Why there is still no cure for brain cancer?

Why there is still no cure for brain cancer?

The brain forms the motherboard of the human body. Producing every thought, experience, memory and feeling, it is the most complex organ. Brain is, structurally, a jelly-like mass of tissue, weighing around 1.4 kg. It contains about one hundred billion nerve cells, called as neurons. Complexities in the connectivity between the brain cells is mind-boggling. Each neuron connects to thousands or more neurons via synapses. Our brain forms millions of new connections every second of our life. Thus, the pattern is ever changing and no two brains are alike. This vital organ is therefore, the control unit for all other organs of the human body.

However, even this important organ is not free from diseases. With more than 1 million cases every year, brain cancer is in the forefront. The tumor may start in the brain or it may start elsewhere and spread to the brain. In brain cancer, the brain cells begin to grow and multiply abnormally. These rapidly growing cells spread within the brain resulting in cancerous tumors. Cancerous cells may spread to other body organs as well, causing tumors there.

Brain cancer can be of either low grade or high grade. The low grade ones are slow growing while the high grade ones are fast growing. It must be said beforehand, that tumors are not curable. Various treatments available might shrink the tumor or slow its growth down. This helps in controlling the symptoms for some time. Some slow growing tumors cannot be cured but be made to grow very slowly. Depending on the type of tumor and where it is located, tumors may be treatable. Treatment also works better if diagnosis is early and the tumor responds well to treatment. Even if a tumor responds well to treatment, it may come back at a later point in life. 

Types of Brain Cancer

There are two primary types of brain cancer. These classification is shown below with a brief description-
  1. Primary cancer: - The most common primary brain cancer that occurs in adults is glioblastoma. Often referred to as GBM, it is one of the most aggressive forms of brain cancer. Other common primary brain tumors include gliomas, meningiomas, pituitary adenomas and medulloblastomas. Glioma includes glioblastomas, ependymomas, astrocytomas and ogodendrogliomas. These are named after the originating brain cell or the part of the brain in which they occur. 
  2. Secondary cancer: - Secondary cancers are the ones that are spread from one part of the body to another. However, ones like secondary glioblastoma originate in the brain developing from a brain tumor of lower grade. This lower grade brain tumor type is known as astrocytoma. These tumors are also called Metastatic brain tumors. They are made of cancerous cells from a tumor that has occurred elsewhere. The spread of the cells to the brain is through a process called metastasis. It forms the most common type of brain cancer. 

Symptoms of Brain Cancer

The symptoms of primary as well as metastatic brain cancer are similar. These symptoms are as follows-
  1. Headache and dizziness (also called vertigo) 
  2. Weakness and fatigue 
  3. Clumsiness in day to day works 
  4. Experiencing difficulty in walking 
  5. Seizures in the person involved 
  6. Altered status of mind in the person involved. He or she may feel changes in memory, attention, concentration or alertness. 
  7. Vomiting and nausea 
  8. Abnormalities in vision 
  9. Difficulty in speaking 
  10. Gradual changes in intellectual capacity of the person involved. There may also be delayed emotional response in him or her. 

Treatments of Brain Cancer

Treatments of Brain Cancer
Treatments of Brain Cancer
Treatment depends on several factors like the person's age and health, and also on the type of tumor and its size, location. What's more is that we also need to look out for the side effects involved with each treatment. It's important to note that cancer is not an external disease. It is basically a mutation of our own cells that leads to uncontrolled growth. Cancer is complex and requires a multitude of treatments to be kept in check. There's tons of doctors involved like health care provider, neurosurgeon, oncologists and more. As stated earlier, it's not completely curable. Here are some of the treatments to keep the symptoms of brain cancer in check-
  1. Brain surgery: - This involves surgically removing the tumor from the brain. It requires extreme precision on part of the surgeon involved. Steroid drugs like Decadron may be prescribed to help relieve the swelling. To relieve seizures, anti-convulsant drugs may be given. Excess cerebro-spinal fluid may be removed using a shunt. 
  2. Radiation Therapy for Brain Cancer: - Radiation therapy is generally used for people who can't undergo surgery. It is also used to remove any remaining cancer cells after surgery. This procedure generally affects only the cells in its path. Being a local therapy, it typically does no harm elsewhere in the body. 
  3. Chemotherapy for Brain Cancer: - Chemotherapy is the use of powerful drugs to help kill the cancer cells. The drugs are generally given through the mouth or through an IV line or even through the shunt. It is usually done in cycles followed by a short rest time period for recovery. Each cycle mostly lasts for a few weeks. 
  4. Immunotherapy for Brain Cancer: - Immunotherapy is a targeted therapy involving either activation or suppressing of immune system. This type of treatment involves strengthening our immune system, the body's natural defense system. Amplification of the immune response in our body helps our body itself fight against cancer. 

Why there's still no cure for brain cancer?

Although, there's a myriad of treatments available for cancer, there still hasn't been a cure. Even after spending millions on research, we still haven't figured out a cure. As stated earlier, cancer is not a disease but actually a mutation. Normal cells accumulate mutations in cancer. Most of the time, cells fix these mutations by altering them or through self destruction. However, some mutations allow these cancerous cells to grow unchecked. These cells invade nearby tissues or even metastasize distantly located organs. Any type of cancer becomes almost incurable once they metastasize. Also, cancer is very complex as there exists hundreds of types of cancerous cells. The various reasons why there still hasn't been a cure for brain cancer are as follows-
  1. Brain Cancer is incredibly complex: - As stated earlier, any type of cancer is complex. This is because there doesn't exist just one type of cancerous cell but hundreds of them. Combine that with the millions of neurons and their connections in the brain, and you get one incredibly complex situation. Also, there doesn't exist a single treatment for all types of cancerous cells. General methods of treatment like surgery thus, becomes extremely difficult in these cases. Chemotherapy and radiation therapy are also not a hundred percent effective. Depending on the age that you were diagnosed, the tumor may lead to your eventual death. Or in some cases, you may live a normal life and die from something else before. All of this depends on several factors like location and response to treatment. Complexity of the treatment procedure leads to a less effective treatment. Some people may even have a tumor that goes away with treatment only to return some time later. 
  2. Adequate study of brain cancer cells is hard and has complexities involved: - Before figuring out a cure, we need to find how they work on a person. We need a better method of studying cancerous cells. Most cancer treatments for brain cancer are developed in labs. These methods employ cell lines grown from cultures of human tumors. The cultured cells help by giving us critical information about the genetics and biology of cancer cells. But, they lack the level of complexity present in the brain of an actual living organism. This results in frequent failure of new drugs. New drugs may work on lab grown cells but fail in clinical trials. Thus, there must be development of new methods to study cancerous cell growth before a cure. 
  3. Presence of multiple populations of different cancerous cells: - Another complexity of these aggressive tumors is that there can be several populations of cancerous cells. These cells can be slightly different from each other. Each type has their own basic genome. Over time, different genetic mutations accumulate in these cancerous cells at different parts of the cancer. This leads to formation of unique sub clones. For example, aggressive brain tumors called glioblastomas can have up to six unique sub clones. And this is all in one single patient. The phenomenon mentioned above is called clonal heterogeneity. This makes treatment of cancer very difficult. One drug that may work quite effectively on on one sub clone can have no effect on another. Thus, clonal heterogeneity, i.e. presence of several unique sub clones hampers treatment of cancer. If we can successfully figure out a drug that effects various sub clones then we may find a way to treat them more effectively. 
  4. Cancerous cells form a closely related interconnected system: - A tumor is a dynamic interconnected system where cancerous cells are closely connected. Cancerous cells constantly communicate with each other through sharing of info. These cancerous cells also communicate with the healthy cells nearby. The cancerous cells can induce the normal cells of the body to form blood vessels. Blood vessels, so formed, feed the tumor and also help in removing of waste products. Cancerous cells by forming a close network among themselves and other healthy cells hampers treatment. It becomes difficult for a drug to distinguish between different cells. Effectiveness of new drugs is severely hampered due to this nature of tumor cells. Shutting down these lines of communication may prove effective in the treatment process. 
  5. Cancerous cells suppress the functions of the immune system: - This point is an extension of the previous one. The immune system is the body's central line of defense against diseases. Immune response protects the body against harmful microbes and keeps us healthy. But, when this response system is tampered with, it can lead to disastrous outcomes. And this is exactly what a cancer cell does. Cancerous cells interact with the immune system to suppress its function. Suppression implies keeping the immune system from recognizing and destroying the cancer cells. Moreover, cancer cells may evade our immune system and may even suppress key elements of the immune response. This results in a failed immune response. With our body's own defense system shut down, we are left helpless against cancer. 
  6. Presence of cancer stem cells: - Additional evidence has come up suggesting that to cure cancer, we need to eradicate stem cells. Cancer stem cells are rare but seem to have special properties. These special properties make the cancer stem cells resistant to chemotherapy and radiation. Stem cells are extremely dangerous. Even if all cancer cells are eradicated from the body, a single residual stem cell can seed the growth of a new tumor. The stem cells are extremely stubborn and very difficult to eradicate. Erasing stem cells may prove effective in treating cancer. 
  7. Evolution of cancer cells have made them resistant: - Cancer cells are rapidly growing cells. This rapid growth causes damage to the cell DNA. The damage caused to the DNA is also repaired. Genetic changes add up over time resulting in evolution at a rapid rate. 
This is important because the cancer you find today may change when you try to treat it in a few weeks time. Cancer cell evolution makes it a difficult challenge to successfully treat cancer. It is hard to cure cancers if enough cancer cells survive the initial treatment. These cells evolve further and even targeted combination therapies fail to treat them.
Additionally, cancer cells are called masters of adaptation. They can survive under extreme stress by adjusting their cellular characteristics. When bombarded with chemotherapy or radiation, some cancer cells use protective shields by changing gene expressions. These shields effectively protect cancerous cells from the treatment provided. The rapid adaptability and evolution potential makes cancer cells difficult to deal with.
Infographic - Why there's still no cure for brain cancer?
Why there is still no cure for brain cancer?

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