Brain Tumor: Causes, Symptoms and Treatment

What Is a Brain Tumor?

A brain tumor is an abnormal mass of tissue that grows within the brain or its surrounding structures. Tumors can be primary, meaning they originate directly in the brain tissue, or secondary (metastatic), meaning cancer cells have spread to the brain from another part of the body. Primary brain tumors are named after the cell type from which they arise. Gliomas (such as glioblastomas and astrocytomas) and meningiomas are among the most common types. Brain tumors can be benign (non-cancerous) or malignant (cancerous). Even benign tumors, however, can become life-threatening due to the limited space within the skull and the pressure they exert on surrounding brain tissue.

Causes and Risk Factors

The exact causes of brain tumors are not fully understood in many cases. The following factors are known to increase the risk:

• Ionizing radiation: Prior radiation therapy to the head is a well-established risk factor.
• Genetic syndromes: Hereditary conditions such as neurofibromatosis type 1 and 2, Li-Fraumeni syndrome, and tuberous sclerosis are associated with an increased risk.
• Immunodeficiency: People with a weakened immune system, for example due to HIV infection or organ transplantation, face a higher risk of certain brain tumor types.
• Age: Some tumors such as glioblastoma are more common in older adults, while others such as medulloblastoma primarily affect children.

A conclusive link between mobile phone use or environmental toxins and brain tumor development has not been scientifically established to date.

Symptoms

Symptoms vary depending on the location, size, and growth rate of the tumor. Common signs include:

• Headaches: Often worst in the morning and accompanied by nausea and vomiting, indicating increased intracranial pressure.
• Seizures: New-onset epileptic seizures in adults are an important warning sign.
• Neurological deficits: Weakness, numbness, speech difficulties, or visual disturbances depending on the affected brain region.
• Personality and behavioral changes: Changes in mood, thinking, or behavior may indicate a tumor in the frontal lobe.
• Memory and concentration problems: Cognitive impairment is frequently reported.
• Dizziness and balance problems: Particularly associated with tumors in the cerebellum or brainstem.

Diagnosis

Diagnosis is established through a combination of neurological examination and imaging studies:

• MRI (Magnetic Resonance Imaging): The most important tool for visualizing the location, size, and characteristics of the tumor, often performed with contrast agent.
• CT (Computed Tomography): Frequently used in emergency diagnostic settings.
• Biopsy: Removal of a tissue sample for histological and molecular pathological analysis is essential for definitive diagnosis and treatment planning.
• PET (Positron Emission Tomography): May be used as a complementary method to assess tumor metabolism.
• Lumbar puncture: Examination of cerebrospinal fluid is used when certain tumor types are suspected.

Treatment

Treatment depends on the type, location, size of the tumor, and the overall health of the patient. The main treatment approaches are:

Surgery

Surgical removal (resection) of the tumor is the primary treatment step when feasible. The goal is to remove as much of the tumor as possible while preserving healthy brain tissue. Modern techniques such as neuronavigation and intraoperative MRI greatly improve surgical precision.

Radiation Therapy

Radiation therapy is often used after surgery to destroy remaining tumor cells. Specialized techniques such as stereotactic radiosurgery (Gamma Knife, CyberKnife) allow highly precise treatment with minimal impact on surrounding tissue.

Chemotherapy

Certain brain tumors, especially glioblastoma, are treated with chemotherapy, most commonly with the drug temozolomide. The blood-brain barrier presents a significant challenge for drug delivery to the tumor.

Targeted Therapy and Immunotherapy

Newer treatment approaches include targeted molecular therapies and immunotherapies (e.g., checkpoint inhibitors, CAR-T cell therapies), which are currently being investigated in clinical trials and show promising results for specific tumor types.

Supportive Treatment

Supportive measures include corticosteroids to reduce cerebral edema, antiepileptic drugs for seizure prevention, and rehabilitative therapies such as physiotherapy, occupational therapy, and speech therapy.

Prognosis

Prognosis varies significantly depending on tumor type and grade. Benign meningiomas often carry an excellent prognosis after complete removal. Malignant tumors such as glioblastoma (WHO Grade IV) have a more limited prognosis despite multimodal therapy, with a median survival of approximately 15 months. Advances in molecular pathology and emerging therapies continue to improve outcomes.

References

1. Louis DN et al. - The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro-Oncology, 2021.
2. National Cancer Institute (NCI) - Adult Brain Tumors Treatment (PDQ). www.cancer.gov
3. Stupp R et al. - Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. New England Journal of Medicine, 2005;352(10):987-996.