Management of Brain Tumor in Elder-Aged People

Introduction-

It is essential to distinguish between primary and secondary brain tumors. Primary brain cancer are tumors that start in the brain and grow there; secondary brain tumors develop in certain other organs like the lungs, breast, and kidneys and spread to the brain. Secondary brain cancers are much more common than primary brain cancers. Brain cancers can occur at any age during life.

Certain brain cancers, like medulloblastoma, are more common in children, whereas other tumors, like glioblastoma, can be seen in middle-aged and older adults. There is a difference between men and women in terms of the risk of developing primary brain cancer. In a lifetime, a man’s chances of getting brain cancer are about 7 in 1000 patients, whereas, for women, it is 5 in 1000 patients.

What Are the Types of Brain Tumors?

The most common primary brain tumor is a meningioma. Most meningiomas are benign and are found on the brain’s outer surface, the top of the brain, or the base of the skull. Meningiomas can be of three types-

• Grade 1- Benign meningioma, grows slowly.

• Grade 2- Atypical meningioma, grows more quickly.

• Grade 3- Malignant meningioma, grows and spreads rapidly.

What Are the Signs and Symptoms?

There are a lot of different signs and symptoms that a person with a brain tumor can have, and they vary depending on the location and size of cancer. One of the most common things is seizures. Other than that, ongoing severe headaches, especially in the morning, weakness or numbness on one side of the face or body, change in personality, change in a person’s ability to speak normally, and change in vision, particularly loss of vision on one side, nausea and vomiting, other types of focal neurologic deficit like hearing difficulties, and balance difficulty. Most tumors grow slowly, and it is easy to confuse tumor symptoms with something else as all the signs are very common and can be associated with different health conditions as an effect of aging.

What Causes Brain Tumors?

The exact cause is unknown. Other than that, gene mutation or chromosomal abnormalities and exposure to radiation at an early age are known reasons.

What Are the Treatment Options?

The survival rate for brain central nervous system tumors varies widely. Some brain tumors can be cured. But others are much more challenging to treat. In the brain, it is impossible to make a margin as compared to other parts of the body. One can resect a normal tissue to make sure the entire tissue is removed, but it is a difficult case for the brain as it is a critical organ. Also, many brain tumors are infiltrating, which means they are not a discrete mass but some tumor cells that extend beyond the areas of the tumor, which can be identified on magnetic resonance imaging (MRI) scans.

• Surgery can remove the area that has been identified on the scan, but there will be some tumor cells left behind, and that is why chemotherapy and radiation therapy become critically important to treat any other areas of tumor that have been left behind after surgery.

• Categories of tumors with brain and central nervous systems, such as meningiomas or acoustic neuromas, can often be cured with surgery, but that can be challenging and are best performed by an individual with special expertise in tumor removal and complex tumor removal.

• The most common primary brain tumor in adults is glioblastoma, and it is the most challenging as, unfortunately, this type of tumor often reoccurs in a patient even after their initial treatment therapies.

• The tissue which is removed during surgery can also be properly stored and analyzed for gene mutation, and also it is very important for clinical trials and informing treatment decisions.

How to Manage Brain Tumors in Older Patients?

It can be very frightening or disorienting to suddenly experience the symptoms of a brain tumor in an elderly. A few things need to be taken care of after treatment. There are sort of two stages- one is after surgery, and one is after radiation or chemotherapy.

• After the treatment, regular MRI scans are done, which can be exhausting for the elderly. The frequency of the MRIs depends on the diagnosis. If it has more propensity or frequency in terms of changing or growing, the MRI scans can be close to even two months apart. If the problem is on a slower course, the scans can be done every three to four months and then stretched out to every six months and even once a year. One thing to count on is once the diagnosis is made, whether the patient has the surgery or not, regular MRIs are the best way to monitor what is happening within the tumor.

• Following surgery, patients will have stitches or their staples removed; if it is a problem that requires additional treatment, they will be sent to see an oncologist or radiation doctor.

• Usually, patients are back to their work for around a month, but it does vary depending on the form of work they are involved in. A person with more stressed work, physically or mentally, is advised to avoid it for a few months.

• By two to three weeks, a patient can feel normal in terms of their energy status, but a lot of it depends on the tumor’s location and how cancer might be affecting different parts of their brain. Also, for older adults, as their bodies sustain less energy, it might take more time for them.

• The usual hospital stay is for three days. Still, the goal is to get the elderly through the process quickly and to get back to their normal living environment and their normal level of functioning as soon as possible.

• It is crucial to ensure that the patient is being treated at a center of excellence because it is a rare disease and needs as much expertise as possible.

• Encourage older adults for clinical trials.

• Educating the patient and their family members about the disease and the treatment options.

Conclusion-

For every patient, the best they can do is give them the best possible treatment and provide them with every potential option to treat their cancer. With old age, it can be more difficult to fight brain tumors as people are also associated with other health conditions like diabetes, hypertension, arthritis, etc. It is a tough journey that requires support from a healthcare professional and family members.