Brain Cancer (cont.)

Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Primary brain tumors

The brain is made up of many different types of cells and tumors that arise from a brain cell type are termed primary brain tumors.

• Cancers occur when one type of cell transforms and loses its normal characteristics. Once transformed, the cells grow and multiply in abnormal ways.
• As these abnormal cells grow, they become a mass of cells, or tumor.
• Brain tumors that result from this transformation and abnormal growth of brain cells are called primary brain tumors because they originate in the brain.
• The most common primary brain tumors are gliomas, meningiomas, pituitary adenomas, vestibular schwannomas, primary CNS lymphomas, and primitive neuroectodermal tumors (medulloblastomas). The term glioma is an expansive one since it includes numerous subtypes, including astrocytomas, oligodendrogliomas, ependymomas, and choroid plexus papillomas.
• These primary tumors are named after the part of the brain or the type of brain cell from which they arise.

Brain tumors vary in their growth rate and ability to cause symptoms. The cells in fast growing, aggressive tumors usually appear abnormal microscopically. The National Cancer Institute (NCI) uses a grading system to classify tumors. The NCI lists the following grades:

• Grade I: The tissue is benign. The cells look nearly like normal brain cells, and cell growth is slow.
• Grade II: The tissue is malignant. The cells look less like normal cells than do the cells in a grade I tumor.
• Grade III: The malignant tissue has cells that look very different from normal cells. The abnormal cells are actively growing. These abnormal-appearing cells are termed anaplastic.
• Grade IV: The malignant tissue has cells that look most abnormal and tend to grow very fast.

In the United States, primary brain tumors and other nervous system cancers are estimated to develop in about 22,000 people in 2010, according to the National Cancer Institute.

Metastatic brain tumors

Metastatic brain tumors are made of cancerous cells that spread through the bloodstream from a tumor located elsewhere in the body. The most common cancers that spread to the brain are those arising from cancers that originate in the lung, breast, and kidney as well as malignant melanoma, a skin cancer. The cells spread to the brain from another tumor in a process called metastasis. The process metastasis occurs when cancer cells leave the primary cancer tissue and enter either the lymphatic system to reach the blood or the bloodstream directly. These cancer cells eventually reach the brain tissue through the bloodstream where they develop into tumors.

Metastatic brain tumors are the most common type of tumor found in the brain and are much more common than primary brain tumors. Metastatic tumors are usually named after the type of tissue from which the original cancer cells arose (for example, metastatic lung or metastatic breast cancer). Brain blood flow usually determines where the metastatic cancer cells will lodge in the brain; about 85% locate in the cerebrum (the largest portion of the brain, located in the upper part of the skull cavity). Unfortunately, the majority of metastatic brain tumors occur at more than one site in the brain tissue.