Brain Cancer - Research Paper Example

? Brain Cancer Saad A. Alotaibi of Arkansas Brain Cancer Introduction A is provided with regard to the several issues relatingto the present status of brain cancer and associated matters, such as its treatment and epidemiology. It is hereby claimed that brain cancer cannot be eliminated successfully with the extant medical procedures. However, research on treatments involving stem cells has provided a ray of hope in containing this problem. Stem cells are cells that have the capacity to multiply or renew themselves. At the same time, stem cells possess the potential to develop into other cell types (Mandal, 2013). The growth of cancer cells in the brain tissue is termed as brain cancer. A tumor or mass of cancer tissue is formed by the cancer cells. These tumors affect the functions of the brain, such as memory, muscle control and memory. Tumors are classified as malignant, when they are comprised of cancer cells. On the other hand, tumors consisting of non – cancerous cells are termed as benign (Davis & Stoppler, 2013). Furthermore, cancer cells resulting from brain tissue are termed primary brain tumors; whereas the cancer cells that spread to the brain from other sites in the body are termed as metastatic brain tumors. It has been projected, by the available statistics that brain cancer could develop in approximately 22,000 individuals per year. Moreover, 13,000 deaths could occur due to cancer (Davis & Stoppler, 2013). Symptoms Individuals with glial origin tumors depict general, non – focal signs and symptoms, or focal manifestations pertaining to the specific region of the brain where the tumor is located. The most frequently observed symptoms among such individuals include headache, nausea, vomiting, generalized seizures and alterations in the level of consciousness. Headache tends to accompany several instances of brain tumors; nevertheless, only a few individuals with headache have a brain tumor (Pan & Prados, 2003). Headache tends to be the sole symptom in a fifth of the patients with brain tumors. Such headaches vary between moderate to severe, tend to be intermittent, and pronounced to a greater degree in the early morning, or increase with coughing and other actions that enhance the intracranial pressure. Headaches that are associated with increased intracranial pressure tend to be generalized, non – focal and non – lateralizing to the location of the tumor. Furthermore, tumors can be localized by headaches that are not associated with enhanced intracranial pressure (Pan & Prados, 2003). In 15% of the cases, the initial manifestations of brain tumors are seizures. In addition, 30% of the individuals with brain tumors could develop seizures in the long run. Usually, seizures transpire along with the slower developing and superficial tumors that involve the sensorimotor cortex (Pan & Prados, 2003). Some of the rapidly developing brain tumors may not present seizures as a distinguishing feature, but may do so eventually. With respect to adults, the onset of a new seizure necessitates neuroimaging, so as to eliminate the presence of a brain tumor as the underlying cause. Brain tumors have been seen to prevail to the extent of 10% among patients suffering with generalized seizures (Pan & Prados, 2003). With regard to children, seizures had been observed to result from intracranial tumors in less than a hundredth of the instances. This could be indicative of the fact that the majority of the central nervous system lesions in children transpire infratentorially. All the same, if a child exhibits seizures that tend to be difficult to control, then magnetic resonance imaging techniques have to be used, in order to evaluate the condition. In general, the brain tumors that cause seizures in children tend to be slow growing neoplasms (Pan & Prados, 2003). Increase in intracranial pressure can cause vomiting in a patient with glial tumors. On rare occasions, such vomiting can be due to invasion by the tumor of the vagal nucleus in the posterior fossa. Sometimes, a rapid increase in intracranial pressure could produce projectile vomiting. Moreover, true vertigo or disequilibrium could result from increased pressure on the vestibular apparatus and medullary nuclei. Cause of Brain Tumors The cause of the majority of the brain tumors has not been determined. In some people, genetic factors seem to determine the development of brain tumors. For instance, the risk of developing gliomas has been discerned to be comparatively higher among individuals with the hereditary ailments neurofibromatosis type 1, Turcot’s syndrome, Li – Fraumeni cancer syndrome and tuberous sclerosis. Such individuals have a tendency to develop a glioma during their childhood or youth (Kenny, 2012). Such glioma occurrence constitutes a small percentage of glioma tumors, as the majority of these tumors develop in the older adults. A person who had undergone cerebral radiotherapy tends to be at a greater risk of developing gliomas. Moreover, metastatic brain tumors arise from various cancers and have several causes (Kenny, 2012). Brain tumors, per se, have the capacity to develop at any age. However, some varieties, such as medulloblastoma, tend to be more frequent among children, whilst benign meningioma and glioblastoma multiforme are more common among adults. In general, the tumors that develop in adults tend to be more common with increasing age. Furthermore, metastatic brain tumors are more frequently encountered than the benign brain tumors and the malignant primary brain tumors (Kenny, 2012). Impact of Brain Tumor on Human Health There could be substantial interference with important processes, with respect to caring for the chronically ill. In addition, there could be long term emotional, physical and social consequences for patients and those who provide them with care. One of the major consequences is sleep loss, which is frequently experienced by caregivers (Pawl, Lee, Clark, & Sherwood, 2013, p. 386). Individuals whose sleep undergoes frequent disturbances are at higher risk of undergoing altered immune functioning, cardiovascular disease, depression, endocrine disorders, kidney disease and metabolic syndrome. In comparison to non – care providers, caregivers exhibit greater morbidities and a higher incidence of mortality. The levels of cortisol, insulin resistance and lipids are enhanced by sleep loss and stress. Moreover, these have been correlated to an increase in Type II diabetes and cardiovascular disease. Furthermore, stress and sleep loss have been associated with an increase in fatigue severity, cognitive impairments, and negative mood (Pawl, Lee, Clark, & Sherwood, 2013, p. 386). Several aggressive interventions have been introduced in the treatment of brain cancer. Some of these are cytotoxic chemotherapy, radiation therapy and surgical resection. However, these treatments have failed to render brain cancer curable. As such, the median survival for brain cancer is less than 15 months. The chances of survival for two years, among brain cancer patients, have been determined to be just 26.5% (Grizzi & Di Ieva, 2013, p. 871). One of the most common malignant primary brain tumor is glioblastoma. With regard to the treatment of this ailment, conventional oncology has proved to be a singular failure, as described by the Mayo Clinic (Mayo Clinic, 2013). This untenable situation has induced several researchers to seek for novel and better targeted therapeutic options and improved prognostic biomarkers (Grizzi & Di Ieva, 2013, p. 871). It has been determined that brain cancer is the outcome of multiple alterations that bring about transformations in the expression patterns of genes and proteins. These genes and proteins function in intricate networks and control critical cellular functions. One of the principal tasks of tumor research is the translation of molecular biomarkers into clinical practice. All the same, there is an absence of concurrence regarding the nature and sequence of measures to be adopted, in order to effect the efficient translation of biomarkers into clinical use (Grizzi & Di Ieva, 2013, p. 871). It had been estimated that around 30,000 individuals in the US would be diagnosed with head and neck cancer, as of the year 2006. It had also been projected that around 7,000 of these patients would succumb to the disease. With regard to the five year disease – free survival, no significant change had been discerned, since the 1950s. Cancer screenings had depicted an improvement in the mortality rates, with regard to several types of cancer (Patterson & Mary, 2007, p. 547). Epidemiology The incidence of cancer tends to be enhanced by exposure to radiation, such as gamma rays, X – rays and the ingestion of radioisotopes. Radiation from these sources possesses sufficient energy to bring about ionization, and is therefore termed ionizing radiation. The non – ionizing radiation includes, ultraviolet light, visible light, extremely low frequency radiation and microwave radiation (Goldsmith, 1997, p. 1579). It had been commonplace to believe that non – ionizing radiation was not carcinogenic. This was despite the incidence of skin carcinogenicity from exposure to ultraviolet radiation. Extremely low frequency radiation was subjected to extensive study and evaluation. This was in the aftermath of evidence that there was an increase in leukemia among children living near power lines and distribution facilities (Goldsmith, 1997, p. 1579). Population at Risk As much as 70% of the brain tumors belong to the category of gliomas. Among these, glioblastoma tends to be the most frequent and malignant histologic variety. The highly developed and industrialized nations depict a greater occurrence of gliomas. Moreover, there are several reports; such as McLendon et al, The glioblastoma multiforme in Georgia, published in Cancer. 56, 894 – 897; and Kuratsu et al, Trends in the incidence of primary intracranial tumors in Kumamoto, Japan, published in International Journal of Clinical Oncology. 6, 183 – 191. These reports suggest that Caucasians have a higher incidence of gliomas than the Asian or African populations. The prognosis of glioma patients has not improved, with the exception of pilocytic astrocytomas (Ohgaki, 2009, p. 323). Temporal or Seasonal Considerations The number of glioblastoma patients who live beyond five years of diagnosis of the condition is less than 3%. In this context, older age has emerged as the most important and consistent prognostic factor related to poorer outcome. As such, gliomas are components of a number of tumor syndromes that are inherited (Ohgaki, 2009, p. 323). However, the level of prevalence of these syndromes tends to be very low. Increased glioma risk has been correlated with a number of environmental and lifestyle factors. Some of these are several occupations, environmental carcinogens and diet. All the same, the sole factor that has been indisputably associated with increased risk is that of therapeutic X – irradiation (Ohgaki, 2009, p. 323). Specifically, treatment of acute lymphoblastic leukemia with X – irradiation in the pediatric population has depicted a marked increase in the risk of developing gliomas and primitive nuero – ectodermal tumors. Such development of gliomas has frequently been within a decade of the therapy (Ohgaki, 2009, p. 323). There is scant knowledge regarding the etiology of brain tumors. Knowledge regarding the etiology of gliomas can be enhanced significantly by conducting biologically intensive studies that include novel molecular genetic techniques. Moreover, the utilization of the more consistently applied histopathologic categorization systems, in conjunction with improved understanding and employment of genetic and molecular markers to classify tumors can be invaluable in describing the pathogenesis and natural history of brain tumors (El – Zein, Minn, Wrensch, & Bondy, 2002, p. 262). Geographic Considerations Better collaboration and greater communication is necessary amongst the scientific society, with regard to brain tumor research. Such initiatives have to be accompanied by a prioritizing of specific research topics. It becomes difficult to conduct studies related to pediatric brain tumors, due to the constraints inherent in obtaining a sufficiently large sample in single geographic areas. The situation is rendered worse, due to the prevalence of a large number of childhood brain tumors (Bondy, et al., 2008, p. 1963). Known, Possible or Suspected Etiological Risk Factors of Disease It is now a well – recognized fact that there are several reasons behind the occurrence of brain tumors, one of the sources of this information is the charitable organization, Cancer Research UK (Cancer Research UK, 2013). All the same, it has proved difficult to isolate a single cause for the majority of these tumors. The existence of several possibilities makes it possible to discover the related risk factors (El – Zein, Minn, Wrensch, & Bondy, 2002, p. 263). There are several factors; such as, inherited susceptibility, host immunologic status, immune response and viruses that admit of etiological significance. As a consequence, the study of this veritable surplus of factors necessitates large scale collaborative efforts (Bondy, et al., 2008, p. 1963). The influence of developmental, environmental and genetic factors in brain tumors can be understood to a much better extent, upon conducting large scale epigenetic and genetic analyses. This has to be in conjunction with the rapidly evolving bioinformatics and data analytic techniques, and improved exposure evaluations. The occurrence of any specific type of brain tumor tends to be comparatively rare (Bondy, et al., 2008, p. 1963). This stresses the importance of collaboration and communication, to a much greater extent, among researchers. Prevention There are several methods of treatment, in the context of brain tumors. The first of these is surgery, which is the principal method of treatment for every variety of brain tumors, whether benign or malign. Another method is that of radiation therapy. This technique employs high dose Rontgen Rays or X Rays to shrink tumors and destroy malign cells. Radiation therapy can be internal or external, depending upon the source of the radiation. Chemotherapy is a technique that takes recourse to medicines to destroy cancer cells. Such medication is administered orally or intravenously (The University of Kansas Cancer Center, 2013). In the absence of early diagnosis and timely treatment, brain tumors can wreak havoc upon the health of the afflicted individual. In general, benign brain tumors do not spread. However, they can cause damage to the adjoining areas, by exerting pressure. Most varieties of these tumors do not recur after surgical removal. Nevertheless, the grade 2 gliomas admit of the possibility of regrowth and transformation into malignant tumors that grow and spread rapidly (NHS Wales, 2013). There are three levels with regard to attempts to prevent cancer. These are primary prevention, which entails preventing an etiological agent from commencing the carcinogenic process. The secondary prevention attempt involves the rendering of a carcinogen harmless by not allowing it to reach its target or by affecting its metabolism. The third of these is the tertiary prevention strategy (Kew, 2008, p. 86). Primary Prevention Strategies It has proved impossible to prevent the primary brain tumors. Considerable research continues to be devoted to the genetic and hereditary factors, and exposure to specific chemicals and viruses (Harvard Medical School, 2013). The early identification of problem progression or disease constitutes one of the archetypal clinical issues in palliative and hospice care. On many an occasion, the early identification of progression translates into less aggressive and more efficient treatment of the condition. Some of the ailments, wherein early identification of problems is essential, are cancer, diabetes and heart failure (Kemp, 1998, p. 355). In general, literature pertaining to hospice and palliative care tends to focus upon the strategy to be adopted when a problem crops up. It has been suggested by several researchers that early identification or anticipation and prevention should be made an integral part of hospice and palliative care (Kemp, 1998, p. 355). Metastatic sites present a substantial degree of complexity. For instance, some patients tend to depict fewer metastatic sites and problems, others exhibit different sites and problems, while still others portray scant evidence of metastatic disease. In addition, considerable variation is inherent in the intrinsic aggressiveness of tumors. This holds good, even in cases involving tumors of the same dimensions and histology. This provides the rationale behind the variation in the speed and other factors in progression (Kemp, 1998, p. 355). Despite these obfuscating features, the spread and behavior of tumors admits of a degree of predictability. Such predictability furnishes a crucial device in the care of patients afflicted with cancer. As such, metastasis constitutes the most difficult feature of cancer treatment. Moreover, metastasis is the cardinal cause of mortality among cancer patients. One of the important stages in the process of metastasis is angiogenesis or the growth of the primary tumor and neovascularization (Kemp, 1998, p. 355). Secondary Prevention Strategies As a result, it has become possible to prevent the occurrence of certain secondary brain tumors that had commenced in other organs. For instance, the eschewal of tobacco products reduces the risk of pulmonary cancer, which in turn decreases the possibility of malignant pulmonary cells appearing in the brain (Harvard Medical School, 2013). The capacity to isolate damaged cells of the type involved in cancer is possessed by the mesenchymal stem cells. These cells could furnish clinicians with a novel device for gaining access to the inaccessible cerebral parts. Malignant cells tend to multiply and conceal themselves at such places (HUB staff report, 2013). Tertiary Prevention Strategies The tertiary prevention level entails the prevention of precancerous lesions from developing to cancer. It also involves proper treatment, recovery time, the prolonging of life and reduction in suffering. As such, tertiary prevention provides the best strategy for obtaining accurate diagnosis and treatment. It has also proved effective in preventing the progression of the ailment, and in improving quality of life and promoting recovery (Brilliant, 2012). Conclusion Brain cancer is a major ailment that affects lives across the world. Brain tumors can be classified as primary and metastatic. Genetic factors influence the occurrence of this disease, which affects important processes, such as sleep and emotions of the patient and their caregivers. Exposure to radiation enhances the risk of brain cancer. Moreover, Caucasians had been identified as being at a higher risk of contracting gliomas than the Asians or Africans. There are three levels of prevention strategies with respect to brain cancer. The primary prevention, which consists of preventing an etiological agent from commencing the carcinogenic process. The secondary prevention process, which involves the rendering of a carcinogen harmless, by obstructing its path to the target. The tertiary prevention level consists of preventing precancerous lesions from developing into cancer. The above discussion regarding brain cancer compels one to conclude that brain tumors cannot be prevented or treated with any measure of success, in the majority of the cases. All the same, the future augurs well and there are several reliable indications that brain cancer can be contained. At present, several research projects are underway that study gene therapy and treatment with stem cells, in order to deal with the issue of cerebral cancer. Stem cell possess the capacity to develop into any type of cell. They are also capable of renewing themselves and multiplying. These properties can be of tremendous help in regenerating the brain cells damaged on account of brain cancer. Thus, stem cell research will provide a significantly better cure for brain cancer. Instances are the research being conducted by the Neurosurgery Brain Tumor Stem Cell Laboratory of the John Hopkins University, and the Brain Tumor Stem Cell Lab of the Massachusetts General Hospital. It is the considered and heartfelt opinion of many renowned research scholars that a breakthrough in the treatment of brain cancer will be achieved by stem cell research. References Bondy, M. L., Scheurer, M. E., Barnholtz – Sloan, J. S., Davis, F. G., Il'yasova, D., Kruchko, C., . . . Rajaraman, P. (2008). Brain Tumor Epidemiology: Consensus From the Brain Tumor Epidemiology Consortium. Cancer Supplement, 113(7), 1953 – 1968. Brilliant. (2012, April 1). Tertiary prevention of tumor. Retrieved November 27, 2013, from http://cancerlive.net/cancer-knowledge/tertiary-prevention-of-tumor/ Cancer Research UK. (2013, June 24). Brain tumour risks and causes. Retrieved November 29, 2013, from http://www.cancerresearchuk.org/cancer-help/type/brain-tumour/about/brain-tumour-risks-and-causes Davis, C. P., & Stoppler, M. C. (2013). Brain Cancer. Retrieved November 19, 2013, from MedicineNet: http://www.medicinenet.com/brain_cancer/page2.htm#what_is_brain_cancer El – Zein, R., Minn, A. Y., Wrensch, M., & Bondy, M. L. (2002, February 19). Epidemology of Brain Tumors. Retrieved November 19, 2013, from http://soc-neuro-onc.org/levin/Levin_ch10_p252-266.pdf Goldsmith, J. R. (1997). Epidemiologic Evidence Relevant to Radar (Microwave) Effects. Environmental Health Perspectives, 105(Supplement 6), 1579 – 1587. Retrieved November 19, 2013 Grizzi, F., & Di Ieva, A. (2013). Rethinking immunotherapy for brain cancers in the light of cancer complexity. Indian Journal of Medical Research, 137(5), 871 – 873. Harvard Medical School. (2013, October 25). Brain Tumor. Retrieved November 19, 2013, from Harvard Health Publications: http://www.sparkpeople.com/resource/health_a-z_detail.asp?AZ=69&Page=5 HUB staff report. (2013, March 13). Stem cells from fat show promise in treatment of brain cancer. Retrieved November 27, 2013, from HUB: http://hub.jhu.edu/2013/03/13/fat-fighting-brain-cancer John Hopkins Medicine. (n.d.). Neurosurgery Brain Tumor Stem Cell Laboratory. Retrieved November 29, 2013, from http://www.hopkinsmedicine.org/neurology_neurosurgery/research/neurosurgery-brain-stem-cell-lab/ Kemp, C. (1998). Part one: Introduction, bladder cancer, and brain cancer. American Journal of Hospice and Palliative Medicine, 15(6), 355 – 360. Kenny, T. (2012, July 19). Cancer of the Brain and Brain Tumours. Retrieved November 11, 2013, from http://www.patient.co.uk/health/cancer-of-the-brain-and-brain-tumours# Kew, M. C. (2008). Prevention. In W. Y. Lau (Ed.), Hepatocellular Carcinoma (pp. 85 – 128). Singapore: World Scientific. Mandal, A. (2013). What are Stem Cells? Retrieved November 29, 2013, from NEWS Medical: http://www.news-medical.net/health/What-are-Stem-Cells.aspx Massachusetts General Hospital. (2013). Brain Tumor Stem Cell Lab. Retrieved November 29, 2013, from http://www.massgeneral.org/research/researchlab.aspx?id=1500 Mayo Clinic. (2013). Novel Therapies for Glioblastoma. Retrieved November 29, 2013, from http://www.mayoclinic.org/medicalprofs/novel-therapies-glioblastoma.html NHS Wales. (2013). Brain tumour, benign. Retrieved November 19, 2013, from Encyclopedia: http://www.nhsdirect.wales.nhs.uk/encyclopaedia/b/article/braintumour,benign/ Ohgaki, H. (2009). Epidemiology of brain tumors. Methods in Molecular Biology, 472, 323 – 342. Pan, E., & Prados, M. D. (2003). Holland – Frei Cancer Medicine. Retrieved November 19, 2013, from NCBI: http://www.ncbi.nlm.nih.gov/books/NBK13708/ Patterson, H., & Mary, L. (2007). An Innovative Program to Support Family Caregivers of Brain Tumor Patients. Oncology Nursing Forum, 34(2), 547. Pawl, J. D., Lee, S. Y., Clark, P. C., & Sherwood, P. R. (2013). Loss and Its Effects on Health of Family Caregivers of Individuals with Primary Malignant Brain Tumors. Research in Nursing & Health, 36(4), 386 – 399. The University of Kansas Cancer Center. (2013). Brain Cancer Treatment. Retrieved November 19, 2013, from http://www.kucancercenter.org/cancer-information/specialties-and-treatment/brain-cancer/treatment Read More