"Send you a little red flower", brain tumors are not incurable diseases

At the beginning of 2021, a "Send You a Little Red Flower" became popular in theaters, and a small red flower connected countless individuals and families who fought against the disease.

2020 is a very special year, the epidemic has made everyone feel the oppression brought by the disease, and the uncertainty and insecurity about the future are shrouded in people. And these are the daily routines that brain tumor patients and their families are constantly avoiding and having to face. Despair and hope, is the best summary of 2020, but also the best expectation of 2021, in the face of disease, what we can do is to keep hope and cherish.

"Hello, my name is Wei Yihang, do you want to see my brain tumor pathological slices", many people who have seen "Little Red Flower" will remember this line. In fact, Wei Yihang is lucky among many brain tumor patients, his tumor pathology level is 2, the recurrence rate after total tumor resection is low, and there is a great chance that he can survive for a long time. Of course, relative to the healthy public, he is unfortunate, the "sword" of tumor recurrence hangs overhead at all times, even if people are doomed to die, no one wants to be reminded at all times - you are the one who will slide into the fast lane of death at any time.

What kind of disease is a brain tumor? Many people think that brain tumors are "brain cancer", which is an incurable disease. In fact, many brain tumors are benign diseases, and they are all little red flowers full of hope, and they can even be cured. Even for some malignant brain tumors, under the comprehensive treatment of various specialties, the small red flowers can still bloom. Here, I will tell you the story of brain tumors.

Brain cancer and brain tumors are not a concept

Brain tumors are divided into benign tumors and malignant tumors. Usually, the so-called "brain cancer" refers to brain malignant tumors, which are divided into two categories: primary and secondary. Among them, primary brain malignancy is most caused by glioma, which is a tumor that originates from glial cells in the brain. The World Health Organization (WHO) divides gliomas into grades I-IV according to pathological results, of which grades I and II are low-grade gliomas, and grades III and IV are high-grade gliomas, the higher the level, the higher the degree of malignancy, and the shorter the survival period. With the continuous advancement of various advanced comprehensive treatment technologies, the treatment effect of glioma has also been greatly improved compared with before.

Secondary tumors mainly refer to brain metastatic tumors formed by tumor metastasis in other parts of the brain, and their incidence is about 10 times that of primary brain tumors. Common primary cancers in brain metastases are lung cancer, breast cancer, digestive malignancy, urinary malignancy, gynecological malignancy, etc. In recent years, precision minimally invasive surgical treatment and various precision targeted treatment methods have made the treatment of brain metastases achieve better and better results.

There are also a considerable part of brain tumors that belong to benign tumors, such as meningiomas, schwannomas, pituitary tumors, etc., these tumors usually belong to the primary tumors of the brain, if found early, early treatment, many patients can be cured through precise and minimally invasive surgical resection of lesions.

Don't let go of these clues of brain tumors

Brain tumors occur in 85% of adults, increase with age, decrease after age, decrease after age 40, significantly reduce incidence over 60 years of age, and decrease to a minimum after age 70; slightly more men than women. The incidence of primary tumors in the brain is about 10 people/100,000, and the incidence of brain metastases is higher.

The incidence of brain tumors has a trend of gradual increase, mainly for several reasons: first, people pay more attention to health, and see a doctor in time when symptoms appear; second, the average life expectancy of Chinese mouth has been greatly extended; third, the treatment level of various malignant tumors has increased, and the survival time of patients has been greatly extended, increasing the chance of possible metastasis to the brain.

The onset of head tumors is a multifactorial combination like other tumors:

[Genetic factors] A few tumors are clearly related to heredity: neurofibromatosis, angioretic cell tumor, retinoblastoma, etc.

【Physical factors】Ionizing radiation, brain trauma, inflammatory stimulation, etc. will have an inducing effect on brain tumors. For example, mobile phone radiation. Studies have shown that prolonged use of mobile phones in the ear can lead to an increased incidence of gliomas, and while this needs to be confirmed by further research, it requires sufficient vigilance.

【Chemical factors】Mainly polycyclic aromatic hydrocarbons and nitrosamines. Polycyclic aromatic hydrocarbons are the earliest known chemical carcinogens, and animal experiments have shown that aromatic hydrocarbons planted in different parts can cause brain tumors.

【Environmental factors】Automobile exhaust, cigarettes, smoke, baking and roasting of pickled foods, etc.

"Long-term survival" is not out of reach

Due to the particularity of the brain and the presence of the blood-brain barrier, most brain tumors are insensitive to drugs and radioactivity, so the best treatment plan at present is a comprehensive treatment based on surgery.

Taking the Department of Neurosurgery of Fudan University Affiliated Cancer Hospital as an example, at present, around the "concept of precision minimally invasive surgery", the guidance of multimodal imaging fusion of neural navigation, neuroendoscopy, fluorescence contrast technology, electrophysiological monitoring and other technologies can be realized to avoid important neural functional areas, blood vessels and other structures, and to maximize the protection of normal brain tissue structure while removing tumors to the greatest extent.

At the same time, radiation therapy and chemical drug therapy play their own characteristics, and new means such as targeted drugs, immunotherapy, and electric field therapy are also constantly developing and improving, and the cure rate and remission rate of brain tumors are constantly improved.

Speaking of which, many people are concerned about whether brain tumors can achieve long-term survival? In fact, benign brain tumors, such as meningioma, acoustic neuroma, etc., can obtain long-term survival after surgery, and even achieve a healing effect. Low-grade malignant tumors of the brain, adjuvant radiotherapy after surgical resection, can also achieve long-term survival. For low-grade glioma patients such as Wei Yihang, after the operation of total resection, regular follow-up according to the situation, strict follow-up, or after receiving assisted radiotherapy, many patients can also survive for a long time.

Brain malignant tumors are still a worldwide problem, but they also show hope in terms of efficacy. With the continuous advancement of therapeutic technologies, postoperative simultaneous chemoradiotherapy, targeted therapy, and electric field therapy have been shown to prolong the survival of patients. In short, for patients with brain tumors, early detection and early intervention are the keys to achieving a good survival prognosis. At the same time, good psychological construction and an optimistic attitude are also very important. We are willing to use our professional skills to print an eternal little red flower for each brain tumor patient.

(The author is Cao Yiqun, director of the Department of Neurosurgery, Fudan University Affiliated Cancer Hospital)

Early "signaling" of brain tumors

1. Intracranial hypertension: headache, nausea with vomiting, papilledema (visually impaired vision is unclear).

2. Focal symptoms: Brain tissue in different parts has different functions, so tumors in different locations will have different manifestations. Common symptoms include: motor dysfunction, changes in visual vision, olfactory hallucinations (smelling non-existent odors for no reason), auditory hallucinations (hearing non-existent sounds for no reason), hallucinations (seeing things that don't exist for no reason), altered temperament, memory loss, irritable or cheerful behavior introverts, seizures (foaming at the mouth, general convulsions, or twitching of a limb, brief absence of concentration), changes in endocrine conditions (amenorrhea, lactation, infertility; stubborn hypertension, diabetes; acromegaly, acromegaly, gigantism).

Once there are any traces of these, check for them as early as possible. MR (magnetic resonance imaging) is the test of choice for brain tumors and can determine tumor location and size. CT screening is not as clear as MR imaging, but some tumors have specific changes and are also an important test. Other auxiliary means include PET, PET-CT, PET-MR, electroencephalogram, magnetoencephalography, etc. In addition, the tumor in the saddle area may have hormonal abnormalities, and the metastases may have specific tumor indicators.

Source: Wen Wei Po