What are the clues to brain cancer? How can patients go further?

At the beginning of 2021, a movie "Send You a Little Red Flower" brought countless viewers to tears. The two young protagonists in the play are both brain cancer patients, and the experience of dancing with cancer has brought them together. The heroine Ma Xiaoyuan died due to tumor recurrence; the male protagonist Zhuo Yihang continued to fight brain cancer. The tortuous fate of the two protagonists has attracted everyone's attention to brain cancer. How to find clues to brain cancer? How far can the male protagonist's future life go? What are his chances of recovering? Is brain cancer an incurable disease? Wu Jianfeng, deputy chief physician of the Department of Radiotherapy of Jiangsu Cancer Hospital (Affiliated Cancer Hospital of Nanjing Medical University), unveiled the mystery of brain cancer for you.

Correspondent Xu Linhua

Yangzi Evening News/Purple Cow News reporter Yang Yan

Who is more likely to cause brain cancer?

A movie brings the audience closer to brain cancer at zero distance, and many people notice that there is such an ill-fated group around them. Wu Jianfeng said that brain cancer can be seen at all ages and has the highest incidence among children. In China, brain tumors account for 1% to 3% of systemic tumors, and it is also the second leading cause of death from childhood cancer. According to the latest data from the National Cancer Center, in recent years, the incidence of brain tumors has shown an upward trend, ranking 9th among tumors throughout the body.

What are the clues to brain cancer?

As we all know, the brain is the "command center" of the human body, once the brain becomes cancerous, the tumor can compress the brain tissue, damage the central nervous system, and endanger the patient's life when severe. There are two main types of symptoms:

One is the symptom of tumors causing increased intracranial pressure. The most typical is headache nausea and vomiting, often after waking up headache, more often occurs in the morning, some patients may wake up due to headache during sleep, and the headache can be gradually reduced after getting up; and if the headache is accompanied by jet vomiting, be particularly careful; followed by vision loss, manifested as blurring or ghosting of things; hearing loss, unexplained unilateral hearing loss; and some people have cognitive changes, previously cheerful and lively, suddenly become very melancholy and taciturn, etc.

The other is the abnormality of nerve function caused by tumors. The most common is epilepsy, which shows different symptoms depending on the location of the tumor. Tumors that grow in the motor area may show limb deviations and motor sensory impairment; in the hippocampus area, cognitive function injuries occur, typical manifestations such as Alzheimer's disease, and the performance of Alzheimer's disease is similar to that of Alzheimer's disease. Suddenly and repeatedly the above symptoms, you must go to the hospital for a professional examination, rule out the cause of trauma, and be vigilant against the occurrence of brain cancer.

Why does Zhuo Yihang often go to the hospital for review?

In the play, Zhuo Yihang's parents are cautious in their lives, and they are particularly nervous when they accompany him to the hospital for review. Why is that? Director Wu said that because brain cancer is a difficult to treat type of tumor, and it is easy to recur. On the one hand, because of the importance and particularity of intracranial anatomy, it brings difficulty to conventional treatment.

The brain is the general conductor of the human body, the intracranial confined space, the brain nerves are rich. Tumors and brain tissue are often indistinguishable, surgery is difficult to cut the tumor clean, cutting more may damage the nerves, causing disability or even death; cutting less may clear the unclean tumor, easy to recur; and the brain has a protective layer "blood-brain barrier" to protect the brain from the invasion of harmful substances, but also prevents most drugs from entering the brain tissue, limiting the application of drug treatment; on the other hand, the recurrence rate of brain cancer reaches more than 90%, and clinical patients and families are indeed worried about tumor recurrence as the people in the play. However, the proportion of brain cancer patients who usually relapse after five years is much lower than before.

Does the male protagonist have a chance to go further in the future?

In "Send You a Little Red Flower", the heroine Ma Xiaoyuan passed away. The male protagonist Zhuo Yihang is still battling brain cancer. How far does he have a chance to go in the future? Director Wu introduced that in China, the five-year survival rate of brain cancer is less than 30%, which is lower than that of ordinary tumors, but not all of them are incurable diseases. Different types of brain cancer with different stages of disease, different treatment methods, different personal constitutions, and different treatment effects.

Malignant brain tumors are divided into gliomas, germ cell tumors and metastases. Zhuo Yihang suffered from glioma accounted for nearly 50%, and its pathology was divided into I-IV grades, of which grades I and II were low-grade gliomas, and grades III and IV were high-grade gliomas, the higher the level, the higher the degree of malignancy, and the shorter the survival period. The five-year survival of level IV is less than 10%, while the five-year survival period below level III is nearly 50%. 20 years ago, an 8-year-old boy with a glioma was treated with radiation treatment at Director Wu Jianfeng, recovered well after treatment, went to school and worked with children of the same age, and sent Director Wu a wedding candy 3 years ago. For low-grade glioma patients like Zhuo Yihang, after surgery, regular re-examination according to the situation, close follow-up, or after receiving assisted radiotherapy, there are many patients who can survive for a long time, and he also has the opportunity to go further.

What other treatments are available for inoperable brain cancer patients?

In the 1980s, the treatment method of brain cancer was relatively simple, surgery + chemotherapy, and it was difficult for many patients to stick to it due to the strong toxicity of chemotherapy drugs. Since 2005, adjuvant radiotherapy plus drug therapy after brain cancer has become the standard treatment plan. In recent years, radiation therapy equipment has been continuously updated and upgraded, and new therapies such as targeted drugs, immunotherapy, and electric field therapy have been continuously introduced, which has improved the efficacy of brain cancer patients and brought new hope.

Director Wu Jianfeng suggested that all brain cancer patients, regardless of whether surgery is possible or not, should undergo radiotherapy as long as the body allows. It is less risky than surgery, can cover the tumor tissue in the irradiation field, and interfere with the synthesis of tumor DNA through radiation. In recent years, the radiotherapy program is becoming more and more refined, the machine is becoming more and more precise, from the previous two-dimensional radiation therapy into the era of three-dimensional and intensity adjustment, which can make the radiation accurately directly to the tumor center, thereby reducing the damage to the surrounding tissues and reducing the side effects of radiotherapy. Not only improves the survival of patients, but also improves the quality of life of patients.

Source: Yangtze Evening News