BRAIN CANCER

The Brain
Contained within the skull Receives and interprets signals sent from body parts and external environment Control center for vital activity necessary to survival Controls emotion The brain makes us conscious, emotional, and intelligent

Brain Cancer
Disease in the brain in which cancer cells (tumor) arise in the brain tissue Inherently serious and life-threatening because of its invasive and infiltrative character in the limited space of the intracranial cavity
Two types: primary and secondary (metastatic)

Early detection of a brain tumor is difficult because..

The brain is well protected by the skull Brain tumor can only be seen when diagnostic tools are directed at the intracranial cavity Detection occurs only in advanced stages when the presence of the tumor has caused unexplained symptoms

The most common primary brain tumors are:

Gliomas (50.3%) Meningiomas (20.9%) Pituitary adenomas (15%) Nerve sheath tumors (8%)

NCI grading of brain tumors

Grade I: The tissue is benign. The cells look nearly like normal brain cells, and they grow slowly. Grade II: The tissue is malignant. The cells look less like normal cells than do the cells in a grade I tumor. Grade III: The malignant tissue has cells that look very different from normal cells. The abnormal cells are actively growing and have a distinctly abnormal appearance (anaplastic). Grade IV: The malignant tissue has cells that look most abnormal and tend to grow quickly.

Brain tumors are named accdg to..

Cell type and grade because they seldom spread to other organs ; eg. grade III (anaplastic) glioma
As opposed to other types of cancer that are named accdg to location and spread; eg. Stage 4 lung cancer

Causes of brain cancer

Risk factors Modifiable Persons working in oil refinery, handlers of jet fuel or chemicals like benzene, chemists, embalmers, or rubber-industry workers Non-modifiable Genetics (heredity)

Signs and Symptoms (3 categories)

Category 1: Consequences of intracranial hypertension Headaches Vomiting (sometimes without nausea) Altered LOC (somnolence, coma) Dilation of the pupil on the side of the lesion (anisocuria)

Category 2: Damage to surrounding brain tissues leading to cognitive and/or behavioral changes Impaired judgment, memory loss, lack of recognition, spatial orientation disorders Personality or emotional changes Hemiparesis, visual field impairment, impaired sense of smell, impaired hearing, facial paralysis

Category 3: Irritation Abnormal fatigue, weariness Tremors Epileptic seizures

Diagnosis of brain cancer

Medical history Physical examination Diagnostic tools
CT scan(computerized tomography) MRI (magnetic resonance imaging) Biopsy Other tests (white blood cell counts, electrolytes, or examination of cerebrospinal fluid)

Treatment for brain cancer

Should be individualized Surgery Removal of the tumor cells by cutting the tumor away from normal brain tissue Radiation therapy Destruction of tumor cells by using high-energy radiation focused onto the tumor affecting the tumor cells' ability to function and replicate

Chemotherapy Attempts to destroy tumor cells using chemicals (drugs) that are designed to destroy specific types of cancer cell Eg. Bevacizumab (Avastin)- drug approved for treatment of glioblastomas

Side effects of treatments

Surgical side effects Damage to normal brain tissue, brain swelling, and seizures Chemotherapy side effects Nausea, vomiting, hair loss, loss of energy, immunocompromised Radiation side effects Reddish and darkened skin, hair loss

Nursing Interventions

(Chemotherapy)

Prevent Infection Check V/S q 4h Report fever (<38.3C) for longer than 1 hour Pt should be in a private room Do not expose pt to people with recent infection Avoid rectal or vaginal procedures Instruct pt to use electric razor Avoid fresh fruits, raw meat, fish and vegetables

Nursing Interventions

(Radiation therapy)

Maintain tissue integrity Discuss potential hair loss and regrowth with pt and family Prevent trauma to scalp with Vit A and D ointment to decrease itching Begin to wear wig before hair loss Prevent skin breakdown (do not apply anything to it unless prescribed by the physician)

Nursing Interventions

(Surgery)

Provide Safety Institute seizure precautions Assess increased ICP Assess LOC of client Assess any damage to any part of the brain which will be manifested by specific altered body functions

Thank You!