Chapter 16: brain tumors

Question 1

Primary tumors

Answer 1

Form within the CNS

Question 2

Secondary tumors

Answer 2

Form in other parts of the body outside the CNS, and then the cancer cells migrate to the brain.

Question 3

Meningioma

Answer 3

A benign (goedaardige) brain tumor that forms in the cells of the meninges that protect the brain.

Question 4

Gliomas

Answer 4

A brain tumor that forms within the glial cells, a malignant (bad/dodelijk) type of tumor.

Question 5

Benign vs. malignant tumors

Answer 5

Stage I tumors are benign, while from stage II upward they become malignant. They are more likely to return and develop into the next stage.

Question 6

Cognitive impairments

Answer 6

Congitive impairments happens more in stage IV than at stage I or in certain types of molecular markers of the tumor. A glioma with IDH-wildtype shows more cognitive impairments than a glioma with IDH-mutant mutation. People with meningiomas can also experience cognitive impairments, because the tumor can act as pressure to the tissue.

Question 7

Neurosurgery

Answer 7

Doing a biopsy of the tumor to determine the diagnosis in order to determine the treatment. Neurosurgery can relieve neurolgoical symptoms and improve life expectancy by removing (a part) of the tumor). People shouldn’t be awake during surgery to make sure the vital tissue is not damaged.
Cognitive functioning usually improves after surgery, but in gliomas it can still be deteriorated.

Question 8

Chemotherapy

Answer 8

Is directed to stopping the rampant division of tumor cells, often as an early treatment. The treatment is given in cycles with recovery periods between them. If this is done in combination with readiotherapy, the BBB can be disrupted and neurotoxicity of the chemo can cause brain damage and cognitive impairments.

Question 9

Radiotherapy

Answer 9

Damages the genetic material of the cell. Tumor cells are more sensitive to radiation, so it kills the tumor cells and leaves the healhty tissue surrounding it. Consequences can be:
- Oedema: swelling of the brain, which leads to fatigue, headaches and neurological symptoms.
- Demyelination due to distrubances in the BBB.
- Cerebral atrophy
- Inflammations in the white matters
- Hormonal changes

Question 10

Medication

Answer 10

Mostly in gliomas, epilepsy may occur and therefore medication can be prescribed. Corticosteroids can also be administered before neurological surgery of the tumor to reduce the swelling/oedema and the intracranial pressure.