What is brain cancer?
Primary brain cancer develops from cells within the brain. Part of the central nervous system (CNS), the brain is the control center for vital functions of the body, including speech, movement, thoughts, feelings, memory, vision, hearing and more.
Primary brain tumors are classified by the type of cell or tissue the tumor affects, and the location and grade of the tumor. Tumor cells may travel short distances within the brain, but generally won’t travel outside of the brain itself.
When cancer develops elsewhere in the body and spreads (metastasizes) to the brain, it’s called a secondary brain tumor, or metastatic brain cancer. Metastatic brain tumors are more common than primary brain tumors. Some cancers that commonly spread to the brain include lung, colon, kidney and breast cancers.
There are over 120 different types of brain tumors, according to the National Brain Tumor Society. The most common primary brain tumors are called gliomas, which originate in the glial (supportive) tissue. About one third of all primary brain tumors and other nervous system tumors form from glial cells.
Other neurological cancers
Aside from tumors in the brain, cancer can begin in, or spread to, other areas of the central nervous system, such as the spinal cord or column, or the peripheral nerves. Cancer that develops in the spinal cord or its surrounding structures is called spinal cancer. Most tumors of the spine are metastatic tumors, which have spread to the spine from another location in the body.
What is glioblastoma?
Glioblastoma, also called glioblastoma multiforme, or GBM, is a type of primary brain cancer. This means that GBM tumors begin in the brain, rather than traveling to the brain from other parts of the body, such as the lungs or breasts. GBM is the most common type of primary brain cancer in adults.
Where in the brain does GBM occur?
Most people get GBM tumors in their cerebral hemispheres—the left and right halves of the brain that control reading, thinking, speech, muscle movement, and emotions. Rarely, GBM can also appear in the brain stem or spinal cord.
What kind of symptoms does GBM cause?
GBM does not usually spread to other areas of the body. However, GBM tumors grow quickly in the brain. Because of this, you may have noticed symptoms appearing suddenly, as if out of nowhere.
As a GBM tumor grows, it can put pressure on the brain, causing:
- Nausea and vomiting
Depending on the location of the tumor, GBM can also interfere with how the brain controls other parts of the body, leading to:
- Weakness on one side of the body
- Difficulty with memory or speech
- Changes in vision
Why is GBM hard to treat?
Glioblastoma is one of the most common forms of brain cancer, affecting about 10,000 patients each year — about half of whom will die within 15 months of diagnosis.
Tumors that arise in the brain without a known origin are called gliomas, and the most malignant forms are glioblastomas. They are aggressive, infiltrative and cannot be cured by surgery, according to the University of Texas MD Anderson Cancer Center.
The researchers pointed out that more tumor that can be removed, the better the prognosis. But, the tumor spreads throughout the brain on nerve fibers and blood vessels, allowing it to invade new areas that surgeons are typically reluctant to operate on. Even if the main tumor can be removed, it’s often spread throughout the brain by the time a person is diagnosed.
That’s where the new technique — developed by scientists at the Georgia Institute of Technology in Atlanta — comes in. The team designed an alternative fiber out of a polymer called polycaprolactone (PCL) surrounded by flexible polyurethane that mimics the surfaces of nerves and blood vessels that glioblastoma cells would typically follow.The fibers are about half the diameter of human hair. Instead of guiding the cancers to different areas of the brain, the track takes the cells to a “tumor collector” gel located outside of the brain containing a drug called cyclopamine, which is toxic to cancer.
The scientists tested this novel approach in rats, comparing the effects with implanted fibers made of a different polymer, or a PCL fiber without the contours mimicking nerves and blood vessels.
After 18 days, they found rats treated with the new technique had tumor sizes reduced by up to 90 percent compared to the other rats, with cancer cells seen moving the entire length of the fibers into the tumor collector gel.
“Cancer cells normally latch onto these natural structures and ride them like a monorail to other parts of the brain,” said Bellamkonda. “By providing an attractive alternative fiber, we can efficiently move the tumors along a different path to a destination that we choose.”
The treatment is far from ready for human use. The Food and Drug Administration requires extensive testing that can take up to a decade, with rat research among the earliest steps. The scientists are hopeful that if successful, the approach may one day be used to treat other diseases as well.
“If we can provide cancer an escape valve of these fibers, that may provide a way of maintaining slow-growing tumors such that, while they may be inoperable, people could live with the cancers because they are not growing,” he said. “Perhaps with ideas like this, we may be able to live with cancer just as we live with diabetes or high blood pressure.”The new research was published Feb. 16 in Nature Materials, with research supported by the National Cancer Institute.
Keyhole Surgical Approaches
The ideal surgical approach for each patient is determined by the specific tumor type and location. Regardless of the route chosen, our goals are to maximize tumor removal and minimize manipulation of critical structures, thereby avoiding complications and patient disfigurement, while promoting a more rapid, complete and less painful recovery.
At Pacific Brain Tumor Center, our number one goal is restoring or maintaining our patients’ quality of life. Our team of neurosurgeons and ENT/ skull base surgeons led by Center Director Daniel Kelly, has been at the global forefront of advancing these minimally invasive approaches for a wide range of common and uncommon brain and skull base tumors including:
Keyhole Brain Tumor
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Dr. Kelly and his team have extensive expertise with both conventional and keyhole approaches totaling over 4500 such procedures over the past two decades. This large experience allows us to provide a truly tailored approach best suited for each patient.
Learn About Different Keyhole Approaches:
The supraorbital eyebrow approach is useful for many patients with meningiomas, craniopharyngiomas and other tumors near the optic nerves and pituitary gland, as well as gliomas and metastatic brain tumors in the frontal and temporal lobes.
This versatile, minimally invasive approach minimizes normal tissue disruption and brain retraction, allowing for a more direct approach to these lesions. Occasionally, an abdominal fat graft may be necessary to seal large nasal sinus defects.
This approach is typically performed with the assistance of an endoscope, allowing for further visualization. As such, patients recover well and have good cosmetic outcomes long term.
At the Pacific Brain Tumor Center, we have extensive experience with this approach, helping pioneer this operation since its introduction. We have published extensively on this topic.