Home Page>Brain Cancer symptoms, diagnosis and natural, holistic complementary ways to go forward with your life.
Brain CancerDr Kingsley’s comments Cancer of the Brain. Cancer of the brain can effectively be divided into two groups, namely primary and secondary brain cancers, with secondary ones being the most common. Secondary brain tumours can have spread from a primary cancer almost anywhere in the body, a sample of the tumour indicating its origin, although sometimes it is insufficiently clear. The value to the doctor is that, not only can he consider treating the primary, but it will also influence what treatment he recommends for the brain tumour itself. For the sake of this section, I will only describe primary brain cancers, which are divided into astrocytomas, meningiomas, medulloblastomas, oligodendrogliomas and ependymomas. Symptoms and Signs. Brain tumours comprise about 5% of all types of cancer, but 20% of cancers in children. They occur most commonly between the ages of 5 and 10 and between 50 and 60 years of age. Primary tumours almost exclusively increase in size within the brain, with spread through the lymphatic and blood systems being virtually unheard of. There are many starting symptoms and signs, but the most common are headache of some sort, especially first thing in the morning when the person has been lying down during the night, as becoming upright allows fluid in the brain to drain downwards. Thus this is a sign of pressure inside the skull, known as ‘raised intracranial pressure’. For the same reason a person may first notice a change in vision, which an optician explains as pressure signs at the back of the eyes, called papilloedema. Dizziness may be a presenting symptom. In young people, as well as older people of course, the first indication may be an epileptic fit coming out of the blue. There may also be some degree of altered mental function, such as a loss of concentration or memory, or loss of sensation in a limb, with or without a degree of functional difficulty, such as a loss of grip or a limp. Doctors call this ‘focal neurological deficit’. Some people may also have difficulty with words, in that they can either hardly speak for a while or simply cannot get words out, even if they can think of what they want to say. The build up of pressure within the brain can sometimes affect specific parts of the brain leading to vomiting, a slow pulse or increased blood pressure, as well as a general reduction of consciousness. Investigations. CT and/or MRI scans are standard for brain tumours, and a surgeon is likely to want to do a biopsy, mainly to identify whether it is a primary or a secondary. Also the type of primary indicates not only the course of treatment to be recommended, but also the prognosis, i.e. what the likely long-term future will be. In the past a lumbar puncture was sometimes done, but it has its dangers. As there is increased pressure within the skull, taking even a small amount of fluid out of the spinal area could cause a condition called ‘coning’, where the brain contents are forced downwards into the neck area, which is V-shaped. As so many of the nerves involved in breathing and the heart are present there, there is a risk of stopping the heart or the breathing altogether. Conventional Treatment. Once the diagnosis of a tumour in the brain has been made, two drugs in particular are likely to be given early on, before any other form of treatment is started. Dexamethasone, an anti-inflammatory steroid, helps to reduce swelling in the brain, so can reduce the effects of intracranial pressure. As there is a risk of having an epileptic fit, even if there has not been one so far, an anti-epileptic drug is also likely to be prescribed as a preventative. After that, surgical removal of as much of the tumour as possible is the next line of treatment, especially in low grade tumours, most tumours of the brain being divided into high grade and low grade. Radiotherapy is often tried when surgery is impracticable, possibly because of the size of the tumour, even if it is not causing too many symptoms, or because of access to it. Radiotherapy will usually be administered when it is not possible to remove the entire tumour. This will then reduce the rate of recurrence. If the tumour is high grade, radiotherapy will only be given if the symptoms from the tumour are not too extensive and do not affect the patient too severely. In high grade tumours, chemotherapy is sometimes offered, but it is not very effective. A special type is used which has to be lipophilic (fat soluble), so that it can cross the blood-brain barrier. When the tumour is found to be a secondary, appropriate investigations will be carried out to find the primary, such as a full detailed body examination, a chest X-ray and scans of other parts of the body. Standard blood tests will automatically be done as well, as they can sometimes give clues. An Explanation by Dr Kingsley Before Your Consultation about your Brain Cancer “Most consultations with doctors are fairly quick affairs, lasting perhaps five minutes, even if you are suspected of having cancer in your brain. You may be lucky to have more time spent on you, but when you have your consultation with me, I will spend as much time as you want. There is no time limit. We will take as long as you want. Often when I see some people for the first time, they are in a state of panic. They haven’t a clue what it is all about. No one has explained anything to them. Perhaps in the past they have been admitted for an emergency operation, or they had simply been told to come into hospital on such-and-such a day when they were either operated on or started a course of chemotherapy or radiotherapy. Once in hospital some sort of explanation may have been given, and you were probably seen by a junior doctor who not only took a short history of any symptoms you had, but also examined you to look for any signs of your brain cancer, but, by then, you were already captive and didn’t really have much choice in the matter. To be fair to doctors, they assume that their advice is the best on offer. After all, they are the experts. Virtually all doctors would treat your brain cancer in roughly the same way, so it seldom occurs to them that you just might not want to follow their advice. In any case, most patients have been frightened by their diagnosis and want to get on with the treatment, assuming that the doctor can deal with it for them. Most people put their faith in their doctor, assuming he knows what he is doing. There is absolutely no intention on my part to tell you whether to follow your doctor’s advice of not. That is a decision you have to make. No one can make it for you, but I will help you make up your mind. The Consultation The virtual consultation with me has been planned as though you are with me in my consulting room. I will go though your history, or the history that I come across so often, explaining the parts of it that give me clues to the cause of people’s problems. The chances are that, having taken a medical history from many thousands of patients over nearly forty years of medical practice, especially in the detail that I find so valuable, it is likely that much of it will be appropriate to you. The consultation is one of the longest parts of this programme, as you would imagine, and it is full of fascinating information. Periodically I lecture to medical colleagues on the subject of ‘What a clinical history and the clinical examination can tell me’. All this information is the result of my many years of listening to patients, letting them tell their stories, believing in their observations that have often been ignored, and learning by experience. So, enjoy yourself, feel enlightened, smile, be happy and radiate confidence in what you are going to do. Be positive and forget the doom and gloom merchants. If someone has given you a poor prognosis, forget it. You no longer fit into their statistics. You are going to do something for yourself. You are now in charge. ---------------------------------------- What you do now is in your own hands. We would like you to take advantage of all the benefits of becoming a member of our Cancer Help Centre, which is free to join, so please look at the Members’ Area Overview, where you will find a summary of all that is on offer. |
|
(c) 2006 |
