Recognizing the signs and symptoms of brain tumours: The importance of early diagnosis and effective treatment

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To many people, a brain tumour is one of the most frightening diagnoses imaginable, with symptoms affecting the very core of one’s personality and self-control. In most cases, the symptoms of a brain tumour are dramatic and can significantly impact a person’s health – physically, mentally and emotionally, and as a result their overall quality of life.

In Canada, it is estimated that 55,000 people are living with a brain tumour, and each year, approximately 10,000 more are newly diagnosed. As a neurologist, it is essential to communicate the importance of detecting a brain tumour early, so that patients can be successfully diagnosed and treated.

Symptoms of a brain tumour may develop due to one or more of the following circumstances: First, the tumour may block the flow of cerebrospinal fluid or because of its size, cause pressure to build up inside the head. Second, if the tumour presses on or damages the brain, it can affect its ability to function normally. Third, the tumour may irritate the brain and cause seizures.

General symptoms often begin with non-throbbing headaches that come and go – most patients will have them at some stage during their illness. Patients often report that these headaches are worse in the morning and when exercising or changing position. With time, the headaches become more frequent and more severe, and may be accompanied by nausea or vomiting. Seizures are also common, and are caused by disruption in the brain’s electrical activity. Problems with mental ability such as memory, speech and concentration can occur, and more severe mental changes affecting behaviour, temperament and intellectual ability can also affect patients.

Focal symptoms, such as progressive weakness or numbness of one side of the body, unsteady walking, difficulty speaking, or vision changes, often occur along with the headaches and other general symptoms.

Brain tumours are categorized as either primary or secondary. Primary brain tumours start in the specialized cells that make up the brain and its coverings. On the other hand, secondary or metastatic brain tumours start in another body organ such as the lung, breast, kidney or skin and then spread to the brain.

The most common and deadliest type of primary brain tumour is glioblastoma multiforme (GBM), also called astrocytoma grade IV. The average survival time among patients with GBM, even with the most aggressive treatment, is unfortunately usually less than one year.

However, over the last year there has been some good news for patients with GBM. In addition to improvements in radiation therapy (new imaging techniques and multimodal treatment approach), in February 2006, TEMODAL¨ (temozolomide) was the first treatment to be approved for use in combination with radiotherapy for adult patients with newly diagnosed GBM, following priority review by Health Canada. TEMODAL, taken by mouth daily during radiation therapy then five days every four weeks for six months after radiation therapy, improves survival compared to radiation therapy alone. TEMODAL produces relatively mild side effects in most patients. In a disease for which few effective treatments exist, TEMODAL provides hope for Canadians living with this particularly serious and aggressive type of brain tumour. As a treating physician, TEMODAL gives neurologists and oncologists another way to help patients in their fight against this deadly disease.

To detect and treat a brain tumour early, people should consult with their doctor if they experience any significant changes in their daily health pattern. For example, you should consult with your doctor if you have headaches that progressively worsen, are particularly severe, are always in the same area, or include nausea, vomiting, blurred or double vision. This is a terrible disease, but through early diagnosis, we can provide patients with the most effective treatment for their condition.