Monday, May 30, 2011

Brain Tumour Primer

May is Brain Tumour Awareness Month in the U.S.  As a result, there are a lot of new stats about brain tumours in the headlines.  While most of this is stuff that we've read before, most people aren't as obsessed with reading about brain tumours as I am.  Therefore, the teacher in me decided that it was time to share some of this information now - just as we are preparing for the Saskatoon Spring Sprint and raising money to support those with brain tumours.

{Shameless plug} Kolbjorn is a spokesperson for this event and will be doing a speech before the actual sprint.  We have really appreciated the handbook published by the Brain Tumour Foundation, and have also benefited from the information and support we have received as part of being involved in the support group, and believe that this is a very worthy cause to be involved with.  Please consider joining, or sponsoring Kol's Krew.  Even if you don't sponsor Kol or join the team, we'd love to see you at the event - come and have some fun and hear Kol's speech.  There will be a band, and a barbeque, and more.  It's at Meewasin Park, north on Spadina near Pinehouse Dr.  {end shameless plug}

Before I start the primer, I want to review some of the details of Kol's tumour as we understand them.  Kolbjorn's tumour is a primary, malignant tumour.  It is a sPNET tumour, which stands for "supratentorial primitive neuroectodermal tumour".  Supratentorial refers to the place in the brain where the tumour is found, and "primitive neuroectodermal" refers to the type of cell that the tumour originated from.  An sPNET can be further differentiated, so Kol's tumour is a neuroblastoma sub-type of sPNET.  All sPNET tumours are tumours of the central nervous system (CNS.)  It was a sphere, roughly 4 cm in diameter, growing in the fluid space in the brain - the left lateral ventricle.  This is where spinal fluid is made.  The surgeon said that there was also some calcification - most likely tumour - in the thalamus, just below the ventricle, which could not be removed through surgery.  During surgery, 90 - 95% of the tumour in the fluid space was removed.  Now there is only an oval shaped piece of something, (we don't know what, maybe scar tissue; living, slow-growing tumour; dead tissue - something else?) which is 1 cm long and about 0.1 cm wide at the widest.

If you want to know more about the brain structures and where exactly in the brain Kol's tumour actually was, there is a good tutorial from St. Jude Children's Research Hospital in Tennessee.

The Brain Tumour Foundation of Canada website has a lot of basic information about brain tumours.  From Brain Tumour 101:
  • A brain tumour is a mass of abnormal cells within or around the structure of the brain.
  • A brain tumour can be primary or secondary,  benign or malignant.  
  • Primary tumours originate from cells within the brain, and remain in the brain and spinal fluid. 
  • Malignant tumours are :
  • classified as WHO Grade 3 or 4
  • Fast-growing
  • Poorly defined borders
  • Can invade surrounding tissue
    I haven't been able to find many Canadian stats about brain tumours, but we've heard "through the grapevine" (so I don't have solid back-up for this) that there are roughly 52 malignant brain tumours diagnosed in Saskatoon and area each year - or about 1 a week.   This would include primary tumours, (starting in the brain) secondary tumours (as a side effect of earlier cancer treatment, caused by chemo or radiation) and metastatic tumours (as a result of a different kind of cancer, such as breast, or melanoma spreading to the brain).  Approximately half of all brain tumours are benign, (also according to "the grapevine",)  so that would mean that there are somewhere around 104 new brain tumours diagnosed each year in Saskatoon.  Regina would, presumably, have have about the same.  

    Here are some of the U.S. statistics from the National Brain Tumor Society.  I've bolded the stats that I find most compelling.

    Facts about Brain Tumors

    • There are over 600,000 people in the US living with a primary brain tumor and over 28,000 of these cases are among children under the age of 20.
    • Metastatic brain tumors (cancer that spreads from other parts of the body to the brain) occur at some point in 20 to 40% of persons with cancer and are the most common type of brain tumor.
    • Over 7% of all reported primary brain tumors in the United States are among children under the age of 20.
    • Each year approximately 210,000 people in the United States will be diagnosed with a primary or metastatic brain tumor. That's over 575 people a day:
      • An estimated 62,930 of these cases are primary malignant and non-malignant tumors.
      • The remaining cases are brain metastases (cancer that spreads from other parts of the body to the brain).
    • Among children under age 20, brain tumors are:
      • the most common form of solid tumor 
      • the second leading cause of cancer-related deaths, following leukemia
      • the second leading cause of cancer-related deaths among females
        • Among adults, brain tumors are:
          • the second leading cause of cancer-related deaths among males up to age 39
          • the fifth leading cause of cancer-related deaths among women ages 20-39
          • There are over 120 different types of brain tumors, making effective treatment very complicated.
          • Because brain tumors are located at the control center for thought, emotion and movement, their effects on an individual's physical and cognitive abilities can be devastating.
          • At present, brain tumors are treated by surgery, radiation therapy, and chemotherapy, used either individually or in combination.
          • No two brain tumors are alike. Prognosis, or expected outcome, is dependent on several factors including the type of tumor, location, response to treatment, an individual's age, and overall health status.
          • An estimated 35% of adults living with a primary malignant brain or CNS tumor will live five years or longer.
          • Brain tumors in children are different from those in adults and are often treated differently. Although over 72% percent of children with brain tumors will survive, they are often left with long-term side effects.
          • Symptoms of a brain tumor can include headaches (recent, new, or more severe than usual), seizures (in a person who does not have a history of seizures), cognitive or personality changes, eye weakness, nausea or vomiting, speech disturbances, or memory loss. While these are the most common symptoms of a brain tumor, they can also indicate other medical problems.

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