How Brain Cancer Is Staged and Graded » Brain Cancer Stages

Brain Cancer Stages
Brain cancer, the name itself represents cancer caused to brain cells. Anyone can associate with the disease. However, it’s crucial that you develop an understanding of this disease to help your close ones, get over it steadily. It may not be easy to get through it. But, when you have awareness about this grave disease, you can take necessary measures to make living easier for the person suffering from it. Here we explain what brain cancer stages are and what type of treatment & care are required in each stage. If necessary precautions & treatment are given, then definitely it can relieve the patient and may also aid increasing his/her life span.

It is important to get ideas of how brain cancer progresses to gain an understanding of different stages of brain cancer

How brain cancer progresses?

A person with brain cancer can expect different kinds of symptoms. As he/she goes through different stages of brain cancer, they accordingly show different symptoms based on the stage. It is likely to be an overall decline in health, which affects the body as a whole. A part or whole of the brain can be affected, which may be caused by swelling and the tumor.
A particular area of the brain controls a specific body function. A tumor in a particular area of the brain associated with a certain function will then affect that function. For example, a tumor in an area controlling speech will affect one’s ability to talk. Such effects are seen in the early stages of brain cancer. As the stage progresses, these symptoms become more apparent.
The tumor and swelling on the brain impact the general functioning of the brain. As the cancer stage progresses, it may give rise to the below symptoms:
  1. Increase in sleep;
  2. The decrease inability to move;
  3. trouble speaking and/or comprehending conversation;
  4. Memory loss. Example- the ability to build new memories;
  5. impaired judgment; the ability to judge how much help one needs to get around, is impaired;
  6. weakness, affecting either side of the body;
  7. seizures;
  8. frequent headaches;
  9. extreme mood swings.
Medications can help with a few of these symptoms. Steroids may be prescribed, to fight swelling in the whole of the brain and around the tumor. Anticonvulsants manage seizures — Acetaminophen (Tylenol®) ease headaches. Stronger painkillers like opioids are suggested, but it is challenging to control the headaches. Pain medications are used for several types of pain, but usually, pain is not a significant issue in brain cancer.

The decrease in coordination and alertness can make the swallowing tough. The problem due to swallowing may cause secretions to enter the lungs, which may increase lung congestion. Food intake may also become an issue. It may become difficult to control and swallow liquids than solids. Thickening agents, available in pharmacies, can be added to fluids to help to swallow. Speech-language specialists can help with swallowing problems. They may also help with any communication issues that may arise. Difficulties with swallowing, eating and drinking need own solutions that make the patient comfortable.

Family members may worry if a person isn’t getting enough food or fluids when a person is having trouble swallowing. Swallowing difficulty is only one factor contributing to issues related to food and fluids.

Over 120 types of brain and central nerves system tumors are present today. They need to be correctly diagnosed with proper and accurate treatment. We also need to know whether it is a primary tumor or a secondary tumor. Primary tumors are those tumors that develop or originate in brain tissues. Cancer cells can develop from parts of our body. Like from breast, lung, etc. they can reach the brain through our lymphatic system or the bloodstream. Secondary brain tumors develop from other body parts or inside another body organ. Then they spread to the brain and cause cancer.

The word ‘metastasize' means to spread or grow. These are more common than primary brain tumors. We use a staging system for these tumors. A staging system is used for various cancer types which determine or help us to understand the tumor's growth and spread. We also get knowledge about the tumor's location, how much is it spreading and the extent it is affecting other body parts. However, there is no such reliable or standard staging system for adult brain tumors. The reason is that most primary tumors do not usually spread beyond our central nervous system. Cancer staging is the process used to measure the extent to which cancer has grown inside our body gradually or aggressively. For this, we generally assign a number I to IV. This means cancer of stage I is isolated cancer and IV being cancer which has extended to standard assessment measures. We stage this according to its cell type. 

Cancer staging can be done using the so-called TMN(Tumor, Node, Metastasis) staging which is based on the location and growth of cancer cells. For the clinical stage and pathological stage, we use a small "c" or "p" before the stage. We get all the information before performing surgery to remove the tumor in the clinical phase. The extra information is obtained by performing the pathologic stage. This is where a pathologist examines the tumor under a microscope after its removal by surgery. The accuracy rate of this surgery is high due to the direct examination of the tumor. There are various stages of cancer, each requiring a different treatment. The treatment must be done accordingly.
Brain Cancer Stages

The stages can also be classified as Roman numerals Staging since it uses Roman numerals like I, II, III and IV(even 0) to describe the spread of cancer. They are as follows:
  1. Stage 0: Tumors that are unlikely to grow or move from their places.
  2. Stage I: Cancerous cells localized or limited to one part of our body. If they happen to be small enough, they can be eliminated surgically.
  3. Stage II: Locally advanced cancers that can be treated by chemotherapy, radiation, or surgery.
  4. Stage III: Locally advanced cancers are succeeding in stage II.
  5. Stage IV: Cancerous cells in metastatic conditions, spreading to different parts of our body.
  6. Stage V: Only patients with Wilm's Tumor fall under stage V.
However, all these stages do not apply to brain cancer. So we cannot use this staging system to determine the progression of brain cancer. Instead, we assign a "grade" for the various stages of brain cancer. There are over 120 brain tumors classifications, based on tumor cell type and location. This makes the overall diagnosis quite complicated. Henceforth, the World Health Organisation(WHO) introduced a system of classification. A number ranging from 1-4, most commonly represented by Roman numerals I-IV is used. The number which we assign the tumor is called the "grade." Pathologic features( how these cells looks under a microscope) also determine the ‘grade' given that specific brain tumor. It tells us how aggressive a tumor is, and how much it can spread or grow. Tumors can often be a collection of cell grades and are free to change as they grow and spread. It also describes how these tumor cells can be similar or abnormal compared to normal cells. Thus, this grading system helps us to predict the outcomes. It also helps us to provide proper and better treatments.n be broadly classified as :
  1. Lower Grade Tumors: Brain tumors belonging to grade I and II. They have a better-expected prognosis. These brain tumors are not very harmful. They are not quite aggressive. Patients having these have better chances of long-term survival than the ones having brain tumors of grade III and IV.
  2. Higher Grade Tumors: Brain tumors belonging to grade III and IV. These brain tumors can be very harmful and aggressive. They can metastasize very quickly. They are more difficult to remove or treat and the patients having these have lower chances of survival. They are mostly malignant or cancerous.

The four grades are as follows:

Grade I Tumor :

  1. The cells grow very slowly
  2. Almost identical to normal cells when seen under a microscope
  3. Usually noncancerous
  4. Chances of long-term survival
  5.  Better expected prognosis

Grade II Tumor :

  1. Comparatively slow growing cells
  2. Looks slightly abnormal when seen under a microscope
  3. Capable of spreading to adjacent normal tissues
  4. Can change into a tumor of higher grade

Grade III Tumor :

  1. Aggressive production of abnormal cells
  2. Looks abnormal when seen under a microscope
  3. Capable of spreading to adjacent brain tissues
  4. They can recur even after treatment or removal
  5. Can change into a tumor of higher grade

Grade IV Tumor :

  1. Rapid production of abnormal cells
  2. Major abnormality in appearance under a microscope
  3. New blood vessels formed to maintain rapid growth
  4. Contains areas of dead cells in the center
Brain tumors can have several grades of cells. The cell which is the most malignant determines the category for the entire tumor (even if more tumors are of lower rank). Some tumors also have the capability to change the way they grow or spread during a period and may become malignant over time.

Thus, we see that the WHO recognizes four malignancy grades. Category I tumors being the least aggressive and grade IV being the most aggressive. Histological criteria for malignancy grading are not much uniform for all tumor types. Thus classification of all tumors is necessary before we determine the malignancy grade. There are some tumor types to which we can only assign one or two malignancy grades. Brain tumors are quite known to progress and become more malignant with time. Such a progression will be fatal. The diagnosis has undergone by a patient mostly depends on the most malignant part of the tumor. Henceforth, it is of utmost importance to sample the tumor correctly to determine its type and judge its malignant potential. Following these procedures, malignancy grading on biopsies/stereotactic biopsies has the least grading. This grading system is essential for the classification of brain tumors.

Radiation therapy before histological diagnosis may make classification and malignancy grading difficult. Also, in some cases, impossible. We determine the clinical implications of the classification of a tumor and malignancy grading. 

A brain is a sensitive and vital organ, and any damage to this part can be quite fatal. Brain cancer can be very dangerous amongst all other cancer types. The reason is that all tumors arising in our brain are malignant. Also, it is harder to detect or treat because of the blood-brain barrier. The blood-brain barrier acts as a hindrance to most drugs trying to enter the brain. Due to this, newer methods of treatments are developed such as the use of nanoparticles. Also, there have been many recent advancements in this field. These include application of objective methods of measurement of cell proliferation. Besides this, death in tumors and malignancy grading are also some of them. However, there is still much work required to be done in these fields. Better treatment procedures are also helping to reduce brain cancer these days. However, brain cancer can be very harmful, in some cases even leading to death.
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