BREAKING DOWN BRAIN CANCER Primary Brain Tumours Are Treated Using a Multipronged Approach That Can Involve Surgery, Radiotherapy Or Chemotherapy
OUTLOOK BRAIN CANCER
BRAIN DRAIN BREAKING DOWN BRAIN CANCER Primary brain tumours are treated using a multipronged approach that can involve surgery, radiotherapy or chemotherapy. Yet the long-term outlook and survival rates of people with such malignancies remains poor. Brain cancer comprises only 2% of cancers, but is notoriously difficult to treat. Understanding the location of such tumours, as well as the underlying genetics, will help to tackle this devastating disease. LOST TIME By Julie Gould; infographic by Alisdair Macdonald. The average years of life lost is a good measure of the extent to which life is cut short by various cancers. This is the sum di erence in years between the ages at which people with a particular condition died and AGAINST THE CLOCK the ages to which they would otherwise have lived, divided by the total number who died. Brain tumours are classi ed using a grading system that ranks them from least (grade I) Testis to most (grade IV) aggressive. Frontal lobe Parietal lobe The frontal lobe constitutes almost two- fths of The parietal lobe has di ering roles in the left Early diagnosis is linked to ON THE BRAIN Cervix 5 the human brain. It has a role in modulating and right hemispheres of the brain. Tumours in better survival times . The highest many brain functions, including voluntary the left lobe often a ect a person’s speech, and percentage of all brain Hodgkin’s lymphoma movement, uency of speech and expression of those in the right lobe can a ect perception of 1 year tumours that originate emotion. People with a tumour in this area often the physical location of body parts and Brain and nervous system 3 years in the brain and experience seizures as an initial symptom. understanding of geographical location. Brain cancer is responsible for central nervous system 5 years Breast (female) the fourth-highest number of (CNS) are benign years of life lost4. This is growths that occur in mainly because the disease is Ovary 100 the meninges1, a Ventricle so di cult to diagnose and structure consisting of The ventricles are hollow Uterus treat, but also because it is the three layers of parts of the brain that are most common cause of death from cancer in children. 90 protective tissue that lled with cerebrospinal Oral cavity and pharynx uid. Conventionally, surround the cerebral 2% intraventricular tumours are Liver and bile duct cortex. Most malignant treated initially by draining All sites combined 80 primary brain tumours, excess cerebrospinal uid Skin melanoma however, occur in the using a shunt, which helps to 1 cerebral cortex — with relieve pressure in the brain. 0 5 10 15 20 25 30 35 40 70 the highest percentage 26% Average years of life lost developing in the 2% frontal lobe*. 60 LEVEL-HEADED 5 3% 50 Occipital lobe Despite 9% The occipital lobe is the improvements smallest lobe of the in detection 4 cerebral cortex. It plays a and treatment, 40 part in processing visual
the number of after diagnosis (%) Survival information. Tumours in deaths from 30% this lobe can cause loss of 3 30 Temporal lobe brain cancer vision, visual disturbances Both hemispheres of the brain 5% and hallucinations. has remained Other regions contain a temporal lobe. The unchanged in Mortality rates are lower in some 20 Physicians strive to lobe’s location, close to the 4% the past three 2 countries in Asia, including Japan report the exact locations ear, means that most of its decades. functions are related to — possibly owing to genetic of brain tumours. Cerebellum di erences in those populations. 10 However, such growths auditory processing. Surgical Tumours in the cerebellum a ect Brain stem can sometimes extend removal of tumours from the a person’s ability to coordinate Australia temporal lobe is challenging The brain stem connects 1 into several areas of the voluntary movements such as Canada brain, or their locations owing to the region’s the cerebral cortex to the balance and blinking. France 0 might not be recorded complexity. spinal cord. Tumours in the I II III IV for various reasons. region often a ect a person’s Japan ability to walk, speak and United Kingdom per 100,000 people) rate Mortality (age-standardized 0 Grade swallow, as well as their facial United States 1980 1990 2000 2010 DATA: Q. OSTROM/REF. 1; BRAIN: ALEXANDER_P/SHUTTERSTOCK Q. OSTROM/REF. DATA: *Percentages do not add up to 100% because of rounding. tension and vision. J. FERLAY/IARC Year
19% LOCAL THREAT FARTHER AFIELD Lung and bronchus MIND THE GAP 45% The most common Up to 30% of people Around 20% of lung There are di erences 64% 36% Sources: 1. Ostrom, Q. T. et al. 1% Women Neuro Oncol. 17 (suppl.), malignant primary brain with primary cancers cancers spread to in the incidences of Women Men iv1–iv62 (2015). 2. National tumour is a type of in parts of the body the brain3 — the brain cancer in men NON- Brain Tumor Society (NBTS). MALIGNANT MALIGNANT Quick Brain Tumor Facts astrocytoma (a tumour other than the brain highest proportion and women, MALIGNANT Melanoma 55% go.nature.com/2ok3z1r that forms from glial cells) TUMOURS will develop brain of any cancer type. 7% regardless of the age TUMOURS TUMOURS (NBTS, 2018). 3. Davis, F. G., Dolecek, T. A., McCarthy, B. J. & 2 Men known as glioblastoma metastases . At least of those a ected. Villano, J. L. Neuro Oncol. 14, multiforme1. Glioma, a twice as many cases Researchers are 1171–1177 (2012). 4. US 5% Breast (male National Cancer Institute (NCI). group of tumours that 80% of secondary brain 20% and female) unsure why this Person-Years of Life Lost Cancer includes astrocytoma, cancer as malignant might be. Trends Progress Report: Average Glioma Years of Life Lost (NCI, 2018). comprises 27% of all primary brain cancer About 55% of malignant brain tumours However, only around 36% of non- 5. UK National Cancer Meningioma 7% Kidney occurred in men, compared with 45% in malignant brain tumours occurred in men, Intelligence Network (NCIN). tumours, and 80% of Other are diagnosed each NCIN Data Brie ng Astrocytic 1 2 Colon and women, between 2008 and 2012 in the compared with 64% in women, during the Brain Tumours: Survival Rates in malignant tumours . year . 2% 1 1 rectum United States . same period in the United States . England (NCIN, 2013). % Ovary
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BRAIN CANCER OUTLOOK
BRAIN DRAIN BREAKING DOWN BRAIN CANCER Primary brain tumours are treated using a multipronged approach that can involve surgery, radiotherapy or chemotherapy. Yet the long-term outlook and survival rates of people with such malignancies remains poor. Brain cancer comprises only 2% of cancers, but is notoriously difficult to treat. Understanding the location of such tumours, as well as the underlying genetics, will help to tackle this devastating disease. LOST TIME By Julie Gould; infographic by Alisdair Macdonald. The average years of life lost is a good measure of the extent to which life is cut short by various cancers. This is the sum di erence in years between the ages at which people with a particular condition died and AGAINST THE CLOCK the ages to which they would otherwise have lived, divided by the total number who died. Brain tumours are classi ed using a grading system that ranks them from least (grade I) Testis to most (grade IV) aggressive. Frontal lobe Parietal lobe The frontal lobe constitutes almost two- fths of The parietal lobe has di ering roles in the left Early diagnosis is linked to ON THE BRAIN Cervix 5 the human brain. It has a role in modulating and right hemispheres of the brain. Tumours in better survival times . The highest many brain functions, including voluntary the left lobe often a ect a person’s speech, and percentage of all brain Hodgkin’s lymphoma movement, uency of speech and expression of those in the right lobe can a ect perception of 1 year tumours that originate emotion. People with a tumour in this area often the physical location of body parts and Brain and nervous system 3 years in the brain and experience seizures as an initial symptom. understanding of geographical location. Brain cancer is responsible for central nervous system 5 years Breast (female) the fourth-highest number of (CNS) are benign years of life lost4. This is growths that occur in mainly because the disease is Ovary 100 the meninges1, a Ventricle so di cult to diagnose and structure consisting of The ventricles are hollow Uterus treat, but also because it is the three layers of parts of the brain that are most common cause of death from cancer in children. 90 protective tissue that lled with cerebrospinal Oral cavity and pharynx uid. Conventionally, surround the cerebral 2% intraventricular tumours are Liver and bile duct cortex. Most malignant treated initially by draining All sites combined 80 primary brain tumours, excess cerebrospinal uid Skin melanoma however, occur in the using a shunt, which helps to 1 cerebral cortex — with relieve pressure in the brain. 0 5 10 15 20 25 30 35 40 70 the highest percentage 26% Average years of life lost developing in the 2% frontal lobe*. 60 LEVEL-HEADED 5 3% 50 Occipital lobe Despite 9% The occipital lobe is the improvements smallest lobe of the in detection 4 cerebral cortex. It plays a and treatment, 40 part in processing visual
the number of after diagnosis (%) Survival information. Tumours in deaths from 30% this lobe can cause loss of 3 30 Temporal lobe brain cancer vision, visual disturbances Both hemispheres of the brain 5% and hallucinations. has remained Other regions contain a temporal lobe. The unchanged in Mortality rates are lower in some 20 Physicians strive to lobe’s location, close to the 4% the past three 2 countries in Asia, including Japan report the exact locations ear, means that most of its decades. functions are related to — possibly owing to genetic of brain tumours. Cerebellum di erences in those populations. 10 However, such growths auditory processing. Surgical Tumours in the cerebellum a ect Brain stem can sometimes extend removal of tumours from the a person’s ability to coordinate Australia temporal lobe is challenging The brain stem connects 1 into several areas of the voluntary movements such as Canada brain, or their locations owing to the region’s the cerebral cortex to the balance and blinking. France 0 might not be recorded complexity. spinal cord. Tumours in the I II III IV for various reasons. region often a ect a person’s Japan ability to walk, speak and United Kingdom per 100,000 people) rate Mortality (age-standardized 0 Grade swallow, as well as their facial United States 1980 1990 2000 2010 DATA: Q. OSTROM/REF. 1; BRAIN: ALEXANDER_P/SHUTTERSTOCK Q. OSTROM/REF. DATA: *Percentages do not add up to 100% because of rounding. tension and vision. J. FERLAY/IARC Year
19% LOCAL THREAT FARTHER AFIELD Lung and bronchus MIND THE GAP 45% The most common Up to 30% of people Around 20% of lung There are di erences 64% 36% Sources: 1. Ostrom, Q. T. et al. 1% Women Neuro Oncol. 17 (suppl.), malignant primary brain with primary cancers cancers spread to in the incidences of Women Men iv1–iv62 (2015). 2. National tumour is a type of in parts of the body the brain3 — the brain cancer in men NON- Brain Tumor Society (NBTS). MALIGNANT MALIGNANT Quick Brain Tumor Facts astrocytoma (a tumour other than the brain highest proportion and women, MALIGNANT Melanoma 55% go.nature.com/2ok3z1r that forms from glial cells) TUMOURS will develop brain of any cancer type. 7% regardless of the age TUMOURS TUMOURS (NBTS, 2018). 3. Davis, F. G., Dolecek, T. A., McCarthy, B. J. & 2 Men known as glioblastoma metastases . At least of those a ected. Villano, J. L. Neuro Oncol. 14, multiforme1. Glioma, a twice as many cases Researchers are 1171–1177 (2012). 4. US 5% Breast (male National Cancer Institute (NCI). group of tumours that 80% of secondary brain 20% and female) unsure why this Person-Years of Life Lost Cancer includes astrocytoma, cancer as malignant might be. Trends Progress Report: Average Glioma Years of Life Lost (NCI, 2018). comprises 27% of all primary brain cancer About 55% of malignant brain tumours However, only around 36% of non- 5. UK National Cancer Meningioma 7% Kidney occurred in men, compared with 45% in malignant brain tumours occurred in men, Intelligence Network (NCIN). tumours, and 80% of Other are diagnosed each NCIN Data Brie ng Astrocytic 1 2 Colon and women, between 2008 and 2012 in the compared with 64% in women, during the Brain Tumours: Survival Rates in malignant tumours . year . 2% 1 1 rectum United States . same period in the United States . England (NCIN, 2013). % Ovary
©2018 Spri nger Nature Li mited. All ri ghts reserved. ©2018 Spri nger Nature Li mited. All ri ghts reserv27ed. SEPTEMBER 2018 | VOL 561 | NATURE | S41