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Tumors that have spread to the brain (metastatic)

3 weeks ago
818 بازدید

تومورهای منتشر شده به مغز (متاستاتیک)

تومور متاستازیک مغزی (به آن متاستاز مغز یا تومور ثانویه‌ی مغزی نیز گفته می‌شود)، نوعی سرطان است که در هرجایی از بدن شروع می‌شود و تا مغز گسترش می‌یابد. تومور متاستاتیک مغزی معمولاً حاوی همان نوع سلول‌های سرطانی می‌باشند که در محل اولیه‌ی وقوع سرطان یافت می‌شود. به‌طور مثال، سلول‌های سرطانی در ریه، سینه، پوست، روده یا کلیه می‌توانند از طریق جریان خون در بدن حرکت کنند و باعث ایجاد یک تومور متاستازیک یا ثانویه شوند. متاستاز مغز می‌تواند یک تومور یا چند تومور باشد.

زمانی که در بخشی از بدن دچار سرطان شده و سرطان از آن بخش خاص به سمت مغز پراکنده شود، اصطلاحاً عنوان می‌شود که تومور در حال متاستاز است. در حال حاضر، شیوع تومورهای متاستازیک مغزی سریع‌ترین رشد را در بین انواع دیگر تومورها دارد. به خاطر پیشرفت‌هایی در درمان، بیماران بیشتری از سرطان جان سالم بدر می‌برند و طول عمری بیشتر دارند. اگرچه، سرطان اولیه می‌تواند در بدن تداوم داشته باشد و با گذشت زمان ممکن است مجدداً در مغز، به‌صورت یک تومور متاستازیک مغزی، بازگردد

شیوع

  • تومور متاستاتیک مغز، شایع‌ترین تومور مغزیدر مسان افراد بزرگ‌سال هستند. میزان شیوع متاستاز مغز ده برابر بالاتر از میزان شیوع همه‌ی تومورهای مغزی اولیه‌ی ترکیبی تخمین زده‌شده است.
  • افزایش شیوع این بیماری در سنین 45 تا 64 سال شروع می‌شود و در افراد بالای 65 سال، بیشترین میزان را دارد. Since these patients live with their cancers for a longer period of time, most of them will develop metastases. The exact prevalence of metastatic brain tumors is not known, but it is estimated between 200,000 and 300,000 people per year. Research shows that approximately 80% of metastatic brain tumors are multiple tumors and 10-20% are single tumors. A tumor occurs in the brain. About 85% of metastatic tumors are located in the brain (forebrain) and 15% in the cerebellum (hindbrain). Although the spread of melanoma or skin cancer to the brain is more common in men, gender does not seem to play a role in the overall prevalence of brain metastases. Skin cancer (melanoma), lung cancer, and breast cancer are the most common. There are cancers that progress to brain metastasis, accounting for 67-80% of all cancers. Central nervous system (CNS) metastasis is rare in children and accounts for only 6% of tumors in children.

Diagnosis of metastatic tumor

After neurological symptoms appear in the patient, the specialist doctor usually recommends a neurological test and a brain scan (CT scan or MRI) to be able to identify the tumor in the brain. Images taken of the brain help the doctor find out:

  • The size and number of tumors
  • The exact location of the tumors in the brain or spine
  • Damage to nearby structures

Although scans can help the doctor make an accurate diagnosis, testing a sample of tumor tissue (removed through surgery or a biopsy) can confirm accurate pathology diagnosis using a microscope. Another way to discover metastatic brain tumor is to perform clinical tests. Cancer patients can undergo new treatments (such as clinical trials) that require brain imaging, and brain metastases may sometimes be discovered during the imaging. A metastatic brain tumor usually contains the same cancer cells as those found at the site of the primary cancer. For example, lung cancer metastasizes to the brain and causes lung cancer in the brain. However, recent research shows that when some tumors reach the brain, they develop new genetic mutations in the original tumor. In the rare case that a metastatic tumor is detected before the primary cancer is discovered, tests will be done to determine the location of the primary cancer.

Symptoms

The symptoms of a metastatic brain tumor are the same as primary brain tumor and depend on the location and location of the tumor in the brain. Seizures and headaches are the most common symptoms of a brain tumor. Disruption in the way of thinking and processing thoughts (perception) is another common symptom. Movement problems such as weakness on one side of the body or imbalance in walking can be related to the location of the tumor in the part of the brain that controls these functions.

Examples of brain metastasis

Lung cancer metastasis to the brain

  • The most common type of brain metastases seen in men and women. or is found shortly after the initial lung tumor is discovered (on average, 6 to 9 months).
  • Having multiple brain metastases is common.

Breast cancer metastasis to the brain

  • The second most common type of brain metastasis seen in women.
  • Metastases often occur several years after breast cancer is discovered (on average, 2 to 21 months). occur, but metastases are uncommon 5 or 10 years after treatment.
  • Generally found in younger, premenopausal women because they are more likely to develop triple-negative breast cancer (TNBC). It is more common
  • The presence of two or more metastatic brain tumors is common.

Skin cancer or melanoma metastases to the brain

  • It is the second most common type of brain metastasis in men.
  • Metastases often appear several years after melanoma or primary skin cancer.
  • Multiple brain metastases are common.
  • Melanoma tumors Metastatic, they are full of blood vessels that are very likely to bleed.

Intestinal cancer metastasis to the brain

  • Metastases often occur several years after the discovery of the primary cancerous tumor.
  • In this case, a metastatic tumor is common.

Kidney cancer metastasis to the brain

  • Metastases often occur within a few years after the primary tumor appears. occur.
  • Single tumors are common in this case.
  • Metastatic brain tumors often contain blood vessels that are prone to bleeding.

Metastatic tumor treatment

When a brain scan shows a suspected brain tumor, your next step is to consult with specialists who specialize in diseases of the brain and central nervous system, such as:

  • Neurosurgeon
  • Neurologist and oncologist neuro-oncologist (a doctor who specializes in the treatment of cancers of the nervous system).
  • Radiotherapy oncology specialists (a doctor who uses radiotherapy to treat cancer).

The medical team includes a group of specialists in several medical fields who help make the necessary and effective decisions for your treatment. The team must balance the process of treating the primary cancer site and treating the metastatic brain tumor. By looking at the scans and looking at the results, they will determine if the tumor or tumors can be removed surgically or if other treatment options are right for you. The decisions that will be made for the treatment process will not only enable the possibility of saving the patient in the long term, but will also improve your quality of life during and after treatment, as well as your cognitive problems. When planning your treatment plan, the specialist doctor considers several factors:

  • The patient's history of cancer
  • The patient's cancer status
  • The patient's general health
  • The number and size of the metastatic tumors
  • The location of the metastatic tumors in the brain and spine
  • The tumor's response to previous treatment and its potential response to the next treatment

3 The main categories of treatment for metastatic brain tumors include surgery, radiotherapy, and drug therapy (chemotherapy, target therapy, or targeted therapy, or nervous system-based therapy). Your specialist doctor may prescribe a combination of these treatments for you. Like any disease, brain tumor treatment may come with possible side effects. You can ask your doctor about these side effects. He or she can help you and your family weigh the risks of treatment against the benefits.

Surgery

When there is a tumor and the cancer has not spread to other parts of the body, they mostly use surgery to treat it. Some tumors may be removed completely and disappear. Tumors that are deep and penetrate the brain tissue can be reduced in size (debulked). In cases where the tumor cannot be completely removed, surgery can relieve the pressure and symptoms.

Whole brain radiotherapy

Whole brain radiotherapy is the usual treatment of radiation therapy for a metastatic brain tumor, especially when there are multiple tumors (more than three tumors). The goal of this treatment is to treat tumors seen on imaging scans as well as tumors that are too small to be seen. As a result, whole brain radiotherapy can have both therapeutic and preventive aspects. An important and usual concern regarding whole brain radiotherapy is its possible impact on the perception and mind of the patient because a large part of the brain is affected by radiotherapy radiation. Research in this field is still being carried out.

Stereotactic radiotherapy

Radiosurgery or stereotactic radiation surgery (SRS) is a special type of radiotherapy. SRS is a special type of radiation therapy that sends highly focused, high-dose x-rays to a small, specific area in the brain. Since the delivery of radiation to the tumor in the SRS method is more precise and closer than whole brain radiotherapy, it can deliver a higher and more effective dose of treatment to the tumor site. Recent advances have made stereotactic radiosurgery an effective treatment option for some patients with metastatic brain tumors. The focus of this technique is on sending high doses of radiation at a distance closer to the tumor, this distance will be greater compared to the whole brain radiotherapy method, whose approach is to prevent and protect healthy brain tissue around the tumor. This procedure is most often performed in situations where there are fewer than three tumors and the tumors are relatively small (3 cm or less in diameter). Another thing to consider is whether the tumors are in obvious, accessible areas, such as specific motor and speech areas in the brain. Radiosurgery can also be used to treat tumors that cannot be reached with conventional surgery, such as tumors that are deep in the brain. Also, if whole brain radiotherapy has been used before, this method can be used for tumor recurrence, or as a local boost after whole brain radiotherapy. Examples of stereotactic radiosurgery devices include LINAC, Gamma Knife, or Cybernab radiosurgery. panel-widget-for-3371-0-0-1">


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