"Give you a little red flower", brain tumors are not incurable
■Cao Yiqun
At the beginning of 2021, the movie "Send You A Little Red Flower" hits theaters, and a little red flower connects countless individuals and families who are fighting against the disease.
2020 is a very special year. The epidemic has made everyone truly feel the oppression caused by the disease, and the uncertainty and insecurity about the future have enveloped people.
These are the daily routines that brain tumor patients and their families are constantly evading and having to face.
Desperate and hopeful is the best summary of 2020 and 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. Would you like to see the pathological slice of my brain tumor?" Many people who have seen "Little Red Flower" will remember this line.
In fact, Wei Yihang is fortunate among many patients with brain tumors. His tumor pathological grade is level 2, and the recurrence rate after total resection of the tumor is low. There is a good 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 above his head at all times. Even if people are destined to die, no one wants to be reminded all the time-you will slip into death at any time. The one in the fast lane.
What kind of disease is brain tumor?
Many people think that brain tumors are "brain cancers" and incurable diseases.
In fact, many brain tumors are benign diseases, and they are all hopeful little red flowers that 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 tumor are not the same concept
Brain tumors are divided into benign tumors and malignant tumors.
Generally speaking, "brain cancer" refers to brain malignant tumors, which are divided into two categories: primary and secondary.
Among them, primary brain malignant tumors are gliomas, which are tumors originating from brain glial cells.
The World Health Organization (WHO) divides brain gliomas into grades I-IV based on pathological results. Grades I and II are low-grade gliomas, and grades III and IV are high-grade gliomas. The higher the grade, the more malignant. The higher, the shorter the lifetime.
With the continuous progress of various advanced comprehensive treatment technologies, the treatment effect of glioma has also been greatly improved.
Secondary tumors mainly refer to brain metastatic tumors formed by tumors from other parts of the brain that have metastasized to the brain, and the incidence is about 10 times that of primary brain tumors.
The common primary cancers in brain metastases are lung cancer, breast cancer, digestive system malignancies, urinary system malignancies, and gynecological malignancies.
In recent years, precision minimally invasive surgical treatment and various precision targeted therapies have enabled the treatment of brain metastases to achieve better and better results.
A considerable part of brain tumors are benign tumors, such as meningiomas, schwannomas, pituitary tumors, etc. These tumors are usually primary brain tumors. If detected early and treated early, many patients will be removed by precise and minimally invasive surgery The lesion can be cured.
Don't let the clues of these brain tumors go
85% of brain tumors occur in adults, increasing with age, decreasing after 40 years old, and the incidence rate over 60 years old is significantly reduced, and it is minimized after 70 years old; men are slightly more than women.
The incidence of primary tumors in the brain is about 10 people per 100,000, and the incidence of brain metastases is even higher.
The incidence of brain tumors has gradually increased, mainly due to several reasons: first, people pay more attention to health, and seek medical attention when symptoms appear; second, the average life expectancy of the Chinese population has been greatly extended; third, The treatment level of various malignant tumors is improved, the patient's survival period is greatly extended, and the probability of possible metastasis to the brain is increased.
The incidence of craniocerebral tumors is the same as other tumors, which are multi-factorial effects:
[Genetic factors] A few tumors are clearly genetically related: neurofibromatosis, angioreticulomas, retinoblastoma, etc.
[Physical factors] Ionizing radiation, brain trauma, inflammatory stimulation, etc. can induce brain tumors.
For example, mobile phone radiation.
Studies have confirmed that long-term use of mobile phones at the ear can lead to an increase in the incidence of glioma. Although this requires further research to confirm, we need to be sufficiently vigilant.
[Chemical factors] Mainly polycyclic aromatic hydrocarbons and nitrosamines.
Polycyclic aromatic hydrocarbons are the earliest recognized chemical carcinogens. Animal experiments have shown that aromatic hydrocarbons planted in different parts can cause brain tumors.
[Environmental factors] Automobile exhaust gas, cigarettes, smoking, baking and roasting preserved food, etc.
"Long-term survival" is not out of reach
Due to the particularity of the brain and the existence of the blood-brain barrier, most brain tumors are not sensitive to drugs and radiation, so the current best treatment plan is comprehensive treatment based on surgery.
Take the neurosurgery department of Fudan University Tumor Hospital as an example. At present, focusing on the "precision minimally invasive surgery concept", the use of multi-modal imaging fusion neuronavigation, neuroendoscopy, fluorescence imaging technology, electrophysiological monitoring and other technical guidelines can be avoided Important nerve function areas, blood vessels and other structures can maximize the protection of normal brain tissue structures while removing tumors to the greatest extent.
At the same time, radiotherapy and chemical drug therapy have their own characteristics, and new methods such as targeted drugs, immunotherapy, and electric field therapy are constantly being developed and improved to continuously improve the cure rate and remission rate of brain tumors.
Having said that, many people are concerned about the long-term survival of brain tumors?
In fact, benign brain tumors, such as meningiomas, acoustic neuromas, etc., can survive long-term survival after total resection, and even achieve curative effects.
For low-grade brain tumors, adjuvant radiotherapy after surgical resection can also achieve long-term survival.
For patients with low-grade gliomas like Wei Yihang, there are many patients who can survive for a long time in clinical practice according to the regular re-examination and close follow-up according to the situation after the surgery.
Malignant brain tumors are still a worldwide problem, but there is also hope in terms of efficacy.
With the continuous advancement of treatment technology, postoperative concurrent radiotherapy and chemotherapy, targeted therapy, and electric field therapy have been shown to prolong the survival of patients.
In short, for brain tumor patients, early detection and early intervention are the keys to a good survival prognosis.
At the same time, good mental construction and an optimistic attitude are also very important.
We are willing to use our expertise to print an eternal little red flower for every brain tumor patient.
(The author is the director of neurosurgery at Fudan University Cancer Hospital)
Early "signals" of brain tumors
1. Intracranial hypertension manifestations: headache, nausea with vomiting, papilledema (impaired vision and blurred vision).
2. Focal symptoms: different brain tissues have different functions, so tumors at different locations have different manifestations.
Common symptoms include: motor dysfunction, visual field changes, hallucinations (smelling non-existent odors for no reason), auditory hallucinations (hearing non-existent sounds for no reason), hallucinations (seeing non-existent things for no reason) , Temper and personality changes, memory decline, behavioral styles become irritable or cheerful people become introverted, seizures (foaming at the mouth, twitching all over the body, or a limb twitching, temporary absence and trance), changes in endocrine conditions (amenorrhea, lactation, no Pregnancy; stubborn hypertension, diabetes; acromegaly, gigantism).
Once there are these clues, carry out relevant inspections as soon as possible.
MR (Magnetic Resonance) is the preferred examination item for brain tumors, which can determine the location and size of the tumor.
CT screening is not as clear as MR for brain tissue imaging, but some tumors have specific changes and are also important inspection methods.
Other auxiliary methods include PET, PET-CT, PET-MR, electroencephalogram, magnetoencephalogram, etc.
In addition, sellar tumors may have hormone abnormalities, and metastatic tumors have specific tumor indicators.