Primary Tumors of the Central Nervous System, and the

Major Factors that Influence Patient Outcomes.

A primary brain tumor is defined as a mass of abnormal cells whose

growth originates within the brain. These tumors mostly originate from
the brain cells, meninges (membranes around the brain), nerves, or even
glands. According to scientists, there are over 125 brain tumors that can
develop in different regions of the brain. These tumors usually can
damage the brain by triggering inflammation, or exerting pressure on the
brain, hence impairing its functionality. Brain experts classify primary
brain tumors depending on the following factors:
● The exact location of the tumor.
● The type of tissue this tumor has grown on.
● Ability to be malignant (cancerous) or benign (non-cancerous).
● High grade (rapidly growing) and low grade (slowly growing).

The following are the major primary brain tumors:

Gliomas. These are the most common type of primary brain tumors,
especially in faults. They develop from the glial cells (cells that provide
support and protection to the neurons), like astrocytes, oligodendrocytes,
and ependymal cells. Gliomas fall into three categories:
● Astrocytic tumors, astrocytomas, anaplastic, and glioblastomas.
● Oligodendroglial tumors
● Glioblastomas are the most aggressive type of primary brain tumor.

Meningiomas. They grow from the membranes that surround the inside
part of the skull. These are slow-growing tumors and are usually non-
cancerous. In most cases, they occur between the ages of 40 and 70 and
can trigger problems such as seizures.

Pituitary brain tumors. These are types of tumors that arise from the
pituitary gland, an organ responsible for the production and regulation of
many body hormones. Most of these tumors are usually non-cancerous,
although they can cause severe health problems by either pressing on
other brain structures or overproducing excess hormones that your body
doesn't need. Over-production of these hormones triggers other medical
conditions within the body.

Pineal region tumors. These tumors have their origin within the pineal
gland, an organ responsible for producing and regulating hormones such
as melatonin, a hormone that regulates sleep patterns. Pineal tumors are
divided into two categories: Germ cell tumors which begin in the
reproductive cells (ova or sperms) around the pineal gland and pineal cell
tumors, which originate from the parenchymal cells within the pineal
gland.
Primary central nervous system lymphoma. These tumors begin from
the lymphocytes found within the brain, although lymphocytes are also
present in the eyes, spinal cord, and other places. This form of tumor is
more common in persons who have a compromised immune system,
which can be caused by treatments like chemotherapy, other disorders
like HIV, malnutrition, or autoimmunity, among other things.
Factors that Influence Patient Outcomes

Once diagnosed with a brain tumor, the next stage is usually treated.
Whether the tumor is malignant or benign, the treatment depends on
several factors that influence how well or quickly a patient recovers. The
factors are:

Age span. A person’s age is one huge determinant of the outcome once
diagnosed with a primary brain tumor. One of the best ways of predicting
a patient's outcome is by using his/her age and functional status.
According to research, a young person has better outcomes compared to
older adults. This is because as the human body ages, it loses its ability to
recover from diseases as the immunity weakens as well. Again, young
adults are always developing and their bodily resources are constantly
used to create new cells, bones, tissues, and muscles. Since the body is
constantly growing and engaged in all these processes, healing becomes
faster, making young adults better outcomes.

Location of the tumor. Tumors can form in any part of the brain, and this
influences the patient's outcomes. Some tumors may be very difficult to
treat because of their locations. For example, glioblastoma tumors can be
very difficult to remove as their entire removal is usually nearly
impossible. Glioblastomas have finger-like tentacles that spread to other
parts of the brain and also these tumors don’t have clear borders.

Ability to spread. Tumors that can spread to other parts of the body can
be challenging to treat. For example, most tumors starting within the
brain (primary tumors), even if metastatic, may not spread to other body
parts, but may metastasize within the brain. In such a case, this can be
difficult to obliterate them because of their ability to regrow. Doctors
usually link tumors that spread to other parts of the brain or the spinal
cord to poor outcomes.

Size of the tumor. Tumor size also matters when medical experts are
determining the prognosis and outcomes of the patients. Big brain
tumors may pose a challenge to both the patient and the medical experts
removing them. As these tumors enlarge, they may infiltrate into other
key brain areas, exerting pressure on them. This may make it difficult to
remove such tumors in the fear of damaging major brain regions that can
negatively affect the patient. Some patients with small tumors, especially
the ones found within the meninges, can be treated with no problem.

Residual extent. Residual is the amount of tumor that remains in the

brain after the surgery. This is very key because it tells medical
professionals the prognosis of the patient post-surgery. In some
instances, surgeons may prefer not to remove the entire tumor to avoid
impairing brain structures that cause severe consequences such as
disability, hemorrhage, brain death, etc. The best outcome is when the
patient can have the entire tumor removed. This is because it creates
more room for other brain parts to function well. A residual mass may
continue to grow, exerting pressure and causing metastasis or further
damage.

Functional neurologic status. Before surgeons can decide on what

surgery to perform on a patient with a brain tumor, they usually examine
functional neurologic status. This is the ability to perform various tasks
such as walking, thinking, making decisions, speaking, etc. Surgeons use
a Karnofsky Performance Scale (KPS), where a higher score shows that a
person has a better functional status. Therefore, if someone has a better
functional status, he/she has better outcomes even after surgery,
compared to someone with a poor functional score.

Conclusion

Primary brain tumors are tumors that have their origin within the brain.
These tumors can grow within the brain only but can also spread to other
structures like the spinal cord. Primary brain tumors are categorized
based on their location, ability to cause cancer, the type of tissue they
affect, etc. The most common types of primary brain tumors are gliomas,
meningiomas, and primary central nervous system lymphoma tumors.
The outcome of a patient with a primary brain tumor depends on various
factors such as age, residual extent, size, location, and functional
neurological status. These factors tell how well a patient can fully recover
post-treatment, and doctors use them to evaluate prognosis. Although
brain tumors can be difficult to manage especially when located deep
within the brain and are large, early screening can increase the chances
of survival.