Reference
- Brain CancerIn the spectrum of all cancers, brain cancer is a unique entity because it affects people of all ages—brain tumors are the most common cancer of children after leukemias—and has relatively few known causes and risk factors. Brain cancer is also interesting because there are more than 20 different types of primary brain tumors, and the brain is a common location for metastatic cancers from other organs. The most common metastases to the brain are lung and breast cancers.
The most common symptom experienced by people with brain tumors is progressive neurologic deficit, usually weakness. Headaches are the second most common symptom of brain tumors and occur for five different reasons: 1.) increased intracranial pressure (ICP), 2.) high blood pressure secondary to the elevated ICP, 3.) invasion or compression of pain-sensitive structures (e.g., blood vessels) by the tumor, 4.) secondary to difficulty with vision, and 5.) psychological secondary to other symptoms caused by the tumor. Other symptoms may depend on the location of the tumor. If the tumor is supratentorial (above the tentorium cerebelli, the sheet of dura mater that separates the inferior cerebellum from the superior cerebral cortex), other symptoms may include seizures and mental status changes. Infratentorial tumors, on the other hand, may have symptoms of hydrocephalus due to obstruction of cerebrospinal fluid flow.
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Streaming Media
- Fighting Skin Cancer and Brain Tumors with New MethodsTwo of the most aggressive and deadly forms of cancer may soon become the targets of powerful drugs that work in tandem with the body’s own immune system. This program explores recent research in the development of biochemical weapons to fight brain and skin cancer. Visiting a German pharmaceutical company at the forefront of these advances, the film shows how TGF (transforming growth factor) beta proteins create a protective layer around brain tumors and how antisense agents are deployed to break through these malignant defenses. Microscopic time-lapse views illustrate the process. The use of humane animal cloning to produce bispecific antibodies for fighting skin cancer is also illustrated in detail. Numerous expert interviews are included.
Online Resources
- A homing system targets therapeutic T cells to brain cancerSuccessful T cell immunotherapy for brain cancer requires that the T cells can access tumour tissues, but this has been difficult to achieve. Here we show that, in contrast to inflammatory brain diseases such as multiple sclerosis, where endothelial cells upregulate ICAM1 and VCAM1 to guide the extravasation of pro-inflammatory cells, cancer endothelium downregulates these molecules to evade immune recognition. By contrast, we found that cancer endothelium upregulates activated leukocyte cell adhesion molecule (ALCAM), which allowed us to overcome this immune-evasion mechanism by creating an ALCAM-restricted homing system (HS). We re-engineered the natural ligand of ALCAM, CD6, in a manner that triggers initial anchorage of T cells to ALCAM and conditionally mediates a secondary wave of adhesion by sensitizing T cells to low-level ICAM1 on the cancer endothelium, thereby creating the adhesion forces necessary to capture T cells from the bloodstream. Cytotoxic HS T cells robustly infiltrated brain cancers after intravenous injection and exhibited potent antitumour activity. We have therefore developed a molecule that targets the delivery of T cells to brain cancer.
- Parental Exposure to Pesticides and Childhood Brain Cancer: U.S. Atlantic Coast Childhood Brain Cancer StudyThe etiology of childhood brain cancer remains largely unknown. However, previous studies have yielded suggestive associations with parental pesticide use. Objectives: We aimed to evaluate parental exposure to pesticides at home and on the job in relation to the occurrence of brain cancer in children. Methods: We included 526 one-to-one-matched case-control pairs. Brain cancer cases were diagnosed at < 10 years of age, and were identified from statewide cancer registries of four U.S. Atlantic Coast states. We selected controls by random digit dialing. We conducted computer-assisted telephone interviews with mothers. Using information on residential pesticide use and jobs held by fathers during the 2-year period before the child's birth, we assessed potential exposure to insecticides, herbicides, and fungicides. For each job, two raters independently classified the probability and intensity of exposure; 421 pairs were available for final analysis. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic regression, after adjustment for maternal education. Results: A significant risk of astrocytoma was associated with exposures to herbicides from residential use (OR = 1.9; 95% CI, 1.2-3.0). Combining parental exposures to herbicides from both residential and occupational sources, the elevated risk remained significant (OR = 1.8; 95% CI, 1.1-3.1). We observed little association with primitive neuroectodermal tumors (PNET) for any of the pesticide classes or exposure sources considered. Conclusions: Our observation is consistent with a previous literature reporting suggestive associations between parental exposure to pesticides and risk of astrocytoma in offspring but not PNET. However, these findings should be viewed in light of limitations in exposure assessment and effective sample size.
Perspectives
When Breath Becomes Air
#1 NEW YORK TIMES BESTSELLER * For readers of Atul Gawande, Andrew Solomon, and Anne Lamott, a profoundly moving, exquisitely observed memoir by a young neurosurgeon faced with a terminal cancer diagnosis who attempts to answer the question What makes a life worth living? At the age of thirty-six, on the verge of completing a decade's worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor treating the dying, and the next he was a patient struggling to live. And just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air chronicles Kalanithi's transformation from a naïve medical student "possessed," as he wrote, "by the question of what, given that all organisms die, makes a virtuous and meaningful life" into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality. What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir. Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. "I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything," he wrote. "Seven words from Samuel Beckett began to repeat in my head: 'I can't go on. I'll go on.'" When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both. Praise for When Breath Becomes Air "I guarantee that finishing this book and then forgetting about it is simply not an option. . . . Part of this book's tremendous impact comes from the obvious fact that its author was such a brilliant polymath. And part comes from the way he conveys what happened to him--passionately working and striving, deferring gratification, waiting to live, learning to die--so well. None of it is maudlin. Nothing is exaggerated. As he wrote to a friend: 'It's just tragic enough and just imaginable enough.' And just important enough to be unmissable."--Janet Maslin, The New York Times "An emotional investment well worth making: a moving and thoughtful memoir of family, medicine and literature. It is, despite its grim undertone, accidentally inspiring."--The Washington Post "Possesses the gravity and wisdom of an ancient Greek tragedy . . . [Kalanithi] delivers his chronicle in austere, beautiful prose. The book brims with insightful reflections on mortality that are especially poignant coming from a trained physician familiar with what lies ahead."--The Boston Globe "Devastating and spectacular . . . [Kalanithi] is so likeable, so relatable, and so humble, that you become immersed in his world and forget where it's all heading."--USA Today "It's [Kalanithi's] unsentimental approach that makes When Breath Becomes Air so original--and so devastating. . . . Its only fault is that the book, like his life, ends much too early."--Entertainment Weekly "[When Breath Becomes Air] split my head open with its beauty."--Cheryl Strayed
Brain Cancer: Methods of Cancer Diagnosis, Therapy, and Prognosis
This eighth volume in the series Methods of Cancer Diagnosis, Therapy, and Prognosis discusses in detail the classification of the CNS tumors as well as brain tumor imaging. Scientists and Clinicians have contributed state of the art chapters on their respective areas of expertise, providing the reader a whole field view of the CNS tumors and brain tumor imaging in Europe.This fully illustrated volume:Explains the genetics of malignant brain tumors and gene amplification using quantitative-PCR;Presents a large number of standard and new imaging modalities, including magnetic resonance imaging, functional magnetic resonance imaging, diffusion tensor imaging, amide proton transfer imaging, positron emission tomography, single photon emission computed tomography, magnetic resonance single voxel spectroscopy and intraoperative ultrasound imaging, for staging and diagnosing various primary and secondary brain cancers;Explains the usefulness of imaging methods for planning and monitoring (assessment) therapy for cancers;Discusses diagnosis and treatment of primary CNS lymphomas, CNS atypical teratoid/rhabdoid and CNS Rosai-Dorfman disease;Includes the subject of translational medicine. Professor Hayat has summarized the problems associated with the complexities of research publications and has been successful in editing a must-read volume for oncologists, cancer researchers, medical teachers and students of cancer biology.
Atlas of Pediatric Brain Tumors
Recent evidence indicates that the physiology and response to various drugs in the pediatric population differs from that of the adult and must be appreciated to be able to fully address the health needs of the pediatric population. Atlas of Pediatric Brain Tumors covers areas ranging from neuroimaging, the use of crush and touch preps during introperative consultation, classic histological features of brain tumors, tumor variants, and a miscellaneous group of challenging tumors. Chapters consist of essential diagnostic information and features highlighting recognized variants and their differential diagnoses. A section on molecular pathology and electron microscopy is also included for each tumor category; along with a list of classic reviews and innovative articles on each of the tumor entities as suggested reading at the end of each chapter. Created to fill a void in the practice of pediatric neuropathology, this practical and well-illustrated Atlas of Pediatric Brain Tumors represents a collection of interesting, common and unusual tumors for a diagnostic exercise by the reader.
Brain Tumors
Surgical neuropathology is a challenging arena for many pathologists, due in large part to a relative lack of experience of most pathologists in this area compared to other areas of surgical pathology. Brain Tumors is intended to address this need with cases drawn from the surgical neuropathology practices of the authors. This volume provides examples of over 100 brain tumors, running the gamut from the very common to the rare. Each example is presented in a case based format and the wide variety of cases presented covers the entire scope of brain tumors and offers the opportunity to review both the basics for the beginner or relatively inexperienced pathologist and also offers experienced pathologists the chance to see some of the rare entities. Each case is formatted as if it were a consult case and includes a brief clinical history, description of the pathologic findings with numerous illustrations, the line diagnosis, discussion of the entity, and the diagnostic thought process as well pertinent references for further reading. When relevant, current practical applications of immunohistochemistry and molecular pathology are discussed. The Consultant Pathology Series The Consultant Pathology series is designed to disseminate the knowledge of expert surgical pathology consultants in the analysis and diagnosis of difficult cases to the full community of pathology practitioners. The volumes are based on actual consultations and presented in a format that illustrates the expert's process of evaluating the case, including indications for consultation, the consultants findings and comment, and discussion of the entity that amplifies the case description. Each volume in the Consultant Pathology series is authored by international experts with extensive case experience in the areas covered
The Neuroscientist Who Lost Her Mind
In the tradition of My Stroke of Insight and Brain on Fire, this powerful memoir recounts Barbara Lipska's deadly brain cancer and explains its unforgettable lessons about the brain and mind. Neuroscientist Lipska was diagnosed early in 2015 with metastatic melanoma in her brain's frontal lobe. As the cancer progressed and was treated, she experienced behavioral and cognitive symptoms connected to a range of mental disorders, including dementia and her professional specialty, schizophrenia. Lipska's family and associates were alarmed by the changes in her behavior, which she failed to acknowledge herself. Gradually, after a course of immunotherapy, Lipska returned to normal functioning, amazingly recalled her experience, and through her knowledge of neuroscience identified the ways in which her brain changed during treatment. Lipska admits her condition was unusual; after recovery she was able to return to her research and resume her athletic training and compete in a triathalon. Most patients with similar brain cancers rarely survive to describe their ordeal. Lipska's memoir, coauthored with journalist Elaine McArdle, shows that strength and courage but also an encouraging support network are vital to recovery.
And Finally
From the bestselling neurosurgeon and author of Do No Harm, comes Henry Marsh's And Finally, an unflinching and deeply personal exploration of death, life and neuroscience. As a retired brain surgeon, Henry Marsh thought he understood illness, but he was unprepared for the impact of his diagnosis of advanced cancer. And Finally explores what happens when someone who has spent a lifetime on the frontline of life and death finds himself contemplating what might be his own death sentence. As he navigates the bewildering transition from doctor to patient, he is haunted by past failures and projects yet to be completed, and frustrated by the inconveniences of illness and old age. But he is also more entranced than ever by the mysteries of science and the brain, the beauty of the natural world and his love for his family. Elegiac, candid, luminous and poignant, And Finally is ultimately not so much a book about death, but a book about life and what matters in the end.