ALL INDIA INSTITUTE OF MEDICAL SCINECES

BHUBANESWAR

SEMINAR
ON
BRAIN TUMORS

SUBMITTED TO SUBMITED BY
DR. ANAND L KASHYAP K V
ASSOCIATE PROFESSOR M.SC (N) 2ND
AIIMS BBSR AIIMS BBSR
 Brain Tumor

Brain Cancer:
Although all brain cancers are tumors, not all of them are dangerous. Benign brain tumors are the
ones that are not malignant. An unregulated cell growth that has developed inside this brain is
known as a tumor. Though not all brain tumors are invasive (cancerous), some are (non-
malignant, non-cancerous, or benign). A brain tumor can develop there in the brain as well as in
other CNS organs like the spine or cranial nerves. The majority of physical activities, such as
knowledge, movement, perception, thought, speaking, and remembering, is largely under the
direction of the cerebral. The brain's capacity to function normally and effectively while doing
such tasks can be compromised by a tumor.
The majority of malignant brain tumors are slow-growing, have clear boundaries, and seldom
metastasize. Even benign tumors can pose a threat. They can hurt and squeeze the brain,
seriously disrupting it. A benign brain tumor that is in a critical part of the brain can be fatal. A
benign tumor may very infrequently develop into a hazardous one. Mesothelioma, cerebellar
neurofibromas, and temporal hyperplasia are a few illustrations of tumors that are often
moderate. Progressive brain tumors are cancer. Generally, they spread quickly and attack nearby
central nervous system tissue. Due to the changes, it makes to the essential visual cortex, brain
cancer can be fatal. Malignant tumors with their origins inside and close to the brain include
chapter vestibular neuroblastoma and chondrosarcoma.
Types:
More than 120 different forms of brain tumors, lesions, and cysts exist, and they can be
distinguished based on where they develop and the cells which make them up. The majority of
some types of tumors are benign (nearly normal), whereas the majority of others are aggressive
(cancerous). Other people could be equally likely to be malignant. Many of the tumor types
described below, which are sometimes referred to as "surgical treatment tumors," can occur in
bone or any other tissues well outside the nervous system.
 Commonly harmless tumors.
 Cysts and other benign brain lesions.
 Brain Tumors of Different Grades (From More Benign to Malignant).
 Types of cancer: Malignant brain tumors are the most common.
However, they are included in this list because of how close they relate to the brain and how
unlikely it is that they will have an impact on its structural components. The most typical forms
of terminal brain cancer even in humans are:
 Meningioma:
Almost over 30percent of the total of all brain cancer are meningiomas, making them the far
more prevalent type. The meninges, the three metal layers of tissue that enclose and shield the
brain beneath the skull, are where meningiomas develop. Meningiomas are recognized more
frequently in women than in men. Benign tumors are low to the ground, and noncancerous
tumors are at around 85% of cases. Although the majority of meningiomas are benign, some of
them might continue and recur following therapy.
  Astrocytomas:
Sometimes these develop in the cerebral hemispheres, the biggest area of the brain. They begin
in astrocytes, a frequent variety of performer cells. Any grade may be one. They frequently result
in migraines or behavioral abnormalities. Typically, astrocytoma expands across the brain and
melds with the surrounding tissue. The behaviors among these tumors vary, nevertheless. Some
people grow more slowly than others. They don't all develop into these other tissues. Astrocytes,
parietal structures with a starlike form that are a component of the mind's supporting tissue, give
rise to astrocytoma. They can happen almost anywhere in the brain, but the cerebrum is where
they most frequently happen. Astrocytomas can occur in individuals of any age but they are more
prevalent among adults, organizations recognize males. Most pediatric brain tumors are
generally exhibited, which are located in the base of the brain and are much more common in
youngsters or younger ones. Whereas almost all of these tumors are increased in people, the
majority of them are moderate in youngsters.

 Ependymomas:
Your brain or spinal cord is where this chromosome abnormality develops. In addition to the
canal that houses the spinal cord and cerebrospinal fluid, it starts in the neurons that border the
ventricles, which are chlorine chambers in the brain (CSF). They may develop slowly or quickly.
Anaplastic categorized is the name given to them whenever they are rapidly expanding.
Although they spread along the CSF, these tumors do not invade healthy brain tissue. Despite
their potential to affect individuals, over 70% of ependymomas are detected in children below
the age of 3.
  Tumors of the primitive neuroectoderm:
Although they can influence adults, (PNETs) more create public awareness among youngsters.
They begin in neuroectodermal cells, which are developing nervous system cells. These tumors
often grow very quickly and are more common in younger children than in older ones. A
medulloblastoma typically originates in the cerebellum and is among the most typical PNET.
Pine blastomas, which originate in the base of the brain, are one type of PNET. The brain or
spinal cord is where treatment shares begin.
Available approved therapies:
The procedure, radiology, and/or treatment, either alone or in possible permutations, are typically
used to treat neurological disorders, regardless of whether they're primary or metastatic, benign
or dangerous. While it is true that radiation and chemotherapy are more frequently employed for
dangerous, persistent, or repeated tumors, selections regarding the best course of medication are
decided on a case-by-case case basis and are dependent on a variety of criteria.
 Surgery:
Surgery eradication and ongoing observation may be the only kinds of treatment required for
those cancers. Craniotomies, neuroid scopes, thermal evaporation, and laser interstitial thermal
treatment are appropriate treatment methods for removing brain tumors. Brain tumors can be
treated with chemotherapy and/or radiation therapy, which can significantly reduce the tumor,
slow its progression, and/or stop it from returning. Among the available radiation therapies for
brain tumors include chemotherapy and radiation, orthogonal radiosurgery, and external
radiation treatments.
 Stereotactic biopsy:
A stereotactic examination seems to be an additional treatment that is frequently carried out,
typically before major surgery. This less invasive procedure enables medical professionals to
acquire tissue for proper diagnosis. In most cases, a scaffolding is fastened to the patient's head, a
scan is performed, and thus the patient is then brought into the operating theater when a tiny hole
is punched in the skull to provide admission to the aberrant area. Some institutes might carry the
same treatment without either framing depending on where the tumor originates. A tiny sample
is taken for microscopic analysis.
 Ventriculoperitoneal shunting:
Several people who have brain malignancies may require ventriculoperitoneal shunting.
Everybody's brain and backbone contain the spinal cord, which circulates gently throughout the
day. The fluid-containing sacs (the chamber of the heart) can grow and obstruct blood flow,
increasing pressure inside the head and causing hypertension, a disease. Hypertension can cause
death or significant brain damage if it is not addressed. A shunt may be used by the neurosurgeon
to direct spinal fluid away from the brain and so lessen pressure. The intraperitoneal cavity is
typically the bodily cavity into which the CSF is channeled. Typically, the diversion is persistent.
The symptoms of meningitis in its initial state are present unless it becomes stopped.
Challenges in brain cancer therapeutics:
It is sometimes difficult to treat brain tumors effectively. Generally, the blood-brain boundary in
the organism shields the cerebellum and brain from toxic substances. Such a barrier, though, also
prevents several forms of chemotherapeutics from entering. If the tumor is close to a sensitive
area of the brain or spinal cord, resection may be challenging. The plurality of CNS tumors does
not consider to be a component of acquired genetic disorders, although 5–10% of people with
brain cancer have a family history of one. Genetic variations that may be related to a higher risk
of several brain cancers, including glioma and meningioma, have been found in several
investigations. Glycogen is the one investigation; it began looking for a family connection
between brain tumors.
 Numerous studies have been conducted on the connection between esterase radiation
levels from telephones and the development of brain tumors. Considering the discovery
of a heightened incidence of glioma among heavy users of cell phones the International
Agency for Research on Cancer of the World Health Organization classed microwave
radiation as a potential malignancy in 2011. The subject is still being researched today.
 Due to their capacity to pass the capillary barrier, industrial chemicals have long been
suspected of being a cause of tumors. The capillary barrier guards against infections and
poisons entering the brain.
 Conclusions have also been inconclusive for the majority of the variables despite
extensive chemical, environmental, and occupational exposures having been examined in
epidemiological data of neoplasm.
Therapies under clinical trials:
To ensure that innovative therapies are available for patients, human trials are a critical element.
Medical studies are now enrolling only 3 percent of the overall cancer patients with multiple
myeloma, as contrasted to 7.5% of all terminally ill patients, although data indicate that people
want to be asked. We are determined to address this problem. Throughout this area, human trials
are crucial because they teach medical practitioners how to treat brain tumors. You would get the
opportunity to be among the inaugural individuals to benefit from a new treatment by enrolling a
part in a clinical study or encouraging the youngster to do so. Nonetheless, it's possible that the
therapy won't be as successful as the norm.
A clinical trial is an investigation in which participants are involved in the creation of a novel
therapy or method of disease management. It seeks to learn: Which would be the smartest
method to provide it? If the proposed mechanism works and is acceptable, is it preferable to the
previous one? A medicine will all have undergone preclinical testing in the lab, frequently for
generations, before this begins a new treatment.
 Consequences of BBB:
The blood-brain barrier (BBB), the blood-cerebrospinal fluid barrier (BCSFB), and the
subarachnoid space barrier all ensure an ideal milieu for signal transduction since the brain is
particularly vulnerable to a variety of floating harmful chemicals. BBB impairment involves:
i. BBB interruptions, which causes backflow of potentially orally ingested circulating
intoxicants through into CNS.
ii. transmitter disturbances, where its consequences in poor nutrient supply, a caused by the
accumulation of harmful materials there in CNS, and greater admission of customarily
extruded biomolecules.
iii. altered protein expression and secretions by endothelial cells and other NVU immune
cells.

Nanomaterials for targeted gene and drug delivery to the brain:

Between 10 and 1,000 nm in dimension, solid disposable components make up nanoparticle drug
carriers (50–300 nm generally). They need receptor-mediated transport across brain vascular
permeability to get their content into the brain parenchyma because then they can independently
diffuse past the blood-brain barrier (BBB). Although some nanoparticles had also produced
intriguing findings, they have limits that might prevent or at most restrict their potential clinical
applications. These shortcomings are described in this research. Brain-targeted gemcitabine
immunopanel particles will now be created using sulfonamide autoantibodies to the BBB
illustrated graphically channel, which should enable the delivery of entrapped actives into the
brain parenchyma without causing a change in Vascular endothelial cells. Their characteristic
features (composition, binding capacity, bioavailability), as well as the procedures currently in
use for making immunopanel particles, are covered in this analysis.
New approaches treated in vitro and in vivo:
 An experimental setting is used for in vitro methods, which often entails analyzing
cultivated microbes, human, or eukaryotic organisms. Through the application of this
technology, researchers can examine diverse biological processes in a single cell without
ever being distracted by or concerned about any influencing variables that may be present
in whole organisms. Using in vitro testing like a survey instrument is simple. Compared
to trials involving animals or people, research may carry out more in-depth analyses and
assess the implications of global in a larger number of in vitro individuals.
 Approximately 30% of medicine candidates fail human clinical trials because they have
unfavorable negative consequences, despite having promising preclinical outcomes. The
remaining 60% fail to have the desired outcome. An essential component of drug
development generally is in vivo testing, particularly in drug development. Studies
conducted in living organisms (in vivo) offer useful knowledge about particular chemical
properties or the advancement of cancer.
Next generation therapies against brain cancer:
New antibody targets, novel construction technology, and cell tower delivery to that same brain
are ready for testing in a new generation of clinical studies. Despite these developments, some
barriers still stand in the way of the widespread use of treatments for cancer, including the
requirement for some more accurate animal models that can more accurately predict the results
of animal testing. To understand mechanisms of response and patient classification, tumor and
tumor microenvironment samples plus multi-omics evaluation are essential. However, brain
tumors are particularly difficult to access for said tests. These session materials and discussion
include information on the state of immunization in children with young and elderly brain
tumors, as well as potential future work to advance efforts to make immunity a priority in the
treatment of brain tumors.
Brain cancer is still a challenging condition to treat. Particularly among the deadliest are basic
malignant cells like carcinoma and spread brain cancer. Breakthrough nanomedicine approaches
have been developed recently, primarily for the treatment of brain tumors. These approaches,
which are increasingly made to target particular different cells such as response cells and cells
that start brain tumors, promise interesting alternatives to or adjunct to traditional therapy
techniques. Using nanoparticles as devices to facilitate
1) Release of the drug, the above review updates readers on valuable perspectives on
various nanomedicine methods.
2) Genetic engineering, modified cellular therapy, and research perspectives in treating
terminal cancer all fall under the heading of number three.
References:

(1) Brunner and Suddharth's 'Text book of Medical Surgical Nursing" Eleventh
Edition, Volume 2, Lipincott William and William publication, first Indian
Reprint 2008, New Delhi, Page No. 2233 to 2250.

(2) Lipincott "Manual of Nursing Practice" Eight Edition 2006, Lippincott,

William & William Publication Noida, Page No. 522-526.

(3) Basvanthapa BT "Medical Surgical Nursing" Seventh Edition, M.C. Grand

Publications, New Delhi Page No. 540-541.