What is Brain Cancer?
The brain and spinal column make up the central nervous system (CNS), where all vital functions of the body are controlled. When tumors arise in the central nervous system, they are especially problematic because a persons thought processes and movements can be affected. These tumors can also be difficult to treat because the tissues surrounding a tumor that may be affected by surgery or radiation may play a vital role in functioning.
There are two broad types of cancers occurring within this system. Primary tumors originate in the central nervous system, whereas secondary tumors migrate from cancers located elsewhere in the body, such as breast cancers. Secondary, or metastatic, brain tumors, are more common than primary brain cancers. This section focuses on primary brain cancers.
What is the brain?
Together, the brain and spinal cord form the central nervous system. This complex system is part of everything we do. It controls the things we choose to do,like walk and talk,and the things our body does automatically,like breathe and digest food. The central nervous system is also involved with our senses; seeing, hearing, touching, tasting, and smelling, as well as our emotions, thoughts, and memory.
The brain is a soft, spongy mass of nerve cells and supportive tissue. It has three major parts: the cerebrum, the cerebellum, and the brain stem. The parts work together, but each has special functions.
The brain is composed of:
A. The cerebrum, which is divided into two cerebral hemispheres. The cerebrum is the largest part of the brain and is divided into lobes where discrete functions occur. Higher reasoning takes place in the cerebrum.
B. The cerebellum, or little brain, located beneath the cerebrum. The cerebellum controls coordination and balance.
C. The brain stem, which is the lowest portion of the brain and connects to the spinal cord, controls involuntary functions essential for life, such as the beating of the heart and breathing.
D. The meninges, membranes that surround and protect the brain and spinal cord. There are three meninges.
The types of primary brain cancers are classified according to the type of cells from which they originate. Oncologists describe the tumor based on its characteristics. For example, a noninfiltrating tumor can be expected to grow slowly and not invade surrounding structures. A well-differentiated tumor is also slow growing, but has the potential to be invasive. Anaplastic tumors are generally more aggressive.
Gliomas - Most brain tumors are gliomas, which originate in the glial cells (the supportive cells of the nervous system). Gliomas can be described as low-grade (slow-growing); intermediate-grade (more aggressive); or high-grade (very aggressive).
There are many different types of gliomas:
E. Astrocytoma, the most common type of glioma, which usually begin in cells called astrocytes within the cerebrum, or the cerebellum. Glioblastoma multiforme is a form of very aggressive astrocytoma.
F. Oligodendroglioma, a tumor that develops from oligodendrocytes. These cells are responsible for producing the myelin that surrounds nerves.
G. Brain stem glioma, which begins in the glial cells in the brain stem.
H. Ependymoma, which begins in the ependyma, the cells that line the passageways in the brain where cerebrospinal fluid is made and stored.
I. Mixed tumors, which are composed of more than one of the glial cell types.
Nonglial tumors include:
J. Acoustic schwannoma, which occurs in the vestibular nerve.
K. Craniopharyngioma, which begins near the pituitary gland.
L. Meningiomas, which originate in the meninges surrounding the brain and spinal column. Even though these tumors are generally benign, they may cause significant symptoms as they grow and press on the brain or spinal cord.
M. Medulloblastoma, which arises from granular cells in the cerebellum.
N. Primary CNS lymphoma.
O. The pineal and pituitary glands, located near the base of the brain, can also be the source of tumors.
Since brain and spinal cord tumors behave somewhat differently than tumors arising in other parts of the body, they are often referred to as low and high grade, rather than benign and malignant. Oncologists assign the terms low, intermediate, or high grade to a patient’s tumor based on parameters that predict how quickly the tumor can grow and its potential to spread to other parts of the brain.
Treating brain and spinal cord tumors can be difficult. The blood-brain barrier, which normally serves to protect the brain and spinal cord from damaging chemicals getting into those structures, also keeps out many types of potentially beneficial chemotherapy drugs. Surgery can be difficult if the tumor is near a delicate portion of the brain or spinal cord and radiation therapy can damage healthy tissue. However, research in the past two decades has improved the survival rates of patients with brain tumors. More refined surgeries, a better understanding of what types of tumors respond to chemotherapy, and precise delivery of radiation have resulted in longer life span and better quality of life for people with brain cancers.
As we well know, there are many kinds of cancer; unfortunately they all come about because of the out-of-control growth of abnormal cells.
Healthy Cells vs. Cancer Cells
Healthy cells are like a cat. They need structure to determine the size of bones and shape of the body, tail and whiskers. The DNA in genes and chromosomes determine this. They need energy to play and prowl and sustain life. This is derived from chemicals in food. Cats need a system to deliver chemicals (food nutrients like amino acids, carbohydrates, fats, vitamins and minerals) to all parts of their body. These are the blood vessels. Growth factors take a kitten into a lazy old cat, all the while helping it to function normally.
The body and its cells are mostly made up of protein. The building blocks of proteins are substances called amino acids that in the form of enzymes and hormones literally control every chemical reaction within the cells. When these are modified, different messages are sent to a complex control system that can alter their function. There are twenty different kinds of amino acids that are essential to life. Twelve of these can be synthesized within the body however; eight must be supplied by the daily diet.
Structure
Normal Cells
Cancer Cells
DNA in genes and chromosomes go about their business in a normal way.
Cancer cells develop a different DNA or gene structure or acquire abnormal numbers of chromosomes.
Cells divide in an orderly way to produce more cells only when the body needs them.
Cells continue to be created without control or order. If not needed, a mass of tissue is formed which is called a tumor.
Energy
Normal Cells
Cancer Cells
Cells derive 70% of their energy from a system called the “Krebs Cycle.”
Cells have a defective “Krebs Cycle” and derive little or no energy from it.
Cells derive only 20% of their energy from a system called “Glycolosis.”
Cancer cells derive almost all their energy from “Glycolosis.”
Cells derive most of their energy with the use of oxygen.
Cells derive most of their energy in the absence of oxygen.
Blood Vessels
Normal Cells
Cancer Cells
Cells have a built-in blood vessel system.
Cells do not have a built-in blood vessel system. They require more of certain amino acids to grow.
Growth Factors
Normal Cells
Cancer Cells
While similar to cancer cells, the amount of them is more in balance to produce a more normal level of activity.
These cells have over produced, require more chemicals (food) and are over active.
Functions
Normal Cells
Cancer Cells
The enzymes and hormones go about business in a normal balanced manner.
The enzymes and hormones are either over active or under active.
Tumors are Different
Benign
Malignant
Benign tumors are not cancerous. They do not invade nearby tissues nor spread to other parts of the body. They can be removed and are not a threat to life.
Malignant tumors are cancerous. They can invade and damage nearby tissues and organs and they can break away and enter the blood stream to form new tumors in other parts of the body. The spread of cancer is called metastasis.
What causes brain tumors?
The causes of brain tumors are not known. Researchers are trying to solve this problem. The more they can find out about the causes of brain tumors, the better the chances of finding ways to prevent them.
Doctors cannot explain why one person gets a brain tumor and another doesn't, but they do know that no one can "catch" a brain tumor from another person. Brain tumors are not contagious.
Although brain tumors can occur at any age, studies show that they are most common in two age groups. The first group is children 3 to 12 years old; the second is adults 40 to 70 years old.
By studying large numbers of patients, researchers have found certain risk factors that increase a person's chance of developing a brain tumor. People with these risk factors have a higher-than-average risk of getting a brain tumor. For example, studies show that some types of brain tumors are more frequent among workers in certain industries, such as oil refining, rubber manufacturing, and drug manufacturing. Other studies have shown that chemists and embalmers have a higher incidence of brain tumors. Researchers also are looking at exposure to viruses as a possible cause. Because brain tumors sometimes occur in several members of the same family, researchers are studying families with a history of brain tumors to see whether heredity is a cause. At this time, scientists do not believe that head injuries cause brain tumors to develop.
In most cases, patients with a brain tumor have no clear risk factors. The disease is probably the result of several factors acting together.
What are primary brain tumors?
Tumors that begin in the brain tissue are known as primary brain tumors. Secondary tumors are those that develop when cancer spreads to the brain. Primary brain tumors are classified by the type of tissue in which they begin. The most common brain tumors are gliomas, which begin in the glial (supportive) tissue. There are several types of gliomas:
Astrocytomas arise from small, star-shaped cells called astrocytes. They may grow anywhere in the brain or spinal cord. In adults, astrocytomas most often arise in the cerebrum. In children, they occur in the brain stem, the cerebrum, and the cerebellum. A grade III astrocytoma is sometimes called anaplastic astrocytoma. A grade IV astrocytoma is usually called glioblastoma multiforme.
Brain stem gliomas occur in the lowest, stemlike part of the brain. The brain stem controls many vital functions. Tumors in this area generally cannot be removed. Most brain stem gliomas are high-grade astrocytomas.
Ependymomas usually develop in the lining of the ventricles. They also may occur in the spinal cord. Although these tumors can develop at any age, they are most common in childhood and adolescence.
Oligodendrogliomas arise in the cells that produce myelin, the fatty covering that protects nerves. These tumors usually arise in the cerebrum. They grow slowly and usually do not spread into surrounding brain tissue. Oligodendrogliomas are rare. They occur most often in middle- aged adults but have been found in people of all ages.
There are other types of brain tumors that do not begin in glial tissue. Some of the most common are described below:
Medulloblastomas were once thought to develop from glial cells. However, recent research suggests that these tumors develop from primitive (developing) nerve cells that normally do not remain in the body after birth. For this reason, medulloblastomas are sometimes called primitive neuroectodermal tumors (PNET). Most medulloblastomas arise in the cerebellum; however, they may occur in other areas as well. These tumors occur most often in children and are more common in boys than in girls.
Meningiomas grow from the meninges. They are usually benign. Because these tumors grow very slowly, the brain may be able to adjust to their presence; meningiomas often grow quite large before they cause symptoms. They occur most often in women between 30 and 50 years of age.
Schwannomas are benign tumors that begin in Schwann cells, which produce the myelin that protects the acoustic nerve, the nerve of hearing. Acoustic neuromas are a type of schwannoma. They occur mainly in adults. These tumors affect women twice as often as men.
Craniopharyngiomas develop in the region of the pituitary gland near the hypothalamus. They are usually benign; however, they are sometimes considered malignant because they can press on or damage the hypothalamus and affect vital functions. These tumors occur most often in children and adolescents.
Germ cell tumors arise from primitive (developing) sex cells, or germ cells. The most frequent type of germ cell tumor in the brain is the germinoma.
Pineal region tumors occur in or around the pineal gland, a tiny organ near the center of the brain. The tumor can be slow growing (pineocytoma) or fast growing (pineoblastoma). The pineal region is very difficult to reach, and these tumors often cannot be removed.
What are secondary brain tumors?
Metastasis is the spread of cancer. Cancer that begins in other parts of the body may spread to the brain and cause secondary tumors. These tumors are not the same as primary brain tumors. Cancer that spreads to the brain is the same disease and has the same name as the original (primary) cancer. For example, if lung cancer spreads to the brain, the disease is called metastatic lung cancer because the cells in the secondary tumor resemble abnormal lung cells, not abnormal brain cells.
Treatment for secondary brain tumors depends on where the cancer started and the extent of the spread, as well as other factors, including the patient's age, general health, and response to previous treatment.
What are adult brain tumors?
Adult brain tumors are diseases in which cancer (malignant) cells begin to grow in the tissues of the brain. The brain controls memory and learning, senses (hearing, sight, smell, taste, and touch), and emotion. It also controls other parts of the body, including muscles, organs, and blood vessels. Tumors that start in the brain are called primary brain tumors.
What are metastatic brain tumors?
Often, tumors found in the brain have started somewhere else in the body and spread (metastasized) to the brain. These are called metastatic brain tumors.
What are the symptoms of an adult brain tumor?
A doctor should be seen if the following symptoms appear:
Frequent headaches.
Vomiting.
Loss of appetite.
Changes in mood and personality.
Changes in ability to think and learn.
Seizures.
What is the treatment for brain tumors?
Treatment for a brain tumor depends on a number of factors. Among these are the type, location, and size of the tumor, as well as the patient's age and general health. Treatment methods and schedules often vary for children and adults. A treatment plan is developed to fit each patient's needs.
The patient's doctor may want to discuss the case with other doctors who treat brain tumors. Also, the patient may want to talk with the doctor about taking part in a research study of new treatment methods. Such studies are called clinical trials.
Many patients want to learn all they can about their disease and their treatment choices so they can take an active part in decisions about their medical care. A person with a brain tumor will have many questions, and the doctor is the best person to answer them. Most patients want to know what kind of tumor they have, how it can be treated, how effective the treatment is likely to be, and how much it is likely to cost.
Many people find it helpful to make a list of their questions before they see the doctor. Taking notes can make it easier to remember what the doctor says. Some patients also find that it helps to have a family member or friend with them when they talk with the doctor,either to take part in the discussion or just to listen.
Patients and their families have a lot to learn about brain tumors and their treatment. They should not feel that they need to understand everything the first time they hear it. They will have other chances to ask the doctor to explain things that are not clear.
What tests are used to find and diagnose adult brain tumors?
Tests that examine the brain and spinal cord are used to detect (find) adult brain tumor. The following tests and procedures may be used:
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of the brain and spinal cord. A substance called gadolinium is injected into the patient through a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
Adult brain tumor is diagnosed and removed in surgery. If a brain tumor is suspected, a biopsy is done by removing part of the skull and using a needle to remove a sample of the brain tissue. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are found, the doctor will remove as much tumor as safely possible during the same surgery. An MRI may then be done to determine if any cancer cells remain after surgery. Tests are also done to find out the grade of the tumor.
What is the grade of a tumor?
The grade of a tumor refers to how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. The pathologist determines the grade of the tumor using tissue removed for biopsy. The following grading system may be used for adult brain tumors:
Grade I
The tumor grows slowly, has cells that look similar to normal cells, and rarely spreads into nearby tissues. It may be possible to remove the entire tumor by surgery.
Grade II
The tumor grows slowly, but may spread into nearby tissue and may become a higher-grade tumor.
Grade III
The tumor grows quickly, is likely to spread into nearby tissue, and the tumor cells look very different from normal cells.
Grade IV
The tumor grows very aggressively, has cells that look very different from normal cells, and is difficult to treat successfully.
The chance of recovery (prognosis) and choice of treatment depend on the type, grade, and location of the tumor and whether cancer cells remain after surgery and/or have spread to other parts of the brain.
How are adult brain tumors treated?
Different types of treatment are available for patients with adult brain tumor. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
Three types of standard treatment are used.
1. Surgery
Surgery is used, when possible, to treat adult brain tumor
2. Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
3. Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). A dissolving wafer may be used to deliver an anticancer drug directly into the brain tumor site after the tumor has been removed by surgery. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
How metastatic brain tumors are treated?
Tumors that have spread to the brain from somewhere else in the body are usually treated with radiation therapy and/or surgery. Chemotherapy may be used if the primary tumor is the kind that responds well to chemotherapy. Clinical trials are under way to study new treatments.
Brain Stem Gliomas
Treatment of brain stem gliomas may include the following:
Hyperfractionated radiation therapy.
A clinical trial of new anticancer drugs and/or biologic therapy.
Pineal Astrocytic Tumors
Treatment of pineal astrocytic tumors may include the following:]
Surgery and radiation therapy, with or without chemotherapy.
A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.
] Pilocytic Astrocytomas
Treatment of pilocytic astrocytoma is usually surgery with or without radiation therapy.
Diffuse Astrocytomas
Treatment of diffuse astrocytoma may include the following:
Surgery, usually with radiation therapy.
A clinical trial of surgery and radiation therapy with or without chemotherapy for tumors that cannot be completely removed by surgery.
A clinical trial of radiation therapy delayed until the tumor progresses.
A clinical trial comparing high-dose and low-dose radiation therapy.
Anaplastic Astrocytomas
Treatment of anaplastic astrocytoma may include the following:
Surgery plus radiation therapy, with or without chemotherapy.
A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.
A clinical trial of chemotherapy combined with different methods of delivering radiation therapy.
Glioblastoma
Treatment of glioblastoma may include the following:
Surgery plus radiation therapy, with or without chemotherapy.
A clinical trial of chemotherapy placed into the brain during surgery.
A clinical trial of radiation and concurrent chemotherapy.
A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.
A clinical trial of chemotherapy and new methods of delivering radiation therapy.
Clinical trials of new treatments.
Oligodendroglial Tumors
Treatment of oligodendrogliomas may include the following:
Surgery, usually with radiation therapy.
A clinical trial of surgery and radiation therapy with or without chemotherapy for tumors that cannot be completely removed by surgery.
Treatment of anaplastic oligodendroglioma may include the following:
Surgery plus radiation therapy with or without chemotherapy.
A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.
Mixed Gliomas
Treatment of mixed gliomas may include the following:
Surgery plus radiation therapy with or without chemotherapy.
A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
A clinical trial of new anticancer drugs or biologic therapy following radiation therapy.
Ependymal Tumors
Treatment of grade I and grade II ependymomas is usually surgery with or without radiation therapy.
Treatment of anaplastic ependymoma may include the following:
Surgery plus radiation therapy.
A clinical trial of surgery followed by chemotherapy before, during, and after radiation therapy.
A clinical trial of chemotherapy and/or biologic therapy.
Medulloblastoma
Treatment of medulloblastomas may include the following:
Surgery plus radiation therapy to the brain and spine.
A clinical trial of surgery and radiation therapy to the brain and spine for tumors that are more difficult to treat successfully.
A clinical trial of chemotherapy.
Pineal Parenchymal Tumors
Treatment of pineal parenchymal tumors may include the following:
Surgery plus radiation therapy with or without chemotherapy.
A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.
Meningeal Tumors
Treatment of meningiomas may include the following:
Surgery with or without radiation therapy.
Radiation therapy for tumors that cannot be removed by surgery.
Treatment of malignant meningioma may include the following:
Surgery plus radiation therapy.
A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
A clinical trial of new anticancer drugs and/or biologic therapy following radiation therapy.
Germ Cell Tumors
Treatment of central nervous system germ cell tumors depends on the type of cancer cells, the location of the tumor, whether the cancer can be removed in an operation, and other factors.
Craniopharyngioma
Treatment of craniopharyngiomas may include the following:
Surgery to remove the entire tumor.
Surgery to remove as much of the tumor as possible, followed by radiation therapy.
Recurrent Adult Brain Tumor
Treatment of recurrent adult brain tumors may include the following:
Surgery with or without chemotherapy.
Radiation therapy, if not used during previous treatment, with or without chemotherapy.
Internal radiation therapy.
Chemotherapy.
A clinical trial of new anticancer drugs.
A clinical trial of chemotherapy placed into the brain during surgery.
A clinical trial of biologic therapy.
Metastatic Brain Tumors
Treatment of a single metastatic brain tumor is usually surgery followed by radiation therapy to the brain.
Treatment of more than one metastatic brain tumor may include the following:
Radiation therapy to the brain.
Surgery, for large tumors that are pressing on areas of the brain and causing symptoms.
What are the side effects of treatment for brain cancer?
Cancer treatment often causes side effects. These side effects occur because treatment to destroy cancer cells damages some healthy cells as well.
The side effects of cancer treatment vary. They depend on the type of treatment used and on the area being treated. Also, each person reacts differently. Attempts are made to plan the patient's therapy to keep side effects to a minimum. Patients are very carefully watched so that any problems which occur can be addressed.
A craniotomy is a major operation. The surgery may damage normal brain tissue, and edema may occur. Weakness, coordination problems, personality changes, and difficulty in speaking and thinking can result. Patients can also have seizures. In fact, for a short time after surgery, symptoms may be worse than before. Most of the side effects of surgery lessen or disappear with time.
Most of the side effects of radiation therapy go away soon after treatment is over. However, some side effects may occur or persist long after treatment is completed.
Some patients have nausea for several hours after treatment. Patients receiving radiation therapy may become very tired as treatment continues. Resting is important, but doctors usually advise their patients to try to stay reasonably active. Radiation therapy to the scalp causes most patients to lose their hair. When it grows back, the new hair is sometimes softer and may be a slightly different color. In some cases, hair loss is permanent.
Skin reactions in the treated area are common. The scalp and ears may be red, itchy, or dark. These areas may look and feel sunburned. The treated area should be exposed to the air as much as possible but should be protected from the sun. Patients should not wear anything on the head that might cause irritation. Good skin care is important at this time. The doctor may suggest certain kinds of soap or ointment, and patients should not use any other lotions or creams on the scalp without the doctor's advice.
Sometimes, brain cells killed by radiation form a mass in the brain. The mass may look like a tumor and may cause similar symptoms, such as headaches, memory loss, or seizures. Doctors may suggest surgery or steroids to relieve these problems. About 4 to 8 weeks after radiation therapy, patients may become quite sleepy or lose their appetite. These symptoms may last several weeks, but they usually go away on their own. Still, patients should notify the doctor if they occur.
Children who have had radiation therapy for a brain tumor may have learning problems or partial loss of eyesight. If the pituitary gland is damaged, children may not grow or develop normally.
The side effects of chemotherapy depend on the drugs that are given. In general, anticancer drugs affect rapidly growing cells, such as blood cells that fight infection, cells that line the digestive tract, and cells in the hair follicles. As a result, patients may have a lowered resistance to infection, loss of appetite, nausea, vomiting, or mouth sores. Patients also may have less energy and lose their hair. These side effects usually go away gradually after treatment stops.
Some anticancer drugs can cause infertility. Women taking certain anticancer drugs may have symptoms of menopause (hot flashes and vaginal dryness; periods may be irregular or stop). Some drugs used to treat children and teenagers may affect their ability to have children later in life.
Certain drugs used in the treatment of brain tumors can cause kidney damage. Patients are given large amounts of fluid while taking these drugs. Patients also may have tingling in the fingers, ringing in the ears, or difficulty hearing. These problems may not clear up after treatment stops.
Treatment with steroids to reduce swelling in the brain can cause increased appetite and weight gain. Swelling of the face and feet is common. Steroids can also cause restlessness, mood swings, burning indigestion, and acne. Patients should not stop using steroids or change their dose without consulting the doctor, however. The use of steroids must be stopped gradually to allow the body time to adjust.
Loss of appetite can be a problem for patients during therapy. People may not feel hungry when they are uncomfortable or tired. Some of the common side effects of cancer treatment, such as nausea and vomiting, can also make it hard to eat. Yet, good nutrition is important because patients who eat well generally feel better and have more energy. In addition, they may be better able to withstand the side effects of treatment. Eating well means getting enough calories and protein to help prevent weight loss, regain strength, and rebuild normal tissues. Many patients find that eating several small meals and snacks during the day works better than trying to have three large meals.
Patients being treated for a brain tumor may develop a blood clot and inflammation in a vein, most often in the leg. This is called thrombo-phlebitis. A patient who notices swelling in the leg, leg pain, or redness in the leg should notify the doctor right away.
Doctors, nurses, and dietitians can explain the side effects of cancer treatment and can suggest ways to deal with them.
INTEGRATIVE THERAPY
4. THE SCIENTIFICALLY FORMULATED AMINO ACID THERAPY
(Keep in mind, CAAT is much more than just a “diet”; it is an amino acid, carbohydrate, & glucose REDUCTION protocol which strategically uses the chemical reactions of amino acids, foods, and nutritional supplements to impair the development of cancer cells, thus starving them to death.) Clinical trials have already been done with humans using amino acid depravation formulas, and with much success. (Journal American Medical Association. 1967; 200:211)
CAAT is a course of therapy to control a patient’s amino acid intake. This is achieved by taking certain foods out of a persons’ daily food plan for a short time and by replacing them with a scientifically supported formula of amino acids. It is also important to emphasize that the food plan that accompanies the amino acid formula needs to be followed so not to offset any of the benefits we are creating by depriving the cancer cells the nutrients they need to grow. Also, it is important to realize that the patient does not need to abandon their conventional cancer treatment, (surgery, chemotherapy, radiation, hormone treatments) nor is it recommended that they do so unless it has already failed them. CAAT works synergistically with chemotherapy and/or radiation to enhance their benefits (see study by Dr. Marco Rabinowitz of the National Cancer Institute). His report on amino acid deprivation, such as with Controlled Amino Acid Therapy (CAAT), proven to inhibit phosphofructokinase which shuts down the energy supply to cancer cells, simultaneously enhancing the benefits of chemotherapy while lessening their toxic side effects. CAAT has also proven to work successfully alone.
Phase 1: CAAT Formulation
The most important component of CAAT is the scientifically formulated amino acids. Based on the specific formula for each cancer, it consists of separate amino acids, citric acid, and small amounts of sodium benzoate. Each formula replaces most of the regular daily proteins found in meats, dairy, fish, beans and nuts, which cancer cells can derive their energy from. The CAAT formula taken two times per day will nourish the healthy cells while causing the cancer cells to starve to death. Of course each individual has specific needs concerning their diet, and this is explained in the second phase of the protocol as well as with a specialist at the Institute when beginning the CAAT therapy.
Phase 2: Daily Food Intake
DISCLAIMER: The following food program SHOULD NOT be consumed without the amino acid formula and without consent from your doctor and our Institute.
Breakfast:
*1/2 Grapefruit or 1-orange or 6-ounces of fresh orange juice.
Whey Enhanced Protein (Vanilla Flavor – Vitamin Shoppe Brand) approximately
10 – 12 grams of protein – read label carefully, based on 150 lb. person ].
A serving of Grits (Butter, cinnamon and other spices are okay).
1 cup of green or black tea (Fructose is sweetener of choice).
* Do Not have ½ grapefruit if taking Chemotherapy
Explanation: ½ Grapefruit or 1 orange or 6 ounces of fresh orange juice are rich in the natural nutrients called Limonene and Citric Acid. Limonene helps shut down the Ras cancer gene which is over active in 90 percent of all cancers. Citric Acid helps shut down glycolosis which in turn helps starve cancer cells to death.
Whey Enhanced Protein (Vanilla Flavor – Vitamin Shoppe Brand) Phosphorus is a nutrient that cancer cells must utilize in order to grow and reproduce. This brand of whey protein is very low in phosphorous and contains no additional vitamins, so when using approximately 10 – 12 grams of protein per 150 lb. person, it helps to protect normal cells, maintain a normal appetite, and also helps to fight edema. (Edema is the swelling or water build up in the legs or other sites in the body)
Whey protein is included in the daily menu of all advanced or metastatic cancer patients. When treating cancers that are stable or have regressed in size, patients then have the option of including other protein foods at their breakfast meals such as cottage cheese, yogurt, or soy foods. Eggs are allowed in the diets of patients with lymphoma and brain cancers.
Grits or Cream of Wheat or 1 slice of white toast or ½ plain bagel or ½ English muffin (Butter is okay)
Grits or white rice is the preferred carbohydrate food at each meal. The other choices are options once the patient’s cancer is stable or reduced in size. Unrefined carbohydrates are included in the CAAT menu instead of whole grains to deprive cancer cells of a certain B-complex vitamin called Pyridoxine (Vitamin B-6). Cancer cells require this vitamin to manufacture certain amino acids that we keep away from through CAAT’s amino acid reduction formula and diet. Grits is the preferred carbohydrate food at all meals instead of rice, corn, or pasta because it helps deplete Tryptophan in the body, which is essential for the growth and spreading of cancer cells.
1 cup of green or black tea, using fructose as the sweetener of choice. These teas are rich sources of several compounds that help shut down glycolosis and cut off the energy supply to cancer cells. Also, green or regular tea helps to prevent certain hormones and tumor growth factors from stimulating cancer cells to grow and metastasize to other parts of the body. Brassica teas can also be taken because they contain sulphorane, a nutrient that inhibits cancer growth, and also shuts down the cancer genes.
* Why we use fructose as the sweetener of choice will be explained in detail at the end of this phase of the CAAT protocol.
Lunch:
Amino acid formula (4 level plastic scoops) mixed with any of the following: Water & Fructose; Sugar free Kool-Aid; Diet ginger ale; Fresh lemonade & Fructose; Chicken or Beef broth; V8 juice.
Generous amounts of One cooked vegetable or a combination of the following: asparagus, broccoli, cabbage, brussell sprouts, spinach, squash, string beans.
One serving (1/2 cup)of fresh fruit. Choice of: pear, orange, blueberries, raspberries, strawberries.
1 serving (moderate) of grits or corn or rice or pasta (Add tomato sauce or butter)
1 tablespoon of coconut oil
8 to 10 black or green olives
2 tablespoons of vinegar (minimum of 5% acidity) add to vegetables or food
1 cup of green or black tea (Fructose as desired)
Explanation:
This Amino Acid Reduction Formula (4 level plastic scoops may vary) combined with the special diet, allows the CAAT Protocol to reduce certain amino acids in the daily diet of the cancer patient, and is designed to replace most of the animal protein in the diet. Cancer cells require the amino acids glycine, serine, glutamic acid, and aspartic acid to synthesize DNA, build new blood vessels or duplicate its entire contents of proteins. Also, cancer cells require these and certain other amino acids in order to synthesize other proteins that act as growth promoting hormones or tumor growth factors. CAAT impairs the synthesis of a protein called elastin, which is absolutely essential to the manufacture of new blood vessels. The Amino Acid Reduction Formula, diet, certain phytochemicals and herbs work efficaciously to attack cancer cells at each and every biological front.
The generous amounts of one cooked vegetable or a combination of such helps keep normal cells healthy. They are low in carbohydrates and proteins, and high in phytochemicals, compounds which help fight cancer. Patients are allowed to eat these vegetables and salads whenever desired.
The 8 to 10 olives are rich in squalene and oleic acid, nutrients that have been reported to inhibit certain cancer growth factors. The calories in olives also help control body weight and increases ketones in the blood. Ketones help fight cancer by impairing glycolosis – a process in which cancer cells depend almost exclusively upon for their daily supply of energy. Vinegar (and fructose) are two natural products that increase the production of both ACETIC ACID and CITRIC ACID in the body.
Acetic acid and citric acid also help fight cancer by shutting down the process of glycolosis.
Normal cells derive most of their daily energy supply from acetic acid and citric acid, where as cancer cells derive most of their daily energy from glycolosis.
Dinner:
Amino acid formula (4 plastic level scoops) mixed with any of the following: Water & fructose; Sugar free Kool–Ade; Diet Ginger Ale; Fresh lemonade & Fructose; Chicken or Beef broth; V8 Juice.
Generous amounts of One cooked vegetable or a combination of the following: asparagus, broccoli, cabbage, brussel sprouts, spinach, squash, string beans.
One serving (1/2 cup) of stewed plums with fresh cream & fructose; use 4-ounces of orange juice if plums are not in season.
Avacado salad with lettuce, tomatoes, celery, onions, with lemon juice and coconut oil or olive oil.
2 tablespoons of vinegar (minimum of 5% acidity) add to vegetables or food.
1 serving of grits or corn or pasta or rice (Add garlic and butter or tomato sauce)
1 cup of green or black tea (Fructose as desired)
Mid Evening Snack: Ketogenic Cocktail – 2 ounces of fresh cream, ½ ounce each of both coconut & olive oil, 1 tablespoon of Fructose.
Sugar free Jell-O with whipped cream & Fructose or 1 plum or 4 ounces of orange juice.
Explanation: The sugar free jell-o helps to appease the appetite. Plums contain quinlic acid, which is converted into benzoic acid in the body and which in turn helps to deplete the availability of the amino acid Glycine (Glycine is essential to the synthesis of DNA for cancer cells) and the proteins that cancer cells require to build new blood vessels and their tumor growth factors. If underweight take two ounces of light cream and one ounce of olive oil/coconut oil as needed to maintain weight.
Optional Meal:
3 to 4 ounces of Veal, Fish of choice, Beef, Chicken breast, and 1-slice of white bread.
Consume this meal with a minimum of 3 hours before or after taking the amino acids.
Explanation: If the patient is 10 or more pounds underweight or if their albumin levels are below normal is when the optional meal is allowed. This meal should be eaten a minimum of 3 hours before or after taking the amino acids. CAAT provides sufficient protein to maintain the health of normal cells and adequate amounts of calories to maintain desired body weight. Any proteins taken in excess of amounts recommended in the diet will counter act the benefits of the CAAT protocol.
Special Diets: A special diet will be created for any cancer patient whose ability to consume food and liquids has placed them in a critical situation. When a patient is using a feeding apparatus, or they have become too weak or lethargic to eat and drink the daily minimum amount for survival, we will break up the total breakfast, lunch, and dinner over a period of every 2 hours during the entire day until the patient is capable of returning to a daily diet as outlined above.
Carbohydrate and glucose reduction in this diet: CAAT’S dietary menu provides approximately 20 percent of its calories in the form of carbohydrates. Calories need not be a focal point or counted daily. It is recommended that all patients combat their cancers by keeping their body weight at normal or slightly below normal levels. A patient’s desired body weight is regulated by their rate of metabolism, which in turn is regulated by their blood levels of thyroxine, cortisone, insulin, and the amounts of fats and oils in the diet. Studies with human cancer patients and laboratory animals show that reducing the calories of carbohydrates (glucose) in their daily diet by only 10 percent reduced the size of cancerous tumors. When carbohydrate (glucose) calories were reduced 40 percent, the cancers disappeared. It is recommended that those patients who are obese gradually and systematically lose their excess weight to increase the efficiency of the CAAT protocol. Those patients who are underweight shoudn’t gain weight unless they are more than 10 pounds below normal levels. When a patient is underweight due to anorexia or cachexia, such illnesses must be addressed before the CAAT protocol can begin.
Why we use Fructose and Vinegar to treat cancer:
Nobel Prize winner Dr. Otto Warburg discovered more than 50 years ago that all cancer cells produce inordinate amount of lactic acid but he couldn’t explain why.
In 2001 our Institute published the first study to show that cancer cells produce excess amounts of lactic acid because they could not access the oxygen in compartments in the cells called the mitochondria. This provided evidence that cancer cells depend almost exclusively upon glycolosis or the metabolism of glucose as their major source of energy.
Dr. Spitz and Dr. Lee with other cancer researchers published studies showing that when cancer cells are deprived glucose, their energy supply is cut off which causes these cancer cells to commit suicide.
Therefore shutting down glycolosis would be one means of destroying cancer cells because energy can only be derived from glucose through the metabolic process called glycolosis.
Recently our Cancer Institute discovered that both acetic acid and citric acid could inhibit the activity of a key enzyme in glycolosis called phosphofructokinase, which in turn shuts down the process of glycolosis. Our cancer Institute is the first to introduce both fructose and vinegar as treatments for cancer because they either contain or produce acetic acid.
In conclusion, fructose and vinegar are added as supplements to the CAAT protocol because of their acetic acid properties that help shut down glycolosis, shutting off cancer cells energy supply and causing them to die off.
Phase 3: Nutritional Supplements
Nutritional supplements are based on each unique situation. For example, slow growing cancers produce low levels of toxic free radicals. Tumor cells that grow aggressively produce large amounts of toxic free radicals. The patient will be instructed whether or not to take anti-oxidants (in a nutritional supplement) and at what dosage, according to the levels of toxic free radicals produced in the cancerous cells.
An example of how nutritional supplements can help manipulate cancer cells involves vitamin B-6 (pyroxidine) There are four amino acids essential to the synthesis of DNA. However, those amino acids cannot be synthesized without a certain enzyme, which includes vitamin B-6 among other components. Any supplement containing vitamin B-6 SHOULD NOT be taken during the first 2 months of the CAAT protocol.
The patient will be instructed as to which nutritional supplements or phytochemicals should be purchased and at what dosage strength. Keep in mind that each supplement only complements the CAAT protocol. However, when they are combined they augment the therapeutic benefits of the aminoacid, carbohydrate, and glucose reduction diet.
Parsley: Contains ingredients that can help shut down certain enzymes called Epithelial Growth Factors, which stimulate the growth and spread of cancer. ( CAAT’S amino acid reduction diet works in the same manner )
Vitamin D: Helps activate in many kinds of cancers enzymes called Phosphotases, which literally shut down the activities of other enzymes called Kinases, which are essential to the growth and reproduction of cancer cells.
Green Tea Extract: Phytochemicals in tea help shut down glycolosis (cancer cell’s main supplier of energy) and thereby help to starve cancer cells to death. These effects help complement the effects of CAAT’S carbohydrate reduction.
Anti-Oxidants: The controversy as to whether or not to treat cancer with anti-oxidants is slowly resolving with the current understanding of how they affect the activity of genes and enzymes in cancer cells. The prevailing data shows that the benefits or lack of benefits depend upon the oxidative state the cancer cells are in. Anti-oxidants taken when the cells are in a very high oxidative state may prevent cancer cells from entering apoptosis ( apoptosis is when a cancer cell commits suicide) When oxidative stress in cancer cells is only slightly above normal, anti-oxidants are then expected to stop their growth and reproduction.
Blood Chemistry: Blood tests are usually taken every 6 to 8 weeks, depending upon the results of each test. Not only is it important to monitor the tumor markers but equally important to keep abreast of the overall health of normal tissues and organs. For example, it is important to learn of the health of the kidneys and liver, whether the body is producing sufficient red and white blood cells, etc. Low albumin levels most often indicate insufficient intake of proteins in the diet and this problem would have to be addressed. CAAT is designed to attack cancer but keep the normal cells and tissues functioning harmoniously.
Whey Protein: This protein food is recommended at the breakfast meal to help meet the daily needs of amino acids for the normal cells of the body, and to help keep albumin levels normal and to help prevent edema. We recommend Whey protein purchased from the Vitamin Shoppe because it is the only brand that we have seen with no phosphorous or additional vitamins added to it.
Grits: Grits are also recommended at the breakfast meal in place of whole grains because it is low in vitamin B-6. Cancer cells require B-6 to manufacture the amino acid Glycine, which is required for DNA synthesis. Grits, instead of whole grains, therefore helps prevent cancer cells from manufacturing DNA and building new blood vessels.
Calcium D-Glucurate: This phytochemical helps the body to retain a compound called Glucuronic acid. This is necessary to eliminate both estrogen and testosterone from the body. This is why Calcium D-Glucurate is added to the regiments of patients with breast & prostate cancers. Calcium D-Glucurate is not to be confused with calcium carbonate, which is nothing more than a calcium supplement.
D-Limonene: This phytochemical found mostly in citrus fruits blocks the process called Isoprenylation, which is necessary for tumor growth factors such as the RAS gene, Epithelial Growth factor, Tyrosine Kinase, and Insulin-Like-Growth-factor, to send their signals into the nucleus of a cancer cell and directs them to grow and divide into more cancer cells.
Tocotrienols: This member of the Vitamin E family also helps shut down Isoprenylation and assists D-Limonene in blocking the actions of the various tumor growth factors. More specifically, tocotrienols shut down an enzyme called HMG-2, which is essential to the synthesis of the building blocks that form the Isoprenylation process.
Niacin: This B-Complex vitamin works with D-limonene and the Tocotrienols to shut down the process of Isoprenylation, which as mentioned above prevents the cancer promoting RAS genes from sending signals into the nucleus of the cell. Niacin also helps deplete thee amino acid Glycine, which cancer cells need to synthesize DNA. And by reducing cholesterole in the body, Niacin helps lower the production of estrogen and testosterone.
Choline: This B-complex vitamin is included in our supplement list to help the liver metabolize Niacin and other compounds and to help fight fatigue that accompanies most forms of cancer.
Selenium: Numerous studies show that this mineral can interfere with the activity of certain genes that promote the growth of cancer and to induce cancer cells to commit suicide (apoptosis)
Perilla Oil: This oil is rich in Alpha Linolenic Acid which can inhibit the growth of cancer cells in several ways. One way is to inhibit the synthesis in the body of a tumor growth promotin hormone called Prostaglandin-2, also, Alpha Linolenic Acid inhibits the actions of certain genes that promote the growth of cancer cells. Linolenic acid is not to be confused with linoleic acid, which is a bad fat that stimulates the growth of cancer cells. This bad fat, linoleic acid, is found in all vegetable oils and nuts (With the exception of coconut oil). Olive oil has the least amount of this bad fat.
Super Miraforte: This herb impairs the synthesis of estrogen from testosterone in the body and is included in the regiments of women with breast cancer.
Licorice Root Extract & Pantothenic Acid: This herb and vitamin are added to the regiment when it is desirable to produce steroid like actions in the body. Also used to help patient’s gain weight and to inhibit the growth of lymphomas and leukemia’s.
Resveratrol: This phytochemical blocks the actions of a number of a number of cancer promoting genes thereby causing cancer cells to enter into apoptosis (cell death) and is included in the treatment of all cancers.
Indole-3 Carbinol & D.I.M.: These two phytochemicals block the actions of both estrogen and testosterone and are included in the regiments of both breast and prostate gland cancer.
Melatonin: Numerous studies show that this hormone blocks the synthesis of the cancer promoting chemicals in the body called Leukotrienes, and is included in the treatment of all cancers.
Artho Pro System: This combination of herbs and phytochemicals inhibits the synthesis of the cancer promoting hormone called Prostaglandin-2 and the Leukotriens and replaces the drug celebrex when liver problems are present. The Prostaglandin hormone is over active in most cancers and stimulates cancer growth. The body manufactures the Prostaglandin hormone from the bad fat, Linoleic acid, mentioned above.
Licorice Root Extract & Pantothenic Acid: This HERB and VITAMIN are added to the regiment when it is desirable to produce steroid like actions in the body. Used also to help patients gain weight and ti inhibit the growth of Lymphomas and Leukemias.
CAAT is designed to attack cancer, while keeping normal cells and tissues functioning harmoniously.
Orijinal sayfa: http://www.apjohncancerinstitute.org/cancer/brain.htm
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