5: Types of Brain Tumour
Warning: there is an MRI image of a brain tumour below, which might sensibly be seen by children with supervision and explanation. There is explanatory text.
This page will not provide a catalogue of different tumours.
You can find details of different tumour types on the internet by searching for the name of the tumour. Technical information is available in such places as the NSW Cancer Council web site, at Virtual Trials, etc. Hospitals and doctors have web sites. Be conscious that some may be selling a service. Some public health sites provide immense amounts of information, though in casting a net widely, as here, in Northern Sydney and Central Coast, the results are thin.
It is important in discussion in our internet group that if you speak of a situation or ask about your situation, you name the type of tumour.
Here are important variables:
• malignant or benign... for the most part, our members are dealing with malignant tumours.
• if malignant, grade of tumour, from I to IV... diagnosis normally only occurs from II onwards. The most commonly diagnosed is Gliioblastoma Multiforme Grade IV - GBM IV - because it grows so swiftly it is impossible to ignore.
• type of tumour, which also has consequences. Some are more likely that others to respond to particular treatments; some are more likely than others to recur after treatment; Australian government approval for subsidy of treatments is related to particular tumour types for which treatments have been demonstrated.
The image to the right is of Glioblastoma Multiforme Grade IV [GBM-IV], in an MRI scan.
This is the most aggressive of brain tumours. The highest level of malignancy, the most aggressive in growth, the most commonly diagnosed (two thirds of all diagnoses). Very hard not to become aware of it when it can double its cell numbers in less than a day... However, the big black space is probably from some older, lower grade tumour... the black space is fluid, a cyst.
The MRI scan is the critical first step in diagnosis of brain tumour. Much clearer evidence than from a CT scan. In this scan see these factors:
1: there is a large black space which is a cyst of fluid, formed in dead cells inside the tumour. This is not uncommon. As tumours grow, they build their own mucky messy systems of blood vessels as they need a big blood supply or tumour cells, without blood supply, die... and the system forms in that necrotic mess. You can see that the cyst adds to the 'mass effect' of the tumour, exerting pressure on the brain.
2: there is no 'discrete' mass, no benign lump of something that can be easily removed... the tumour infiltrates and seeds.
3: the pressure has shifted the midline of the brain and has also distorted the 'ventricles' - the fluid filled spaces connected to the midline in the scan.
Among factors determining prospects (prognosis) at diagnosis are:
A: type of tumour
B:
how well the person is
C: size of the lesion
D: extent of shift of the midline
E: whether it is a 'discrete mass' or diffuse or infiltrating
F: location in the brain and to what extent 'all of it' can be removed... noting that with GBM_IV you cannot really remove it all.
Type of tumour is thus one of many factors.
That's a very personal scan for me to present here... (writes Dennis) Here alongside is a photo of my late wife Margaret a few hours before her first operation, a few days after that scan, a scan called for because her old sinus pain became too great, she became far too tired, she became a little confused.
The options for treatment a different in different places, they depend on the type of tumour, the type of doctor, the type of attitudes on all sides.
The issues of quality of life and death need to be kept in your hands and not surrendered to the tumour. We only get one life...