hormonal cells that control almost all of the body's hormonal systems. Hanging just behind the brain is a little pine cone called the Pineal Gland, the "third eye." It tells the body when it is day and when it is night via its now popular brain hormone, melatonin.

Brain tumors originate from one cell at a time and travel to other brain cells, unlike other cancers (e.g. bladder and blood cancers). So, it makes sense that the tumors of the brain occur in a frequency that corresponds directly with how many of each cell type are present in the first point of tumor.

Brain tumors can arise either from the brain itself (primary brain tumors: astrocytoma, glioblastoma, oligodendroglioma, ependymoma), or its coverings (meningiomas, pituitary tumors, pineal tumors), or the nerves at the base of the brain (acoustic neuromas, schwannomas), or even from outside the brain (metastatic brain tumors) . This last case occurs when cancer cells travel through the bloodstream and lodge in the brain.

The vast majority of brain tumors are primary. Of these, the malignant astrocytoma and glioblastoma multiforme are the most common, and are responsible for the bad reputation that brain tumors carry.

Important Points Regarding Primary Brain Tumors

* Brain tumors are different!
* Brain tumors are not cancers.
* They grow only in the brain itself, and almost never travel beyond the brain.
* They don't metastasize. Treatment should be limited to the brain.
* Benign is not always "benign." Low grade gliomas, although called benign, often grow inexorably, albeit slowly.
* They involve the whole brain. Even though they seem to grow locally, tumor cells travel around the brain and are always found beyond the tumor margins, even on the opposite side of the brain.
* Benign tumors may be malignant by location -- easy tumors in tough places.
* True tumor margins do not exist. Total removal by local therapy (surgery, radiation, heat, cold, etc.) is not possible.
* The brain is immunologically isolated.
* The Blood:Brain barrier is real.
* Many helpful treatments can't enter the brain via the bloodstream.
* Primary brain tumors are polyclonal. They are actually many tumors in one (sometimes over a thousand!)
* Each clone has differing sensitivity (or resistance) to anti-tumor treatments.
* Each clone has its own cell cycle time, doubling time, etc.

With these observations in mind, the therapy of primary brain tumors has been sharply focused, because only the brain needs to be treated, not the entire body.

But, the treatment of brain tumors is extremely difficult because of polyclonicity, the Blood:Brain barrier, the diffuse infiltrative nature of these tumors, and the perilous location of some tumors.

CONCLUSION:

The only therapy(ies) that could possibly cure primary brain tumors must:

5. Spare the remaining normal brain.

Signs and Symptoms of Brain Tumors

The symptoms of both primary and metastatic brain tumors depend mainly on the location in the brain and the size of the tumor.

Since each area of the brain is responsible for specific functions, the symptoms will vary a great deal.

Tumors in the frontal lobe of the brain may cause weakness and inability to move on one side of the body, known as paralysis, mood disturbances, difficulty thinking, confusion and disorientation, and wide emotional mood swings.

Parietal lobe tumors may cause seizures, numbness or paralysis, difficulty with handwriting, inability to perform simple mathematical problems, difficulty with certain movements, and loss of the sense of touch.

Tumors in the occipital lobe can cause loss of vision in half of each visual field, visual hallucinations, and seizures.

Temporal lobe tumors can cause seizures, perceptual and spatial disturbances, and inability to understand simple of multi-step commands, known as receptive aphasia.

If a tumor occurs in the cerebellum, the person may have difficulty maintaining their balance, known as ataxia, loss of coordination, headaches, and vomiting.

Tumors in the hypothalamus may cause emotional changes, and changes in the perception of hot and cold. In addition, hypothalamic tumors may affect growth and nutrition in children. With the exception of the cerebellum, a tumor on one side of the brain causes symptoms and impairment on the opposite side of the body. For example, a tumor on the left side of the brain may cause numbness in the right arm.

As a brain tumor grows, it invades the healthy tissue in the brain, often causing further deterioration.

Because of the limited space within the skull, the tumor may place pressure on the brain. There may also be a buildup of fluid around the tumor, a condition known as edema.

Both of these may cause frequent headaches that are often unrelieved by over-the-counter medications. Headaches are the most common presenting symptom for patients with brain tumors.

Since all of these symptoms can be caused by other problems, you must be seen by a physician to have your symptoms properly evaluated.

Your physician may refer you to a neurologist, a doctor who specializes in diagnosing and treating disorders of the brain and central nervous system,

or to an oncologist, a doctor who specializes in diagnosing and treating cancer.

"Daddy's Hands"

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