FAQ

What is new in the world of brain tumours in 2010?

Cause
Still unknown. The INTERPHONE study, involving 13 countries and at a cost of $40 million, started looking at the association between mobile phone usage and brain tumours 10 yrs ago and had collected all their data by 2007. However, the results of that study were not published until 2010. The delay in publication put questions on the validity of the study and the integrity of the scientists given that $15 million of the funding came from industry. The conclusions reached in the final manuscript were also a little odd. It read that there was no link found between the use of mobile phones and the development of a brain tumour. It then went on to say....”However, if one is a heavy mobile phone user then there does appear to be a higher risk for developing a brain tumour. This added risk is 1.5 times more than the normal population. Furthermore, if one also looks at the side of usage and more specifically, the area of the brain around the ear, the risk increases to almost 2.5 times. The definition of a “heavy” user is someone who uses a mobile phone more than 30 minutes a day! Bottom line... I believe we are about to face a huge public safety and health catastrophe. The study only looked at adults and there was only one sub-group who were followed for more than 10 years, yet we know that the child’s brain is likely more sensitive to radiation and that it takes at least 10 years to develop brain tumours after exposure to radiation.
Genetic profiling and molecular sequencing are still showing promise. The US has funded this project to the tune of US$150 million and we believe we will soon have the  genetic information about brain cancer that will assist in diagnosis, evaluating risk, personalising treatment and calculating prognosis. The Cure for Life Foundation, through the magnificent work of Dr Kerrie McDonald is concentrating on identifying the genes that may be instrumental in transforming low grade tumours into high grade malignant tumours.

Incidence
Brain cancer is still one of the least common cancers but is increasing in frequency and incidence. The Central Brain Tumor Registry of the United States (CBTRUS), which monitors brain tumour incidence in 19 US states recently published their data for the years 2000 to 2004. These figures documented an exponential rise in incidence from approx. 13 to 18 per 100,000 population.

Diagnosis
Nothing new

Treatment

SURGERY
Minimally invasive techniques are becoming more accepted and are now starting to change the approach to some tumours. Endoscopic access to the skull base through the nose is gaining in popularity. Intra-operative MRI and biological marking of tumours both help with the radicality of excision and studies show that with these tools, inexperienced and young neurosurgeons may achieve the same results as those from the best centres.
                                   

CHEMOTHERAPY
More new agents are being used. These are mostly accessible through trials. Avastin is an agent that targets new blood vessel formation. The benefit of convection enhanced delivery of chemotherapy through small catheters placed in the brain around the tumour remains unanswered. The molecular analysis of brain tumours is gaining importance in the field of personalised treatment. The expression of proteins such as VEGF and MGMT are reliable predictors of response to Temodol and Avastin.
                                   

RADIOTHERAPY
Nothing new. Unfortunately, recent publicity from a centre in Sydney advertised widely that their Gamma Knife machine was a novel treatment for brain tumours. However, firstly it is not novel, having been available overseas for the last 30 years, and secondly, its indications are very specific. It is not a recommended treatment for primary brain tumours. It is mostly indicated for secondary cancer to the brain and some inoperable meningiomas.

Cure for Life Foundation              

The CFLF continues to grow. We now raise over $2 million per year and are still the largest contributor to brain cancer research in Australia. Most funds are directed to the CFLF Neuro-oncology wing of the Lowy Cancer Centre of which Kerrie McDonald is the Head. We continue to support other projects in Sydney, Brisbane and Melbourne with smaller grants. Volvo Australia recently came on board as a major sponsor.

Brain Tumours

What is a brain tumour? A tumour is a "lump" of cells that grow faster than the normal surrounding cells. Sometimes these cells look like normal cells but at other times they are bizarre and unrecognisable. A brain tumour is a tumour in the brain.

How do brain tumours damage the brain? Tumours damage the brain and can cause problems by

• stealing oxygen and nutrients from the surrounding normal tissue or
• compressing the normal tissue or
• what they secrete.

What causes brain tumours?

The short answer is that no-one knows why brain tumours occur. There are many theories, some of which are scientifically sound, others being nothing more than speculation. Here are some of those theories. Please remember that no definitive cause has been found and therefore we should not draw any firm conclusions based on non-factual information:

 Genetic Arguments for this theory are mostly based on the close
association between some congenital syndromes and brain tumours. There is a condition called neurofibromatosis(NF) that is characterised by multiple soft tissue tumours. The abnormal chromosome has been localised to chromosome 22 and 17. Those with NF1 may suffer from tumours anywhere along the visual tract and those with NF2 get tumours of the vestibular nerve. Also, some people with brain tumours have an over-expression of certain growth factors (PDGF) and cancer genes (proto-oncogenes) and a depletion of tumour suppressor genes. These genes and growth factors are found in many people without cancer.

Ionising Radiation Ironically, radiation that is given in limited doses to treat patients with malignant tumours, may also cause malignant brain tumours when given in higher doses.

Electromagnetic Radiation The Scandinavians first alerted us to the adverse effects of very low frequency EMR. They showed quite conclusively that people who lived close to high tensile electrical wires were at greater risk of developing cancers, including brain tumours. To extrapolate this data to other electrical appliances may be over-reacting but it is generally accepted that one should try to limit exposure. Mobile phones emit EMR. More info.

Immunosuppression The scientific community accepts unequivocally that the immune system plays an important role in the genesis and control of any malignancy. The relative importance is disputed. Some people with brain tumours do have deficiencies in their immune system, but the majority are not immunosuppressed. Dr Teo is a strong believer in the importance of keeping the immune system primed. This can be done with exercise, a diet rich in anti-oxidants, positive thought, reduced stress and laughter.