Brain cancer refers to primary malignant tumors originating from brain tissue or surrounding structures, including gliomas, meningiomas, pituitary tumors, acoustic neuromas, and medulloblastomas.Due to the fixed space within the cranium, tumor growth can directly compress brain tissue, impair neurological function, and cause increased intracranial pressure, posing a serious threat to the patient's life.
Global overview of brain cancer
The global annual incidence of primary brain tumors is approximately 5–8 cases per 100,000 people, accounting for 1.4%–2.0% of all malignant tumors.Glioblastoma is the most common malignant brain tumor; it has a poor prognosis, with a median survival of approximately 15 months.Meningioma is the most common benign brain tumor.Brain tumors can occur at any age, though certain types are more common in children or the elderly.
Consult a doctor regarding cancer-related issues
If symptoms such as progressively worsening headache, frequent vomiting, seizures, visual changes, limb weakness, or changes in personality or behavior occur, one should promptly consult a neurosurgeon or neurologist.Upon confirmation of the diagnosis, a multidisciplinary team—including neurosurgery, radiation oncology, and medical oncology—should formulate the treatment plan.
Main types of brain cancer
1.Glioblastoma
WHO Grade IV; the most common and most malignant primary brain tumor; rapid growth; highly infiltrative; prone to recurrence; difficult to treat; poor prognosis.
2.Anaplastic glioma
WHO Grade III; includes anaplastic astrocytoma and anaplastic oligodendroglioma; the degree of malignancy lies between that of low-grade gliomas and glioblastoma.
3.Meningioma
Originates from meningeal arachnoid granulation cells; typically a benign, slow-growing tumor with a rich blood supply; prognosis is good following complete surgical resection, though a small number may undergo malignant transformation.
4.Medulloblastoma
This is the most common malignant brain tumor in children; it originates in the cerebellar vermis, is highly malignant, prone to cerebrospinal fluid dissemination, and sensitive to radiotherapy and chemotherapy, requiring comprehensive treatment.
5.Pituitary adenoma
Originates in the anterior pituitary gland; mostly benign. Classified as functional or non-functional adenomas based on hormone secretion; can cause endocrine disorders and visual impairment.
Typical symptoms and signs of brain cancer
1.Headache and vomiting
Increased intracranial pressure causes a progressively worsening headache—often most pronounced in the morning and aggravated by coughing or straining—frequently accompanied by projectile vomiting; the headache may temporarily subside after vomiting.
2.Epileptic seizure
Tumor irritation or compression of the cerebral cortex can cause focal or generalized epileptic seizures; these may be the initial symptom or appear during the course of the disease, and the possibility of a brain tumor should be considered in cases of new-onset epilepsy.
3.Limb weakness
Tumor compression or invasion of the motor cortex and conduction tracts leads to contralateral limb weakness, numbness, or paresthesia; severe cases may present with hemiplegia.
4.Visual acuity changes
Tumor compression of the optic nerve or visual pathways causes vision loss, visual field defects, or diplopia; pituitary tumors can compress the optic chiasm, leading to bitemporal hemianopia.
5.Cognitive impairment
Frontal and temporal lobe tumors can lead to cognitive and neuropsychiatric abnormalities, such as memory loss, inattention, personality changes, and impaired judgment.
6.Language impairment
Involvement of the language centers in the dominant hemisphere can result in motor aphasia, sensory aphasia, or mixed aphasia, manifesting as difficulties in language expression or comprehension.
Diagnostic methods for brain cancer
1.Neurological physical examination
A detailed neurological examination assesses level of consciousness, cranial nerve function, motor and sensory function, reflexes, and coordination to preliminarily determine the location of the lesion.
2.Head CT scan
CT can rapidly detect intracranial space-occupying lesions, calcification, and hemorrhage, as well as assess ventricular compression and midline shift; it is the preferred examination for emergency screening.
3.Magnetic resonance imaging (MRI)
MRI is the most important diagnostic method for brain tumors; it clearly shows the tumor's location, size, morphology, and relationship with surrounding brain tissue, while contrast-enhanced scanning allows for further assessment of blood supply.
4.Spectroscopic analysis
Magnetic resonance spectroscopy (MRS) can detect the metabolic characteristics of tumor tissue, aiding in the differentiation of tumor types and grades, as well as distinguishing tumor recurrence from radiation necrosis.
5.Histopathological biopsy
Obtains tumor tissue via stereotactic biopsy or surgical resection for pathological examination; serves as the gold standard for confirming the type and grade of brain tumors.
6.Molecular pathology testing
Detecting molecular markers such as IDH mutations, 1p/19q co-deletion, and MGMT promoter methylation guides prognostic assessment and the formulation of personalized treatment plans.
Brain cancer treatment methods
1.Surgical resection: Surgical resection via craniotomy is the primary treatment for brain tumors.The goal is to achieve maximal safe resection of the tumor, relieve intracranial pressure, and obtain pathological specimens to facilitate subsequent treatment.
2.Stereotactic biopsy: For tumors located deep within the brain or in critical functional areas, stereotactic technology is used to precisely obtain tissue samples for pathological diagnosis, thereby guiding subsequent treatment.
3.Radiotherapy: Postoperative adjuvant radiotherapy is used to kill residual tumor cells and reduce the risk of recurrence.IMRT and stereotactic radiosurgery allow for precise irradiation of the target area while protecting surrounding normal brain tissue.
4.Chemotherapy: Temozolomide is the standard chemotherapeutic agent for gliomas and is capable of crossing the blood-brain barrier.The PCV regimen is used for oligodendrogliomas; chemotherapy is often administered concurrently with or sequentially to radiotherapy.
5.Targeted therapy: Targeted drugs acting on specific molecular targets can inhibit tumor growth.Bevacizumab is used for recurrent glioblastoma to alleviate edema and improve symptoms.
6.Electrotherapy: Tumor-treating electric fields inhibit tumor growth by interfering with tumor cell mitosis; used in combination with temozolomide for the maintenance therapy of newly diagnosed glioblastoma.
7.Immunotherapy: Immunotherapies such as immune checkpoint inhibitors, cancer vaccines, and CAR-T cell therapy are being actively explored in clinical trials for brain tumors, with some patients showing clinical benefit.
8.Supportive therapy: Mannitol and glucocorticoids to control cerebral edema and intracranial pressure; antiepileptic drugs to prevent and control seizures; nutritional support and rehabilitation training to improve quality of life.
Conclusion
Surgical resection is the preferred treatment for brain cancer; comprehensive treatment strategies combining radiotherapy, chemotherapy, and emerging therapies can extend patient survival.Personalized, precision treatment guided by molecular classification represents a key direction for future development.
