Understanding Brain cancer with Dr Mboyi

A brain tumour is an abnormal growth of cells that multiply uncontrollably in the brain, either benign or malignant. Benign growths are non-cancerous, and do not spread or become fatal whilst malignant growths are cancerous and spread to other parts of the body.

Different types:

There are primary brain tumours which are mostly gliomas from the glial cells in the brain followed by meningiomas from membranes around the brain and others that originate from different areas in the brain with different cell types. There are also secondary brain tumours due to metastasis.

Risk factors:

• Family history
• Age
• Radiation exposure and other occupational exposures
• Genetic factors
• Infections
• Smoking
• Alcohol
• Diet
• Head trauma

What can be done to reduce the risk of brain cancer?

Avoid exposure to radiation and other toxic chemicals and quit smoking to reduce further risk factors.

Typical symptoms to look out for:

This depends on the location as well as the size of the tumour, but general symptoms include:
• Headaches being the most common
• Vomiting
• Blurred vision
• Confusion
• Seizures
• Change in mental function
• Weakness of the limbs

What are the different stages of brain tumours:

A grading system is used for brain tumours to determine the tumour growth and spread ranging from grade 1 which is the least aggressive to grade 4 which is the most aggressive with a poor prognosis of recovery. The staging system is not used like with other parts of the body as these cancers are unlikely to spread, but the concept is the same from early to late stage.

The role of surgery in treating brain tumours:

Surgery is the mainstay of treatment for all grades provided that it is not in very close proximity to critical structures. There can be a removal of the whole tumour with margins or incomplete excision.

How do neurosurgeons ensure accuracy when removing a brain tumour?

An MRI scan is important to localise the tumour and other factors like the size to ensure that they can completely remove the tumour safely to do an embolisation first and a shunt if there is a build-up of cerebrospinal fluid.

A patient can be offered radiation therapy as adjuvant treatment or primary if irresectable. Chemotherapy is generally used in advanced diseases.

• Generally for people with cancerous (malignant) brain tumours, 40 out of 100 people (40%) survive their cancer for 1 year or more and more than 10 out of 100 people (more than 10%) survive their cancer for 5 years or more.
• The median age at diagnosis for a primary brain tumour is 61 years
• Males have a 1 in 143 chance of developing brain cancer in their lifetime and a 1 in 188 chance of dying from brain cancer in their lifetime. For females, the chance of developing brain cancer is 1 in 186, with a 1 in 239 chance of dying from the disease
• The average survival rate for all primary brain tumour patients is 75.7%

Dr Ntomboxolo Mboyi has a BSc (UKZN), MBCHB (Medunsa), Fc Rad Onc (SA), and is a Postgraduate in Cancer Biology and Therapeutics: High Impact Cancer Research Program (Harvard Medical School). She is likewise an individual from the South African Oncology Consortium (SAOC), South African Society of Clinical and Radiation oncology (SASCRO), American Society of Clinical Oncology (ASCO), and American Brachytherapy Society (ABS) and a Chairperson of the leading body of CanSurvive (non-benefit association offering support to patients).