A brain cancer diagnosis is devastating to both the patient and their family. Learning you have a brain tumor, whether it is a benign tumor or cancerous, brings countless questions. Some of those questions may center around your race and how that may have played a part. The truth is that an African American is more likely to receive a diagnosis later in the development of brain cancer and is more likely to experience certain types. Below, we look at the types, symptoms, and treatments for brain cancer as well as its effects on Black people.
What is Brain Cancer?
There are over 100 different types of brain tumors. While not all of them are malignant brain tumors, they can be life-threatening simply because of the complexity of the brain and the symptoms they can cause. Brain and spinal cord tumors can affect everything from the pituitary gland to the cerebrospinal fluid. Essentially, any part of the brain and central nervous system is susceptible to cancer.
Brain Cancer vs. Brain Tumors
All brain cancers are tumors, but not all tumor cells are cancerous. Some tumors are slow growing and don’t pose an immediate threat. Benign brain tumors can be any size and may be malignant brain tumors in the future.
Brain Tumor Types
From gliomas affecting glial cells to germ cell tumors that begin in reproductive cells that travel to the brain, both primary and secondary brain tumors are serious conditions that should be treated by an experienced team of providers.
- Benign Brain Tumors: These are noncancerous brain tumors that are slow growing and may only need to be watched for signs of cancer in the future. They can be located anywhere in the brain or spinal cord.
- Malignant Brain Tumors: Cancerous brain tumors are primary brain tumors that start in the brain or spinal cord. A brain tumor that starts here may metastasize and spread to another area of the body.
- Metastatic Brain Tumors: Also called secondary brain tumors, these originate in another area of the body and spread to the brain. They commonly begin as lung cancer, breast cancer, and pancreatic cancer.
Risk Factors for Brain Cancer
The American Cancer Society, after researching brain and spinal cord cancer extensively, has not found any risk factors for brain tumors. While some brain tumor types can be linked to radiation therapy used to treat other types of cancer, such as leukemia, other tumors may have no apparent cause. Still, there are some inherited conditions like neurofibromatosis, tuberous sclerosis, and Turcot syndrome that may put you at greater risk for specific brain cancers. Many believe that cell phone use leads to brain cancer, and there are ongoing studies to determine the risk, but there is no known connection at this time.
Brain Tumor Symptoms
The brain is complex and the symptoms caused by a tumor will vary depending on the location of it and its size. For example, vision problems could be a sign of a tumor affecting the temporal lobe, occipital lobe, or brain stem, while an inability to look up may show a pineal gland tumor. The symptoms you experience are clues that your healthcare team will initially use to diagnose the tumor and begin tests to pinpoint it.
- Double vision and other vision changes
- Difficulty swallowing (brain stem)
- Lactation, even in men (pituitary gland)
- A change in menstrual cycle
- Weakness or paralysis (frontal lobe)
- Confusion
- A change in speech or hearing (occipital lobe or temporal lobe)
- Memory problems
- Loss of balance (cerebellum)
- A feeling of pressure near the tumor
- Headache
- Nausea or vomiting
- Fatigue
- Difficulty sleeping
- Siezures
Brain Tumor Treatment
Brain tumor treatment will be different based on individual circumstances. Your team of experienced physicians and other providers will recommend the best treatments. However, these are some of the available treatments that they may offer.
- Craniotomy: Brain surgery to remove the tumor is often one of the first suggestions depending on its size and location.
- Radiation Therapy: This treatment can shrink the tumor, especially if it’s too large to remove initially.
- Brachytherapy: Radiation therapy can be targeted to the brain tumor by surgically placing a radioactive item next to it.
- Chemotherapy: Strong medications are used to kill cancer cells. They often use it with other cancer treatments.
- Immunotherapy: Also called biological therapy, immunotherapy helps to boost your body’s natural fighting ability.
- Targeted Therapy: Drugs fight the specific type of tumor cells present, leaving surrounding brain tissue healthy.
African Americans and Brain Cancer
Black people, and Black men in particular, are more affected by brain cancer than other races. Disparities in the healthcare system can account for some of the problem, but not all. African Americans may be more susceptible simply because of their ethnic background.
Most Common Tumor Subtypes
The six most common brain tumor types for African American adults are lymphoma, meningioma (both benign and malignant), glioma, astrocytoma, glioblastoma multiforme, and anaplastic astrocytoma. According to a 2014 study published in the Medical Science Monitor, those aged 20 to 49 are most susceptible to lymphoma, while those over 50 are more likely to develop glioblastoma.
The Survival Statistics
The survival rates for those with brain cancer vary depending on multiple factors, including the type, location, how advanced the cancer is when found, responsiveness to treatment, and more. However, there are general estimates created based on recent studies and published by the American Cancer Society. Ependymoma has the highest average five-year survival rate when caught early at over 90% while glioblastoma has the lowest. For those over 55, the survival rate is just 6%.
Pediatric Brain Cancer
Leukemia was once the deadliest childhood cancer, but that has since been replaced by brain cancer. One contributing factor is racial disparities in healthcare. Over recent years, survival rates for children with leukemia have improved, while those with brain cancer have declined. Because glioblastoma multiforme is one of the most common brain cancers in African Americans and mixed-race children, the length of time before receiving a diagnosis, the quality of treatment, and post-treatment care are all playing large roles in survival rates.
One study evaluated patients under the age of 19 from 2000 to 2015 and found that five-year survival rates for non-Hispanic White children were over 50% while African American children had an average survival rate of just 44%, the lowest of all races represented.
Barriers to Treating Brain Tumors
The barriers to treating brain cancers are the same for both children and adults. Unfortunately, a brain tumor can present with symptoms that are brushed aside far too long and a patient may not receive a diagnosis until the cancer has advanced and treatment options are limited. Even after receiving a diagnosis, a patient may not have access to the care they need for proper treatment of brain cancer.
Socioeconomic Factors
Many African Americans live in low-income neighborhoods without access to a primary care physician who may notice brain tumor symptoms early. If they do, there may not be a large hospital network or specialist provider nearby that can treat their brain cancer. Black people are less likely to have health insurance coverage, so paying for this treatment may be challenging or impossible. Even the cost of taking time off work or requiring family members to do so in order to take them to medical appointments may be too high a financial burden for those diagnosed with any type of life-threatening illness like cancer, limiting their options for treatment.
Provider and Systemic Racism
Providers who do not understand the differences in care required by the Black community may not recognize brain cancer symptoms or treat them as seriously as they might for a non-Hispanic White patient. This racial equality bias within the healthcare system may result in a delay of treatment that can allow the cancer to advance. Systemic racism has been a part of Medicare and Medicaid since the beginning, influenced by early funding and race relations at the time. While policies are beginning to change, it can be more challenging for African American patients to get the care they need, especially when struggling through an already difficult time.
Lack of Diversity in Clinical Trials
The biggest barrier to treating Black people with brain cancer is simply not understanding how brain tumors affect them. This is because there is a lack of diversity in clinical trials. Minorities in general are underrepresented in the trials that have published results as well as information about the races included in the study. As many as 70% of recent clinical trials do not publish or have not noted the ethnic background of those taking part, which makes it difficult to understand how brain cancer and various treatments are different for African Americans.
The Black Population and Brain Cancer
Is it a benign tumor? Is it malignant? Do you have to worry about secondary brain tumors and it having begun somewhere else? With no known risk factors for brain cancer, it’s difficult to catch early, but even more challenging for Black people who suffer from socioeconomic and healthcare disparities that become barriers to diagnosis and treatment. Only with awareness of brain cancer and these barriers can we ensure everyone gets the treatment they need and deserve. Black Health Matters is working diligently to do just that.
