Editing Brain tumor (section)

{{short description|Neoplasm in the brain}}
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{{Infobox medical condition (new)
| name          = Brain tumor
| synonyms      = Intracranial neoplasm, brain tumour, brain cancer
| image         = Hirnmetastase_MRT-T1_KM.jpg
| caption       = [[Brain metastasis]] in the right [[cerebral hemisphere]] from [[lung cancer]], shown on [[magnetic resonance imaging]]
| field         = [[Neurosurgery]], [[neuro-oncology]]
| symptoms      = Vary depending on the part of the brain involved, [[headache]]s, [[seizure]]s, problem with [[visual perception|vision]], [[vomiting]], [[cognition|mental]] changes<ref name=PDQ2014MD/><ref name=PDQ2014Pt/>
| complications = 
| onset         = 
| duration      = 
| types         = Malignant, benign<ref name=PDQ2014Pt/>
| causes        = Usually unknown<ref name=PDQ2014Pt/>
| risks         = [[Neurofibromatosis]], exposure to [[vinyl chloride]], [[Epstein–Barr virus]], [[ionizing radiation]]<ref name=PDQ2014MD/><ref name=PDQ2014Pt/><ref name=WCR2014CNS/>
| diagnosis     = [[Computed tomography]], [[magnetic resonance imaging]], [[tissue biopsy]]<ref name=PDQ2014MD/><ref name=PDQ2014Pt/>
| differential  = 
| prevention    = 
| treatment     = [[Surgery]], [[radiation therapy]], [[chemotherapy]]<ref name=PDQ2014MD/>
| medication    = [[Anticonvulsant]]s, [[dexamethasone]], [[furosemide]]<ref name=PDQ2014MD/>
| prognosis     = Average [[five year survival rates|five-year survival rate]] 33% (US)<ref name=SEER2019/>
| frequency     = 1.2 million nervous system cancers (2015)<!-- prevalence --><ref name=GBD2015Pre>{{cite journal | title = Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015 | journal = Lancet | volume = 388 | issue = 10053 | pages = 1545–1602 | date = October 2016 | pmid = 27733282 | pmc = 5055577 | doi = 10.1016/S0140-6736(16)31678-6 | vauthors = Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, etal | collaboration =GBD 2015 Disease and Injury Incidence and Prevalence Collaborators }}</ref>
| deaths        = 228,800 (worldwide, 2015)<ref name=GBD2015De>{{cite journal | vauthors = Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, etal | collaboration = GBD 2015 Mortality and Causes of Death Collaborators | title = Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015 | journal = Lancet | volume = 388 | issue = 10053 | pages = 1459–1544 | date = October 2016 | pmid = 27733281 | pmc = 5388903 | doi = 10.1016/S0140-6736(16)31012-1 }}</ref>
}}
A '''brain tumor''' (sometimes referred to as '''brain cancer''') occurs when a group of cells within the [[Human brain|brain]] turn cancerous and grow out of control, creating a mass. There are two main types of [[tumor]]s: malignant (cancerous) tumors and [[benign tumor|benign]] (non-cancerous) tumors.<ref name="PDQ2014Pt">{{cite web |date=14 April 2014 |title=General Information About Adult Brain Tumors |url=http://www.cancer.gov/cancertopics/pdq/treatment/adultbrain/Patient/page1/AllPages |url-status=live |archive-url=https://web.archive.org/web/20140705225928/http://www.cancer.gov/cancertopics/pdq/treatment/adultbrain/Patient/page1/AllPages |archive-date=5 July 2014 |access-date=8 June 2014 |website=NCI}}</ref> These can be further classified as [[primary tumor]]s, which start within the brain, and [[metastasis|secondary]] tumors, which most commonly have spread from tumors located outside the brain, known as [[brain metastasis]] tumors.<ref name="PDQ2014MD" /> All types of brain tumors may produce symptoms that vary depending on the size of the tumor and the part of the brain that is involved.<ref name="PDQ2014Pt" /> Where symptoms exist, they may include [[headaches]], [[seizure]]s, problems with [[visual perception|vision]], [[vomiting]] and [[cognition|mental]] changes.<ref name="PDQ2014MD">{{cite web|title=Adult Brain Tumors Treatment|url=http://www.cancer.gov/cancertopics/pdq/treatment/adultbrain/HealthProfessional/page1/AllPages|website=NCI|access-date=8 June 2014|date=28 February 2014|url-status=live|archive-url=https://web.archive.org/web/20140705230128/http://www.cancer.gov/cancertopics/pdq/treatment/adultbrain/HealthProfessional/page1/AllPages|archive-date=5 July 2014}}</ref><ref name="PDQ2014Pt" /><ref>{{cite book | vauthors = Longo DL |title=Harrison's principles of internal medicine |year=2012 |publisher=McGraw-Hill |isbn=978-0-07-174887-2 |page=3258 |edition= 18th|chapter=369 Seizures and Epilepsy}}</ref> Other symptoms may include difficulty walking, speaking, with sensations, or [[unconsciousness]].<ref name=PDQ2014MD/><ref name=WCR2014CNS/>

The cause of most brain tumors is unknown, though up to 4% of brain cancers may be caused by CT scan radiation.<ref name=PDQ2014Pt/><ref name="nrsCT1">{{cite journal |last1=Smoll |first1=Nicolas R |last2=Brady |first2=Zoe |last3=Scurrah |first3=Katrina J |last4=Lee |first4=Choonsik |last5=Berrington de González |first5=Amy |last6=Mathews |first6=John D |title=Computed tomography scan radiation and brain cancer incidence |journal=Neuro-Oncology |date=6 July 2023 |volume=25 |issue=7 |pages=1368–1376 |doi=10.1093/neuonc/noad012 |pmid=36638155 |pmc=10326490 }}</ref> Uncommon [[Risk factor (epidemiology)|risk factor]]s include exposure to [[vinyl chloride]], [[Epstein–Barr virus]], [[ionizing radiation]], and inherited syndromes such as [[neurofibromatosis]], [[tuberous sclerosis]], and [[von Hippel-Lindau Disease]].<ref name=PDQ2014MD/><ref name=PDQ2014Pt/><ref name=WCR2014CNS/> Studies on [[Mobile phone radiation and health|mobile phone exposure]] have not shown a clear risk.<ref name=WCR2014CNS/> The most common types of primary tumors in adults are [[meningioma]]s (usually benign) and [[astrocytoma]]s such as [[glioblastoma]]s.<ref name=PDQ2014MD/> In children, the most common type is a malignant [[medulloblastoma]].<ref name=WCR2014CNS/> Diagnosis is usually by [[medical examination]] along with [[computed tomography]] (CT) or [[magnetic resonance imaging]] (MRI).<ref name=PDQ2014Pt/> The result is then often confirmed by a [[biopsy]]. Based on the findings, the tumors are divided into [[Grading of the tumors of the central nervous system|different grades of severity]].<ref name=PDQ2014MD/>

Treatment may include some combination of [[surgery]], [[radiation therapy]] and [[chemotherapy]].<ref name=PDQ2014MD/> If seizures occur, [[anticonvulsant]] medication may be needed.<ref name=PDQ2014MD/> [[Dexamethasone]] and [[furosemide]] are medications that may be used to decrease swelling around the tumor.<ref name=PDQ2014MD/> Some tumors grow gradually, requiring only monitoring and possibly needing no further intervention.<ref name=PDQ2014MD/> [[Cancer immunotherapy|Treatments that use a person's immune system]] are being studied.<ref name=PDQ2014Pt/> Outcomes for malignant tumors vary considerably depending on the type of tumor and how far it has spread at diagnosis.<ref name=WCR2014CNS/> Although benign tumors only grow in one area, they may still be life-threatening depending on their size and location.<ref>{{cite web |title=Benign brain tumour (non-cancerous) |url=https://www.nhs.uk/conditions/benign-brain-tumour/ |website=nhs.uk |access-date=29 July 2019 |language=en |date=20 October 2017}}</ref> Malignant glioblastomas usually have very poor outcomes, while benign meningiomas usually have good outcomes.<ref name=WCR2014CNS/> The average [[five-year survival rate]] for all (malignant) brain cancers in the United States is 33%.<ref name=SEER2019>{{cite web |title=Cancer of the Brain and Other Nervous System – Cancer Stat Facts |url=https://seer.cancer.gov/statfacts/html/brain.html |website=SEER |access-date=22 July 2019 }}</ref>

Secondary, or [[metastatic]], brain tumors are about four times as common as primary brain tumors,<ref name=PDQ2014Pt/><ref name=Mer2012>{{cite journal | vauthors = Merrell RT | title = Brain tumors | journal = Disease-a-Month | volume = 58 | issue = 12 | pages = 678–89 | date = December 2012 | pmid = 23149521 | doi = 10.1016/j.disamonth.2012.08.009 }}</ref> with about half of metastases coming from [[lung cancer]].<ref name=PDQ2014Pt/> Primary brain tumors occur in around 250,000 people a year globally, and make up less than 2% of cancers.<ref name=WCR2014CNS>{{cite book|title=World Cancer Report 2014.|chapter-url=http://publications.iarc.fr/Non-Series-Publications/World-Cancer-Reports/World-Cancer-Report-2014|date=2014|publisher=World Health Organization|isbn=978-92-832-0429-9|chapter=Chapter 5.16|url-status=live|archive-url=https://web.archive.org/web/20160919073553/http://publications.iarc.fr/Non-Series-Publications/World-Cancer-Reports/World-Cancer-Report-2014|archive-date=19 September 2016}}</ref> In children younger than 15, brain tumors are second only to [[acute lymphoblastic leukemia]] as the most common form of cancer.<ref name=WCR2014Peads>{{cite book|title=World Cancer Report 2014.|date=2014|publisher=World Health Organization|isbn=978-92-832-0429-9|pages=Chapter 1.3}}</ref> In New South Wales, Australia in 2005, the average lifetime economic cost of a case of brain cancer was AU$1.9 million, the greatest of any type of cancer.<ref>{{cite web|title=Brain Tumour Facts 2011|url=http://www.btaa.org.au/BrainTumourFactSheet2011.pdf|website=Brain Tumour Alliance Australia|access-date=9 June 2014|archive-url=https://web.archive.org/web/20140125234503/http://www.btaa.org.au/BrainTumourFactSheet2011.pdf|archive-date=25 January 2014|url-status=dead}}</ref>
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