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There are two types of brain tumors: primary brain tumors that originate in the brain and metastatic (secondary) brain tumors that originate from cancer cells that have migrated from other parts of the body.
Primary brain cancer rarely spreads beyond the central nervous system, and death results from uncontrolled tumor growth within the limited space of the skull. Metastatic brain cancer indicates advanced disease and has a poor prognosis.
Primary brain tumors can be cancerous or noncancerous. Both types take up space in the brain and may cause serious symptoms (e.g., vision or hearing loss) and complications (e.g., stroke).
All cancerous brain tumors are life threatening (malignant) because they have an aggressive and invasive nature. A noncancerous primary brain tumor is life threatening when it compromises vital structures (e.g., an artery).
Incidence and Prevalence
In the United States, the annual incidence of brain cancer generally is 15–20 cases per 100,000 people. Brain cancer is the leading cause of cancer-related death in patients younger than age 35.
Primary brain tumors account for 50% of intracranial tumors and secondary brain cancer accounts for the remaining cases. Approximately 17,000 people in the United States are diagnosed with primary cancer each year and nearly 13,000 die of the disease. The annual incidence of primary brain cancer in children is about 3 per 100,000.
Secondary brain cancer occurs in 20–30% of patients with metastatic disease and incidence increases with age. In the United States, about 100,000 cases of secondary brain cancer are diagnosed each year.
Causes and Risk Factors
Aside from a known association with exposure to vinyl chloride, there are no known chemical or environmental agents that lead to the development of brain tumors.
Genetic mutations and deletions of tumor suppressor genes (i.e., genes that suppress the development of malignant cells) increase the risk for some types of brain cancer. Inherited diseases that are associated with brain tumors include the following:
Multiple endocrine neoplasia type 1 (pituitary adenoma)
Neurofibromatosis type 2 (brain and spinal cord tumors)
Retinoblastoma (malignant retinal glioma)
Tuberous sclerosis (primary brain tumors)
Von Hippel-Lindau disease (retinal tumor, CNS tumors)
Patients with a history of melanoma, lung, breast, colon, or kidney cancer are at risk for secondary brain cancer.
Exposure to vinyl chloride is an environmental risk factor for brain cancer. Vinyl chloride is a carcinogen, that is, a cancer-causing substance. It is used in manufacturing plastic products such as pipes, wire coatings, furniture, car parts, and housewares, and is present in tobacco smoke.
Manufacturing and chemical plants may release vinyl chloride into the air or water, and it may leak into the environment as a result of improper disposal. People who work in these plants or live in close proximity to them have an increased risk for brain cancer.
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