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ABOUT BRAIN CANCER

What Is Brain Cancer?

Cancer is when there is an abnormal growth of cells in the body called a tumor. This tumor can disrupt an individual’s everyday life or remain undetected and untreated for decades. Brain cancer is when there is a tumor in the brain or nearby it. 

Brain tumors come in various sizes. Some brain tumors are found right away due to noticeable symptoms early on. However, other brain tumors can grow very large before being discovered. Different regions of the brain exhibit varying levels of activity. When a brain tumor originates in a less active area, symptoms may not manifest immediately. This can cause the tumor to reach a significant size before it is detected.

There are different grades to categorize brain cancer. Grade 1 is when the tumor grows very slowly and most likely won't spread to other tissues. Grade 2 is when the tumor grows slowly but can spread to nearby tissues. Grade 3 is when the tumor grows quickly, has a high probability of spreading to nearby tissues, and the cells look different compared to normal cells. Grade 4 is when the tumor grows and spreads very quickly and the cells don't look like normal cells. 

Risk Factors for Brain Cancer

While the exact causes remain unclear, certain factors can increase the likelihood of developing brain tumors. Age is a significant risk factor, as brain tumors are common in children and older individuals, although they can affect people of any age. Family history plays a role, with certain hereditary conditions linked to a higher risk of brain tumors. Exposure to radiation through medical treatments or environmental sources can alter someone’s DNA, possibly leading to tumors.

Additional Resources

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Cancer.Net has compiled a list of common risk factors for brain tumors. Follow the link to learn more. 

Types of Brain Cancer

Brain tumors are distinguished by the specific cell that comprises the tumor. There are many different types of brain tumors but two main categories: malignant (cancerous) and benign (non-cancerous).

 

Benign tumors typically do not exhibit invasive behavior while malignant tumors grow faster and spread to other parts of the body. Glioma tumors are abnormal growth in glial cells. Glial cells support and protect neurons. Gliomas are mostly malignant, but some are benign. Meningioma tumors originate in the membranes around the brain and spinal cord called meninges. Meningiomas are generally benign and are the most common type of benign brain tumor. Pituitary tumors develop in the pituitary gland. The pituitary gland is responsible for regulating metabolism and secreting hormones. Pituitary tumors are mostly benign.

 

While the aforementioned tumors are common, it is important to acknowledge the existence of other types of brain tumors such as germ cell tumors, pineal tumors, and choroid plexus tumors.

Additional Resources

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Johns Hopkins Medicine has this great page on brain tumor types. It includes how common each type is to some of the side effects that the tumor causes. Follow the link to learn more. 

Johns Hopkins Medicine also has this informative video on types of brain tumors. Dr. Weingart talks briefly about the diagnostic process of brain tumors. Watch the video to learn more.  

Signs and Symptoms of Brain Cancer

While the symptoms of brain tumors vary depending on the specific type, here is a compilation of some general symptoms associated with brain tumors: severe headaches, seizures, personality and memory changes, nausea or vomiting, fatigue, and changes in the ability to walk or perform daily activities. Signs that the doctor can perceive include but are not limited to, blood tests, biopsies, and brain scans​.

Additional Resources

Cleveland Clinic uses this 2.5 minute video to describe some of the warning signs of brain tumors. These are only 6 of the many signs of brain tumors. Watch the video to learn more. 

Signs and symptoms are mainly dependent on where the brain tumor is located. The National Brain Tumor Society has this detailed page on the signs and symptoms of brain tumors in different regions of the brain. Follow the link to learn more. 

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Prognosis for Brain Cancer

Prognosis is the likely outcome of a disease. The prognosis depends on many factors. Age, symptoms, tumor location, recurrent tumor, metastatic spread, and tumor histology are all factors the doctors use for a prognosis. Tumor histology is when the doctor analyses a piece of the tumor to determine the type of tumor, what grade it is, and any other features that can affect how fast the tumor will grow. Here are some survival rates based on age: the 5-year relative survival rate for people younger than age 15 is around 75%; for ages 15 to 39, the 5-year relative survival rate is close to 72%; for ages 40 and older, the 5-year relative survival rate is 21%. For a broader perspective, the 5-year relative survival rate for a cancerous brain tumor is around 36%, and the 10-year survival rate is over 30%.

Additional Resources

It is important to consider that survivorship percentages don't apply to everyone and that there are a multitude of factors that contribute to a prognosis. Dr. John deGroot uses this video to explain why he doesn't give his patients percentage of survival. Watch the video to learn more.  

The Canadian Cancer Society has provided survival rates based on the type of brain cancer and what grade that cancer is. Follow the link to learn more. 

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Diagnosis and Treatment for Brain Cancer

When diagnosing brain tumors, doctors use a range of factors. They consider signs and symptoms, the patient's age, and overall health. Additionally, an MRI scan is utilized to visualize the tumor's location and determine its size. A sample of the tumor is required to make a diagnosis using a biopsy. During the biopsy, the doctor will remove a small amount of the tumor to examine under a microscope. The doctor may use other methods of diagnosis like a CT scan, neurocognitive assessment, and spinal tap. 

There are different treatments one can receive that are based on your type of brain tumor, the location of the tumor, whether/where it has spread, what the cells look like under a microscope, and your general health and level of fitness. A common treatment for brain tumors is surgery. Some surgeries can include removing a part of or the entire tumor and draining a build-up of fluid in the brain. In addition to surgery, one might have radiation therapy and/or chemotherapy. Radiation therapy uses high doses of radiation to kill the cancer cells and shrink tumors. Chemotherapy is a drug that is either injected or taken as a pill that kills fast-growing cells in the body. These treatments can cause side effects include, but are not limited to, appetite loss, fatigue, hair loss, and nausea. 

Additional Resources

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The American Cancer Society has a list of resources on different cancer treatments, clinical trials, and support for cancer treatment. Follow the link to learn more. 

This is a great page Mayo Clinic has that explains different diagnostic techniques. It also includes extensive information on treatments and their possible side effects. Follow the link to learn more. 

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Treatment for cancer has many side effects. This Yale Medicine website is a great resource for learning about potential side effects and what causes each side effect. Follow the link to learn more. 

The Financial Burden of Brain Cancer

In addition to the emotional distress that accompanies the cancer experience, the financial burden from mounting obligations, debt, and diminishing wealth can hinder a patient's ability to effectively cope with cancer, its physical symptoms, and the treatment process. Consequently, this detrimentally impacts their overall health outcomes.

 

The financial stress associated with brain cancer is from direct costs like imaging (MRI and CT scan) and treatment. There are also indirect costs like extended hospital visits and transportation fees. 

 

Imaging to diagnose brain cancer can cost anywhere from $4,000-$12,000 with insurance, and surgery is between $50,000-$150,000. Post-surgical treatments like chemotherapy and radiation can cost up to $10,000-$200,000 and $10,000-$50,000 respectively. Regardless of the exact cost, the average American salary is $60,000. This reality implies that a considerable number of individuals are at risk of facing financial stress.

Hidden Costs

 

In addition to the significant expenses of brain cancer treatments, there are indirect costs that arise from the disease. Some patients have life-limiting physical and psychological symptoms and go to a physical therapist or have extended hospital visits. Due to more time spent at home, many have increased water and gas bills and installed home modifications. Covering childcare, household items, and transportation fees (to and from the hospital) are also hidden costs. The most impactful indirect cost is the loss of one or two adult incomes. The brain tumor patient may work less or cease employment, and sometimes a carer may choose not to work in order to care for the patient. When there isn’t a second adult or carer, the family experiences even more financial and emotional stress. 

 

In an effort to manage the accumulation of medical bills amidst financial constraints, the patient's household may reduce the use of other services and goods. These changes can disrupt the patient's lifestyle and decrease quality of life, including utilizing savings, selling assets, borrowing money, or carrying a credit card balance. These measures are typically used when the primary income earner is unable to maintain full employment or regain stable employment. The problem is further exacerbated by lengthy treatment plans, especially in cases of metastatic cancer. Patients with lower incomes, who typically have limited financial resources to alleviate the financial strain of brain cancer expenses, face an increased vulnerability to job loss. As a consequence, this amplifies their financial and emotional stress.

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