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Entries in Meningioma (2)

Wednesday
Jun062012

Sheryl Crow's Tumor Unlikely Cause of Memory Loss, Expert Says

Gary Miller/FilmMagic(NEW YORK) -- It's unlikely that singer Sheryl Crow's meningioma -- a tumor that occurs outside of the brain -- triggered her memory loss, a doctor said Wednesday.

In a recent interview with the Las Vegas Review-Journal, the singer said that she'd found out about the tumor in November after going to the doctor to discuss memory problems.

"I worried about my memory so much that I went and got an MRI," she told the newspaper. "And I found out I have a brain tumor. And I was like, 'See? I knew there was something wrong.'"

It was just a month ago that Crow reportedly forgot the words to her song "Soak Up the Sun" during a concert in Florida.

But Dr. Michael Schulder, vice chairman of the department of neurosurgery at the Cushing Neuroscience Institute in New York, told ABC News Wednesday that Crow's commonly used treatment plan -- a series of MRI scans to follow the tumor's growth -- "suggests that it's not a very large tumor."

"The kind of symptoms she's describing [memory loss] that came and went....It seems unlikely they are the result of tumors unless she had a small seizure" that she was unaware of, Schulder said.

Schulder, who has not treated or examined Crow or seen her MRI, said that although meningiomas often do not cause any symptoms, headaches and seizures are commonly associated with the tumors. He said that tumors that caused memory loss and confused thinking tended to be larger and the symptoms persisted or worsened and might include personality changes as well.

"Either the tumor is bigger than everyone believes, or it [the memory issue] was a coincidence, or she had a seizure that she might not have known about," he said.

Meningiomas grow from the lining of the brain and inside the skull. Although most of them are benign -- and almost never go beyond the head -- and are considered less severe than those occurring within the brain, 1 percent to 2 percent are malignant and tend to grow back despite surgery and radiation.

Schulder said about 10,000 people a year in the United States are diagnosed with a meningioma. Research has linked meningiomas with breast cancer, he said. Crow is a breast-cancer survivor.

"Women -- middle age or older -- are more likely to get them [meningiomas]," Schulder said. "Women are more likely to get breast cancer than men as well, although either diagnosis can occur in a man....There is an underlying hormonal association with the two kinds of tumors [but] it's not well understood."

He said that although most meningiomas could be treated with surgery, those that were connected to critical structures like optic nerves were usually left alone.

According to Dr. Alan Cohen, chief of surgery at Rainbow Babies and Children's Hospital in Cleveland, a large meningioma tumor could eventually become cancerous, but even if it remained benign, it could create pressure on the brain, resulting in vision or hearing loss, headaches, seizures or other problems.

Schulder said that not operating on the tumor meant that there was a chance it could grow. Depending on the tumor's size and location, continued growth could make later treatment more difficult and hazardous. He said the upside to not going the surgery route is that the tumor might grow so slowly or stop growing and the patient might not need treatment at all.

He said while surgery could remove a meningioma and could even cure a person, surgery alone posed a danger. Schulder said an "excellent" alternative treatment for patients is the noninvasive stereotactic radiosurgery, in which highly focused radiation beams treat small tumors during one or several sessions.

He said that nearly 95 percent of the time, "patients with meningiomas who receive [this treatment] have their tumor controlled."

Overall, Schulder said that women and men, including those diagnosed with breast cancer, should not be concerned. He said meningiomas were relatively rare tumors and those with breast cancer will have already been evaluated by their doctors.

Dr. Gene Barnett, director of the Cleveland Clinic's Brain Tumor and Neuro-Oncology Center, agreed, saying that even though the breast cancer-meningioma association was relatively well-known, "even then the risk of having meningioma is still very low."

"People who are 50 or older or women don't need to get MRI scans without the symptoms of a brain tumor," Schulder said. "Don't worry about that.

"A patient with breast cancer who's being followed by his or her doctor should trust the normal evaluation system. As long as they've been screened ... [they] should not long term be concerned or feel they should get MRI."

Copyright 2012 ABC News Radio

Monday
Apr092012

Are Dental X-Rays Causing Brain Tumors?

Stockbyte/Thinkstock(NEW YORK) -- “It’s time for your annual X-rays.”  This is what millions of Americans are told when they visit the dentist.  But new research out of Yale finds dental X-rays may be linked to increased rates of brain tumors.

Meningioma is the most common type of brain tumors that originate in the brain and spinal cord, making up one third of these.  People who were diagnosed with meningioma were compared with healthy individuals.  They were asked how often they had the most common type of dental X-ray, called a bitewing, which involves placing an X-ray film between the teeth and shooting the film from outside of your cheek.  In those who reported having this type of X-ray once a year or more the risk for meningioma was 1.4-1.9 times increased depending on their age.

Another type of dental X-ray, called the Panorex, that rotates around your head taking a picture of all of your teeth from outside your mouth was associated with an almost five-fold increase in rates of meningioma when the X-ray was performed before age 10.  For those older than 10 there was a 2.7 to 3 fold increased risk when this X-ray was performed once a year or more.

Current recommendations by the American Dental Association do admit that there is little use for dental X-rays in healthy people without any symptoms, but still recommends X-rays of healthy children be taken every 1-2 years and every 2-3 years for healthy adults.  The authors think these guidelines may need to be reevaluated in the wake of their findings.

Reactions to the study have been mixed. For critics, the design of the study has some serious flaws. The main weakness is the failure of the researchers to obtain any of the patient’s dental records to verify that the number of X-rays they reported having was true, says Dr. Richard Besser, ABC News' chief health and medical editor.

“People with cancer are more likely to remember having dental X-rays,” explains Besser. “They are searching for some cause of their cancer and may incorrectly attribute it to any number of factors.”  Dr. Besser also points out that the study failed to find any connection between having braces and risk for meningioma.  “When you have braces you remember that clearly, and people who have braces on average undergo more x-rays than people without braces,” says Besser.

Dr. Alan G. Lurie, a Ph.D. radiation biologist who specializes in cancer induction and is president of the American Academy of Oral and Maxillofacial Radiology, agrees with Dr. Besser that the study has a serious flaw.

“They’re asking people to remember (in some cases) a couple of radiographs they had 30 years earlier when they were kids. They’re not going to be able to tell you what kind of X-ray machine was used…what kind of film, were there any retakes?" Lurie says.

Other doctors see this as a strong study and think that it raises valid concerns.  “The current study is well-done and confirms that even in the ‘modern era’ radiation exposure from repeated dental X-rays conveys an increased risk of these tumors,” says Dr. David Schiff of the Neuro-Oncology Center at the University of Virginia.

Overall, doctors are not surprised that dental X-rays could cause this type of tumor because the type of radiation that X-rays give off is known to be associated with brain tumors. “Ionizing radiation is the only well-accepted environmental risk factor for development of meningiomas," says Dr. Schiff.

However they warn that this study cannot prove that dental X-rays cause brain tumors.  It can only reveal a possible association between dental X-rays and tumors.

Still, there are some important things people can do to minimize their exposure to dental X-rays.  For example, patients can ask their doctors whether X-rays are completely necessary, or how much radiation will be delivered by the various options available.

“All health professionals should be thinking that for our patients, each exposure must be beneficial and we should be of a mindset to do the fewest exposures possible to obtain needed diagnostic information," explains Paul Casamassimo DDS, professor and chair of pediatric dentistry at the Ohio State University College of Dentistry and chief of dentistry at Nationwide Children's.

Overall, experts hope that as a result of this study the public gains new awareness of a potential risk and will take their concerns to their dentist.  

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