JEFF WEINBERG, MD, BAS: Hi. My name is Jeff Weinberg and I am an Associate Professor of Neurosurgery in the Department of Neurosurgery at the University of M.D. Anderson Cancer Center in Houston, Texas, and I am here to talk to you today about brain cancer. Brain cancer could occur at any age group. It happens in pediatric patients, children can get brain tumors, and also in the adults. Even up to the elderly can get brain cancer in all forms, both malignant and benign tumors. We do not know specific inciting causes but we do know that there are certain genetic conditions, such as neurofibromatosis, which can cause certain types of brain tumors. We look at the most common type of brain tumor and that's what's called the metastatic brain tumor - that's a cancer that starts from some other part of the body and travels to the brain and in that case, the most common ones are melanoma, which is a skin cancer, breast cancer, and lung cancer, and those happen to about a hundred thousand patients per year in the United States. In contrast, the primary brain tumors, or tumors that start in the brain and grow in the brain, number about 17,000 per year in the United States. In addition, there are about 12,000 which fall under the category of astrocytomas which are the primary malignant brain tumor. The symptoms of brain cancer can present in a number of ways. One and the most common way is what we call focal neurologic deficit, and if the tumor grows near or irritates part of the brain that's responsible for some important function, for example speaking or movement, then it's likely to cause that part of the brain to not function properly and then you're left with, say, weakness or speech problems or vision problems. In contrast, there are other ways that it can present, or headaches or seizures, and those are the three most common ways that brain cancer will present. Brain cancers are diagnosed when patient presents with one of the symptoms I just mentioned and at that time, usually the physician will order a CT scan, a CAT scan, or an MRI scan and that will demonstrate the tumor. The other way the tumors are diagnosed are incidentally, and when that happens, a patient may present with say loss of consciousness after a car accident, or for some other reason that they undergo workup which includes some type of imaging of the brain and then a tumor is found accidentally. There are standard treatment options for patients with brain cancer
and those options typically involve one of three things: Either surgery, chemotherapy, or radiation. For many benign tumors that occur in the brain, we can actually cure patients by removing the tumor if the entire tumor is removed. For patients who have a malignant tumor, then it is usually a combination and it is a multidisciplinary effort, meaning that the treatment of the disease occurs with impact or input from the surgeon, from an oncologist who will provide chemotherapy, and with a radiation oncologist who will provide radiation treatment, and it depends on multiple factors. It depends on the type of tumor. It depends on the grade of tumor, how malignant the tumor is. It depends on the patient's characteristics, how healthy they are, how old they are, whether or not they are able to tolerate some of the treatments. For patients who have metastatic brain tumors, that is a tumor that starts on one part of the body and travels to the brain, again there is combination of options. Some surgery, radiation, or what is called stereotactic radiosurgery, which is a focused radiation treatment directly at the tumor, and then the last is something called proton therapy, which is another type of radiation therapy. The best we can do now I think is early detection, so for example patients with metastatic cancer or patients with a primary cancer outside of the brain might undergo an MRI scan early in their treatment so that way we can find the brain tumors earlier, treat them earlier.
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