There's nothing simple about brain surgery, and even a minor biopsy carries substantial risks. To get around these dangers, using a spinal tap to analyze cerebrospinal fluid may soon be a viable method of diagnosing brain cancers.
A study published recently showed that analysis of microRNA levels in cerebrospinal fluid proved to be a quick, effective tool for diagnosing brain cancers.
Researchers found that this tool could also monitor the effectiveness of cancer treatment.
Ask your oncologist about microRNA analysis.
A joint venture between Brigham and Women's Hospital and the University of California in San Diego showed that the levels of specific microRNAs, miR-10b and miR-21, were significantly increased in patients with active brain tumors or tumor metastasis to the brain from breast or lung cancers.
The levels of these microRNAs were lower in cases where the tumor was in remission, or the lesion was benign (non-cancerous).This could soon give doctors the ability to find out relatively quickly with a simple test whether an abnormal lesion in the brain is an aggressive cancer or a benign growth without performing surgery.
"We are excited about the potential that this test has to ease the process of detecting and monitoring brain tumors," said Anna M. Krichevsky, PhD, the study author from Boston's Brigham and Women's Hospital.
"The test needs to be further developed before it is used in a clinical setting, but I expect it could be particularly valuable for patients who are not surgical candidates due to the tumor's size or location, or due to an underlying medical condition."
The study enrolled 118 patients, analyzing microRNA levels in the cerebrospinal fluid and comparing results with other, traditional methods of brain tumor analysis.
While there are risks with the sampling of cerebrospinal fluid, it is not as prone to complications as other types of detecting or analyzing brain cancer, which generally means a surgical biopsy or brain surgery.
The test worked for detecting glioblastoma as well as metastatic brain tumors from other parts of the body.
Researchers concluded that the cerebrospinal fluid test was also an effective tool for monitoring the effectiveness of treatment, and further development of the test could improve chemotherapy or radiation effectiveness in glioblastoma.
The study was published in the journal Neuro-Oncology on April 17, 2012.
A patent related to the test is pending. The study was funded by National Institutes of Health, the Sontag Foundation and the James S. McDonnell Foundation.
Brain Tumors
Each year in the United States, over 25,000 people will be newly diagnosed with some form of primary malignant brain tumor, and over 90,000 people are currently living with the disease and undergoing treatment. Approximately 13,000 of these patients will die from the disease, representing 2% of all cancer deaths.
Brain tumors encompass a wide variety of types of cancer, some more aggressive than others. They include:
- Glioblastoma multiforme (GBM) ? A deadly tumor forming in the white matter of the brain. Makes up 52% of all cerebral tumors and most common in white and Asian men over age 50. It is very difficult to treat and average survival after diagnosis is 14 months.
- Astrocytoma ? a tumor that forms from the glial cells in the brain (support cells for neurons). These can be benign or malignant (GBM is a form of astrocytoma) and appear in young children as well.
- Oligodendroglioma ? arise from the oligodendrocytes (insulating cells for axoms). They appear mostly in adults around age 35 and represent about 10% of all primary brain tumors and tend to recur after treatment.
- Ependymoma ? arises from tissues in the brain that surround the drainage system of the brain. They represent about 5% of adult brain tumors, and 10% of pediatric brain tumors, peaking at age 35 and earlier at age 5. Often they end up causing hydrocephalus, or ?water on the brain."
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Brain tumors are caused by a change in genetics, much like any other cancer that causes cells to grow out of control. Some brain tumors are associated with specific chromosomal changes, but in most cases, the cause of a brain tumor is unknown, and due to some combination of genetic instability and environmental damage.
Symptoms of a brain tumor depend mainly on the size of the tumor and where it is located in the brain. Because the brain is housed in the skull, a growing tumor will cause something called mass effect, where the enlarging tumor is taking up too much space and cause increased pressure in the brain. This can cause terrible headaches, nausea, vomiting, and changes in consciousness among other specific signs. In other cases, the growing tumor may encroach upon a part of the brain that has a specific function, and cause that function to cease. Depending on what part of the brain the tumor is in, language, motor coordination, vision, balance, and paralysis can occur. In both cases, a brain tumor can present immediately or after several years of growing.
Diagnosis of a brain tumor will ultimately be made by CT scan and MRI. Treatment of brain tumors may involve surgery, radiation, and chemotherapy. Additionally, MRI-guided laser ablation is frequently used, a technique that involves placing a laser directly into the tumor, and then guiding the laser to destroy the tumor with heat while leaving the surrounding brain tissue undisturbed. Each modality presents its own risks and benefits. Surgery is sometimes not possible because of risk to damage of vital brain structures necessary for life.
Prognosis for a brain tumor is entirely dependent on the type of tumor and its location. Some tumors grow very fast and are inoperable due to the cell type and location, and these patients have a poor prognosis. Other brain tumors can be lived with for years, or quickly and easily treated with surgery.
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