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BRAIN CANCER

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The Brain

Contained within theskull

Receives and interpretssignals sent from body 

parts and externalenvironment 

Control center for vitalactivity necessary tosurvival

Controls emotionThe brain makes us

conscious, emotional, and intelligent

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Brain CancerDisease in the brain in which cancer cells (tumor)

arise in the brain tissue

Inherently  serious and life-threatening because of its invasive and infiltrative characterin the limited space of the intracranial cavity 

Two types: primary and secondary (metastatic)

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Early detection of a brain tumor is

difficult because..

The brain is well protected by the skull

Brain tumor can only be seen when diagnostictools are directed at the intracranial cavity 

Detection occurs only in advanced stages when thepresence of the tumor has caused unexplainedsymptoms

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The most common primary braintumors are:

• Gliomas (50.3%)

• Meningiomas (20.9%)

• Pituitary adenomas (15%)

• Nerve sheath tumors (8%)

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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 lesslike 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 abnormalappearance (anaplastic).

• Grade IV: The malignant tissue has cells that look most abnormal and tend to grow quickly.

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Brain tumors are named accdg to..

Cell type and grade because they seldom spreadto other organs ; eg. grade III (anaplastic)

glioma

 As opposed to other types of cancer that arenamed accdg to location and spread; eg. Stage4 lung cancer

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Causes of brain cancerRisk 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)

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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) 

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Category 2:

Damage to surrounding brain tissuesleading to cognitive and/or behavioralchanges

Impaired judgment, memory loss, lack of recognition, spatial orientation disorders

Personality or emotional changes

Hemiparesis, visual field impairment, impairedsense of smell, impaired hearing, facial paralysis 

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Category 3:

Irritation

 Abnormal fatigue, weariness

TremorsEpileptic seizures

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Diagnosis of brain cancerMedical 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)

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Treatment for brain cancer• Should be individualized

Surgery  Removal of the tumor cells by cutting the tumoraway from normal brain tissue

Radiation therapy 

Destruction of tumor cells by using high-energy radiation focused onto the tumor affecting thetumor cells' ability to function and replicate 

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Chemotherapy   Attempts to destroy tumor cells using chemicals

(drugs) that are designed to destroy specifictypes of cancer cell

Eg. Bevacizumab (Avastin)- drug approvedfor treatment of glioblastomas

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Side effects of treatments

• Surgical side effects

Damage to normal brain tissue, brain swelling,and seizures

• Chemotherapy side effectsNausea, vomiting, hair loss, loss of energy,immunocompromised

•

Radiation side effectsReddish and darkened skin, hair loss

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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

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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 anythingto it unless prescribed by the physician)

Nursing Interventions (Radiation therapy)

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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

Nursing Interventions (Surgery)

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Thank You!