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A risk factor is anything that affects your chance of getting
a disease such as cancer. Different cancers have different risk
factors. For example, exposing skin to strong sunlight is a risk factor
for skin cancer. Smoking is a risk factor for cancers of the lung,
mouth, larynx (voice box), bladder, kidney, and several other organs.
But risk factors don't tell us everything. Having a risk
factor, or even several, does not always mean that a person will get
the disease, and many people get cancer without having any known risk
factors.
Most brain tumors are not associated with any known risk
factors and have no obvious cause, but there are a few factors that may
raise the risk of brain tumors.
Radiation exposure
The best established environmental risk factor for brain
tumors is radiation exposure, most commonly from some type of radiation
therapy. For example, before the risks of radiation were recognized,
children with ringworm of the scalp (a fungal infection) were sometimes
treated with low-dose radiation therapy, which was later found to
increase their risk of brain tumors as they got older.
Today, most radiation-induced brain tumors are caused by
radiation to the head given for the treatment of other cancers. This is
most common in people who received radiation to the brain as children
as part of their treatment for leukemia. These brain tumors usually
develop around 10 to 15 years after the radiation.
These tumors are still fairly rare, but because of the
increased risk (as well as the other side effects), radiation therapy
to the head is only given after careful consideration of benefits and
risks. For most patients with cancer involving the brain or other areas
of the head, the benefits of radiation therapy far outweigh the risk of
developing a brain tumor years later.
Family history
Most people with brain tumors do not have a family history of
the disease, but in rare cases brain and spinal cord cancers run in
families. In general, patients with familial cancer syndromes tend to
have many tumors that first occur when they are young. Some of these
families have well-defined disorders such as:
Neurofibromatosis
type 1 (NF1): People with this inherited condition have
higher risks of schwannomas, meningiomas, and certain types of gliomas,
as well as neurofibromas (benign tumors of peripheral nerves). Changes
in the NF1 gene cause this disorder.
Neurofibromatosis
type 2 (NF2): This inherited condition, which is much less
common than NF1, is associated with vestibular schwannomas (acoustic
neuromas) and, in some patients, meningiomas or spinal cord
ependymomas. Changes in the NF2 gene are responsible for
neurofibromatosis type 2.
Tuberous
sclerosis: People with this inherited condition may have
subependymal giant cell astrocytomas (low-grade astrocytomas that
develop beneath the ependymal cells of the ventricles), in addition to
benign tumors of the skin, heart, or kidneys. It is caused by changes
in either the TSC1 or the TSC2 gene.
Von
Hippel-Lindau disease: This condition is associated with
an inherited tendency to develop hemangioblastomas (blood vessel
tumors) of the cerebellum or retina as well as tumors of the kidney,
adrenal glands, and pancreas. It is caused by changes in the VHL gene.
Li-Fraumeni
syndrome: People with this condition are at higher risk
for developing gliomas, along with certain other types of cancer. It is
caused by changes in the p53 gene.
Other inherited conditions, including Gorlin syndrome, Turcot
syndrome, and Cowden syndrome are also linked with increased risks of
certain types of brain and spinal cord tumors. Other families may have
genetic disorders that are not well recognized or that may even be
unique to a particular family.
Immune system disorders
People with impaired immune systems have an increased risk of
developing lymphomas of the brain or spinal cord. Lymphomas are cancers
of lymphocytes, a type of cell of the immune system. Lymphomas usually
form in lymph nodes, which are small, bean-sized collections of
lymphocytes found throughout the body. Primary lymphoma of the central
nervous system is less common than lymphoma that arises outside the
brain.
Deficiencies of the immune system may be congenital (present
at birth), or they may be caused by treatment for other cancers,
treatment to prevent rejection of transplanted organs, or the result of
diseases such as the acquired immunodeficiency syndrome (AIDS).
Factors with uncertain, controversial, or
unproven effects on brain tumor risk
Cell phone use: This
has been the subject of a great deal of debate in recent years. Cell
phones give off (emit) radiofrequency (RF) radiation, a form of energy
on the electromagnetic spectrum between FM radio waves and those used
in microwave ovens, radar, and satellite stations. Cell phones do not
emit ionizing radiation, the type that damages DNA and is known to have
the ability to cause cancer. Still, there have been concerns that the
phones, whose antennae are built-in and therefore are placed close to
head when in use, might somehow raise the risk of brain tumors.
Some early population-based studies suggested a possible
increased risk with cell phone use, but most of the larger studies done
to date have not found an increased risk of brain tumors, either
overall or among specific types of tumors. Still, there are very few
studies of long-term use (10 years or more), and cell phones haven't
been around long enough to determine the possible risks of lifetime
use. The same is true of any possible higher risks in children, who are
increasingly using these phones. Cell phone technology also continues
to change, and it's not clear how this might affect any risk.
Studies are under way to help assess these risks, but it will
likely be many years before firm conclusions can be made. In the
meantime, for people concerned about the possible risks there are ways
to lower exposure, such as using an earpiece to move the phone itself
away from the head when in use. For more information, see our document,
Cellular Phones.
Other factors: Other
environmental factors such as exposure to vinyl chloride (a chemical
used in the manufacturing of plastics), petroleum products, and certain
other chemicals have been linked with increased risk in some studies
but not in others. Exposure to aspartame (a sugar substitute), exposure
to electromagnetic fields from power lines and transformers, and
infection with certain viruses have been suggested as possible risk
factors, but most researchers agree that there is no convincing
evidence to link these factors to brain tumors. Research on these and
other potential risk factors is ongoing.
Last Medical Review: 11/12/2009 Last Revised: 11/12/2009
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