Christopher Clarke Cancer Research Fund

If You Are Worried

If you are worried by what the doctors have said it might help if you know more about what you may have to deal with. There are a few types of brain tumours.

Signs & Symptoms

Symptoms are often triggered as the tumour grows, causing the pressure to rise inside the brain (sometimes called raised intercranial pressure). This often leads to:


   HEADACHES: These may be most painful in the morning, along with this you may feel or be sick, and feel drowsy
   FITS, MUSCLE SPASMS AND FALLING UNCONSCIOUS: These could be due to epilepsy, a fairly common symptom of brain tumours
   BECOMING IRRITABLE OR LOSING INTEREST IN EVERYDAY ACTIVITIES, SUCH AS WORK OR STUDIES
   BLURRED VISION, PROBLEMS WITH BALANCE AND FEELING CONFUSED
   Symptoms can also be related to the tumour's position inside the brain, which prevents it from working properly. These can include unsteadiness when walking, or a weakness down one side of the body, loss of smell and speech difficulties and hormonal imbalance

The symptoms really depend on where the tumour is in the brain. The cause is unknown.

Facts

The Brain

Our brain is our control centre, all our actions, thoughts, emotions, and personality are controlled by it. That's a pretty amazing feat for something roughly the size of a small cauliflower! The brain is part of our central nervous system (CNS). The rest of the nervous system includes the brain stem, spinal cord and all of our nerves. It is a bit complicated, but understanding more about the brain can help with understanding about brain tumours.

The brain is contained within the skull. It is surrounded by three thin membranes or layers called the meninges, between two of these layers there is fluid called cerebrospinal fluid (CSF). These layers surround the brain, the brain stem and the spinal cord. They protect them, acting as a cushion. The brain is made up of three main areas:


   CEREBRUM: This is the biggest part of the brain and is made up of two halves Ė the left and right hemispheres. The right hemisphere controls the left side of the body and the left hemisphere controls the right side of the body. Although they are two halves they are connected and messages are sent between the two hemispheres
   CEREBELLUM: This is at the back tucked underneath the cerebrum
   THE BRAIN STEM: This is the bottom part of the brain and connects the cerebral hemispheres to the spinal cord

What does each part do?


Each cerebrum has four lobes:


   THE FRONTAL LOBE: This is at the front of the brain. It contains areas that control your personality, thought, memory and behaviour. Towards the back of the frontal lobe are areas that control movement and feeling. Our sense of smell is also controlled here
   PARIETAL LOBE: This is just behind the frontal lobe and deals with sensations like touch, pain and temperature
   TEMPORAL LOBE: This is underneath the frontal lobe just above your ear. It helps us recognise sounds, speech and memory
   OCCIPITAL LOBE: This is at the back of the cerebrum and deals with how we work out what we are seeing

The Brain Stem

This is our life support control and responsible for body functions, including blood pressure, breathing, heart beat, eye movements and swallowing.

The brain is a very complicated organ and quite amazing. Like the rest of the body it is made up of cells. There are different types of cells in the brain including nerve cells called neurons. There are around 40 billion neurons - these cells conduct the nerve impulses which are behind every brain function. We are all born with these cells. One of the differences between nerve cells and other cells in the body is that they canít reproduce and when they are worn out they canít produce more so the number of cells in the brain gradually decreases as we get older! There are a trillion connections, called dendrites, linking the brain's neurons, which adds up to more connections around the brain than there are stars in the entire universe.

Causes

We don't know what causes brain tumours, but research is going on all the time to try and find the answer. But be sure, it isn't anything that you have done!

There has been a lot in the news about whether mobile phones might be linked to brain tumours. There is no evidence available to support this but there hasn't been enough time to really say for certain. For now the advice is that young children should 'have their use limited'.

There are several reasons for this:


   The skulls of young children are thinner than adults, and are still growing, which means the radio waves penetrate more easily
   The brain cells of children absorb more of the radio waves than adults and are more sensitive
   People who first start regularly using a mobile phone as young children will have a longer exposure to any affects of mobile phones than older people. The recomendation for young children and teenagers to keep the use of mobile phones to a minimum is not because experts feel there is a risk but is just to be EXTRA safe. So that if, in the unlikely event, that time does show any hazard children who would be most at risk will have been protected

Treatment

If you are suspected of having a brain tumour then you will most probably have to have several tests to diagnose it.

You may go straight to a doctor or hospital specialising in brain tumours, seeing either a neurologist (a specialist in brain disorders) or oncologist (cancer specialist), or you may see doctors with more general experience first.

If you're diagnosed with a brain tumour and not already seeing a specialist, you will be referred to one. You'll probably have to see a lot of doctors.

The hospital doctor will also examine you and arrange for more detailed tests, a variety of which may be needed to diagnose a brain tumour. These may include:


   X-rays
   Electroencephalogram (EEG), showing electrical activity around the brain
   Brain angiogram, which highlights the structure of the brain's blood vessels
   Checking around the eyes. This can show any raised pressure in the head (known as 'raised intracranial pressure'). Eye tests are also used to check vision
   Hearing tests
   Nerve tests
   Blood tests
   Biopsy of the brain. In most situations doctors need to know whether the tumour is cancerous or benign. If it is cancer, they need to know the exact type. Thatís where the biopsy comes in. This is where a small piece of the tumour is removed for analysis in the lab. It means going into hospital for a few days for an operation under general anaesthetic (where you're put into a deep sleep). During the operation, a small hole is made in the skull through which a fine needle is passed to remove a piece of the tumour. In some situations the exact type of tumour canít be identified until the whole tumour (or part of it) is removed during surgery. This is called an excision biopsy.

Waiting for test results can be a scary time, but understanding a little about them - what will happen, how you'll feel and when you'll get the results - can help you cope.

If it is cancer, you might need a few more tests to check how your body is working in general. These could be blood tests, chest x-rays or tests looking at your heart (an echo-cardiogram or electrocardiogram - ECG), or tests to check your kidneys.

This may seem like a lot of tests, but they are necessary to help the doctors provide the right treatment for you.

Brain tumours are treated with surgery, radiotherapy chemotherapy and steroids depending on the type and where it is- you may have one or a combination of these.

Radiotherapy

Radiotherapy is the use of high energy x-rays. X-rays were discovered about 100 years ago and since then radiation has been used to help diagnose and treat cancer. Radiotherapy is used:


   TO CURE THE CANCER: Radiotherapy can be given to destroy the tumour and, hopefully, cure the cancer. It can be given before or after surgery or chemo. Sometimes radiotherapy and chemotherapy are given at the same time which is known as chemoradiotherapy
   TO RELIEVE SYMPTOMS: This is called Ďpalliative treatmentí. Sometimes, if itís not possible to cure a cancer, radiotherapy may be given to relieve symptoms, for example, to lessen pain. Lower doses of radiotherapy are given than in curative treatment, maybe just one or two treatments over a shorter period of time
   IN STEM CELL AND BONE MARROW TRANSPLANTS: This is called total body irradiation and is less common than the other types of radiotherapy. Itís mainly used for people who are having a bone marrow or stem cell transplant, for example, as a treatment for leukaemia. A large, single dose (or 6 to 8 smaller doses) of radiation, is given to the whole body to destroy the cells of the bone marrow. Very high doses of chemo are given, followed by new bone marrow or stem cells to replace the destroyed bone marrow. There will be more about this in our stem cell transplants section

Chemotherapy (Drug Therapy)

Chemo use of anti-cancer drugs to destroy cancer cells, including leukaemia and lymphoma. There are about 50 or so different chemo drugs. Some are given on their own and others are given together - this is known as 'combination chemo'.

The treatment you are given depends on different things, like the type of cancer you have, where in your body it started, what the cells look like under a microscope and whether they've spread anywhere else.

Chemo is given in different situations. It is sometimes the main treatment or it might be given alongside surgery and/or radiotherapy (high energy x-ray treatment). For example, it might be given before an operation, to help shrink the tumour down so that it's easier to remove. Or it might be given after an operation to get rid of any stray cancer cells left behind.

Surgery

If you have seen any TV hospital dramas or documentaries then you probably have a good idea of what happens when someone has surgery.

Surgery is one of the main treatments for cancer and is the removal of the cancer during an operation under anaesthetic. For some cancers it is all that you need, but for other cancers you might need to have chemotherapy and or radiotherapy as well.

Going for an operation whatever it is (whether itís to have a central line(drip) put in or to have your tumour removed) can be pretty frightening. Having some information about what to expect can help you feel a bit more prepared.

I hope this information helps to alleviate your fears.

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Objective 1 
To promote scientific research for the public into the pathophysiology, treatment and prevention of primary brain tumours in young people and to disseminate the results

Objective 2 
To advance the public's education on matter's relating to brain tumours

   Karen Clarke
C/O Lancashire Living
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Ramsbottom
Lancashire
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Mrs Karen Clarke - Chairperson
Professor Noel Clarke
Mr Phillip Wheelhouse
Reverend Steven Harvey
Lady Ruth Trippier
Mr Colin Cooper
Dr Richard Slade
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