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Dr Orrange received her BA in Biology at the University of California San Diego and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health She received her MD from the USC Keck School of…
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Kennedy's Tragedy: Are we Really Seeing More Brain Tumors?
Primary brain tumors arise from different cells of the central nervous system. Distinguish this in your mind from secondary brain tumors which are those originating elsewhere in the body that spread to the brain. Sadly, Senator Kennedy has just been diagnosed with a malignant primary brain tumor and evidence indicates these are becoming more common.
How common are primary brain tumors? Data from 2007 indicated there were 20,000 new primary brain tumor cases in the United States. Brain tumors account for only 2 percent of all cancers and are one-fifth as common as breast or lung cancer. The real tragedy however is that prognosis is dismal and the five-year survival rate for malignant brain tumors is 33 percent. Children or young adults with brain tumors do better than older adults.
Are we getting any better at treating malignant brain tumors? Not really. Overall survival in patients with malignant brain tumors has not improved significantly over the last 50 years. This is partly due to the fact that brain cells are slow growing, and so don't respond well to chemotherapy or radiation no matter how many new therapies we throw at them.
What factors affect prognosis? Young age and high performance status are favorable prognostic factors. Additionally, long duration of symptoms, absence of mental status changes, small tumor size and completeness of surgical resection help you out but not as much.
Who gets primary brain tumors? There is a slight male predominance and Caucasians tend to have a higher incidence compared to Blacks. In general malignant brain tumors are less common among Asian-Americans and Native Americans. The peak incidence of all primary brain tumors is around 50 years of age.
What are the most common types of primary brain tumors in adults? Gliomas account for about 50% and meningiomas 25 to 30 %. Meningiomas generally have a better prognosis and are often diagnosed incidentally when imaging of the brain is done for other reasons. Pituitary tumors (almost always benign) account for 10-20 percent, lymphoma 3-5 percent and craniopharyngioma 1-3 percent.
Senator Kennedy has a Malignant Glioma. What exactly is this? The term "glioma" refers to tumors that come from glial cells (astrocytes, oligodendrocytes and ependymal cells). Each of these cell types can develop into a cancer and has a different name. Common subtypes of gliomas are: astrocytomas, glioblastomas, ependymal tumors . . . you get the idea. We don't know yet what type of malignant Glioma Senator Kennedy has.
What are the most common symptoms in someone with a primary brain tumor? Headaches, seizures, syncope (fainting episode), nausea and vomiting, memory problems, mood or personality changes, and weakness.
Why the rising incidence of brain tumors? The question arises whether we are just better at diagnosing them or are we actually having more brain tumors. The answer seems to be both. The introduction of CT and MRI has led to better diagnosis of brain tumors but that can't explain all of the increase. There is a belief that environmental exposure may account for part of the increasing incidence of brain tumors. The only firmly established environmental risk factor is ionizing radiation which occurs as therapeutic radiation therapy (excessive dental x-rays, radiation treatment, etc) or is seen among atomic bomb survivors. Possible causative factors which require further investigation include allergies, non-ionizing radiation (microwaves, radar), physical and acoustic trauma (head trauma in boxers) dietary nitrosamines (found in tobacco smoke, cosmetics, automobile interiors, cured meats, rubber products like pacifiers and nipples), and certain infections.
How do we treat malignant gliomas? The malignant gliomas are rapidly progressive gliomas which are best managed with a combined approach of surgical resection when possible, postoperative radiation therapy, and chemotherapy. Even with aggressive treatment the prognosis remains dismal.
"The work goes on, the cause endures, the hope still lives and the dreams shall never die."
Edward Kennedy
Dr. O
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for free nursing practice test about the topic.
http://www.youtube.com/watch?v=gke...
You need to see this video about the dangers of cell phone radiation.
The head of a prominent cancer research institute issued an unprecedented warning to his faculty and staff Wednesday: Limit mobile phone use because of the possible risk of cancer.
The warning from Dr. Ronald B. Herberman, director of the University of Pittsburgh Cancer Institute, is contrary to numerous studies that don't find a link between cancer and mobile phone use, and a public lack of worry by the U.S. Food and Drug Administration.
Herberman is basing his alarm on early unpublished data. He says it takes too long to get answers from science and he believes people should take action now - especially when it comes to children.
"Really at the heart of my concern is that we shouldn't wait for a definitive study to come out, but err on the side of being safe rather than sorry later," Herberman said.
No other major academic cancer research institutions have sounded such an alarm about cell phone use. But Herberman's advice is sure to raise concern among many cell phone users and especially parents.
In the memo he sent to about 3,000 faculty and staff Wednesday, he says children should use mobile phones only for emergencies because their brains are still developing.
Adults should keep the phone away from the head and use the speakerphone or a wireless headset, he says.
He even warns against using mobile phones in public places like a bus because it exposes others to the phone's electromagnetic fields.
The issue that concerns some scientists - though nowhere near a consensus - is electromagnetic radiation, especially its possible effects on children. It is not a major topic in conferences of brain specialists.
A 2008 University of Utah analysis looked at nine studies - including some Herberman cites - with thousands of brain tumor patients and concludes "we found no overall increased risk of brain tumors among cellular phone users. The potential elevated risk of brain tumors after long-term cellular phone use awaits confirmation by future studies."
Studies last year in France and Norway concluded the same thing.
"If there is a risk from these products - and at this point we do not know that there is - it is probably very small," the Food and Drug Administration says on an agency Web site.
Still, Herberman cites a "growing body of literature linking long-term mobile phone use to possible adverse health effects including cancer."
"Although the evidence is still controversial, I am convinced that there are sufficient data to warrant issuing an advisory to share some precautionary advice on cell phone use," he wrote in his memo.
A driving force behind the memo was Devra Lee Davis, the director of the university's center for environmental oncology.
"The question is do you want to play Russian roulette with your brain," she said in an interview from her cell phone while using the hands-free speaker phone as recommended. "I don't know that cell phones are dangerous. But I don't know that they are safe."
Of concern are the still unknown effects of more than a decade of cell phone use, with some studies raising alarms, said Davis, a former health adviser in the Clinton Administration.
She said 20 different groups have endorsed the advice the Pittsburgh cancer institute gave, and authorities in England, France and India have cautioned children's use of cell phones.
Herberman and Davis point to a massive ongoing research project known as Interphone, involving scientists in 13 nations, mostly in Europe. Results already published in peer-reviewed journals from this project aren't so alarming, but Herberman is citing work not yet published.
The published research focuses on more than 5,000 cases of brain tumors. The National Research Council in the U.S., which isn't participating in the Interphone project, reported in January that the brain tumor research had "selection bias."
That means it relied on people with cancer to remember how often they used cell phones. It is not considered the most accurate research approach.
The largest published study, which appeared in the Journal of the National Cancer Institute in 2006, tracked 420,000 Danish cell phone users, including thousands that had used the phones for more than 10 years. It found no increased risk of cancer among those using cell phones.
A French study based on Interphone research and published in 2007 concluded that regular cell phone users had "no significant increased risk" for three major types of nervous system tumors.
It did note, however, that there was "the possibility of an increased risk among the heaviest users" for one type of brain tumor, but that needs to be verified in future research.
Earlier research also has found no connection.
http://www.dailymail.co.uk/news/worldnews/article-1038240/What-cancer-researcher-told-staff-Limit-mobile-phone-use-avoid-tumours.html
Officials have warned that because of possible side effects from radio frequency radiation, children under eight should only use a cell phone in emergencies, and teenagers should limit calls to less than 10 minutes.
For many years, most government health agencies were dismissive of any risk. But with more studies, a pattern is emerging that suggests people who have used their cell phones for a long period of time are at greater risk of certain kinds of brain tumors.
Sources: http://healthzone.ca/health/articl...
http://www.cbc.ca/canada/story/200...
OK, what scares the hell out of me here is that this guy was so priviledged his whole life (probably the best air, water, etc. this country has to offer) but still got cancer. So where did this come from? Was it exposure to radiation in Washington, D.C., home of the satellite dish with more cell towers per capita than anywhere else in the world? Would almost come as a relief if it was self-induced as a heavy drinker.
Here's another thing. A non-smoking aunt of mine (mother's middle sister now in herre late 50s) was recently diagnosed with lung cancer after it was spotted in an xray which was actually taken due to a fall/injury. This came as a shock, especially as I have friends who have smoked 50-60 years and don't have cancer - just doesn't seem logical let alone fair.
The aunt did teach at schools in Hudson County, NJ later found to be built on toxic dumps, so that could be it, along with drinking ground water from such sites. But I have another unshakable suspicion - she had a house custom-built in Maine. On the East Coast we have ribs of radon going through the rock underneath. I just wonder if she cut into such rock and lived on it for 20 years - resulting in giving herself cancer in what she thought was paradise. Would be ironic, but would make a hell of a lot of sense.
I now wonder about this possibly. And what about radon and brain cancer? Especially in East Coast Massachusettes?
Last week, three prominent neurosurgeons told CNN interviewer Larry King that they did not hold cell phones next to their ears. Dr. Keith Black, Dr. Vini Khurana, and CNN’s chief medical correspondent, Dr. Sanjay Gupta all maintained that the practice could be unsafe.
Along with Senator Edward M. Kennedy’s recent diagnosis of a glioma, a type of tumor that critics have long associated with cell phone use, the doctors’ remarks have helped reignite the debate about cell phones and cancer.
According to the Food and Drug Administration, three large epidemiology studies since 2000 have shown no harmful effects. However, that the average period of phone use in those studies was about three years, which provides no information about the long-term exposures that could lead to cancer.
“What we’re seeing is suggestions in epidemiological studies that have looked at people using phones for 10 or more years,” says Louis Slesin, editor of Microwave News, an industry publication that tracks the research.
http://www.nytimes.com/2008/06/03/...
Dr O.
Am watching my father go slowly down hill daily.
We are best friends.
My mother passed in '78 with a brain tumor. Dx'd June 19th, she died Aug. 5th. I was only 24 years old. I was devastated. Now going thru the same thing.
You mentioned different types of tumors and for the life of me...I can't remember them. I will reread and then sit down and talk to his doctors for a straight up answer.
Thanks for posting this.
I am so sorry about the great Mr. Kennedy. I'm sorry for anyone that suffers from any kind of brain damage. It's scary.
Thanks again Dr. Orange.
Tasmoe