All tumours present inside the cranium are classified as brain tumours. Tumors can manifest inside the brain or travel through the lymphatic system in the blood vessels. A brain tumour-like other tumours is a life-threatening disease.
The causes of a brain tumour and why it occurs are still unknown. There are certain inherited conditions like the Von Hippel-Lindau Syndrome, Li-Fraumeni Syndrome, Neurofibromatosis and Turcot Syndrome that increase the risk of brain tumours.
What are the Treatment Options for Brain Tumor?
When a person is diagnosed with a brain tumour, a group of specialists including Neurologists, Radiologists and Neurosurgeons assess the extent of a tumour and derive the best possible treatment options. The treatment options largely depend on various factors such as –
- Location of a tumour
- Size of a tumour
- Tumor stage
- Type of tumours
Surgery is often the preferred treatment option when it comes to curing a brain tumour. One should consult the best neuro hospitals if the patient is having a tumour in the brain. There are several techniques employed during surgery including IGS (Image Guided Surgery) which accurately maps out the location of a tumour.
However, before the surgery, depending on the location of a tumour, the doctor will determine whether it is operable or inoperable.
A tumour which can be surgically removed with minimal risk of brain damage is known as an operable tumour.
If a tumour is located in a place near a vital area or structure and is inaccessible by the surgeon; then this tumour is termed as inoperable. Tumors located in the brain stem and thalamus is two such examples. But we do a stereotactic biopsy in thalamic tumours.
What Type of Surgery Is Recommended?
The common types of surgery for brain tumours are:
Biopsy (Open or Needle Biopsy / Stereotactic Biopsy)
A biopsy is a surgical procedure that involves taking a sample in case of not a definite diagnosis and inoperable states of the tumour tissue. It is used to determine the exact type of tumour for further treatment. The sample tissue diagnosis can further be used to determine if radiation therapy/chemotherapy / Radiosurgery will be useful.
What Happens During a Biopsy?
A biopsy is carried out in the following steps:
- Patient with a brain tumour will undergo an MRI or CT Scan to determine the exact location of tumour
- A dose of general anaesthesia is given to the patient
- A small ‘burr hole’ is drilled on the skull by the neurosurgeon
- The surgeon then passes a needle through the hole to take a sample of the tumour
- Hole is closed using stitches and patient is given steroids to help with swelling
A craniotomy is the most common type of surgery for a brain tumour. The procedure involves shaving a portion of the head, making an incision in the scalp then using an operating drill to remove a portion of the skull where a tumour is located. This enables the surgeon to remove as much tumour as possible. Once a tumour is removed, the portion of the skull which was removed is replaced, fixed with titanium plates and screws and then the scalp is stitched back.
- In some cases, if a patient is undergoing awake craniotomy, they will be awake to allow the neurosurgeon to map where the functions of the brain are located
- The brain does not feel pain, and in case of an awake craniotomy the patient might be able to feel only the pulling of a tumour
- Neurosurgeon will remove as much tumour as possible without any brain damage
- When an entire tumour is removed, it is known as ‘total resection.
- When only a part is removed, it is known as ‘debulking’
- The bone flap which is removed is replaced, and the wound is closed using stitches
The Risks of Brain Surgery
No surgical process is without any risk. Brain surgery is a major surgery, and there are some extra risks involved.
The possible risks involved are as follows:
- Bleeding in the brain
- Weakness in some part of body (location dependent)
- Memory problems, impaired speech, vision, or balance
- Allergic reaction to anaesthesia
- Prolonged unconsciousness
Radiation therapy is the use of high-energy x-rays which are employed to destroy tumour cells. After surgery, radiation therapy is used to stop or slow down the further growth of a tumour. In cases where surgery is not a viable option, doctor relies on radiation therapy for the treatment.
The most commonly used radiation therapy is known as external-beam radiation therapy with grade II to IV. It is given by a machine which is employed outside the body. Patients with a brain tumour must get regular radiation therapy for an effective treatment. It is scheduled for a period of time.
Types of Radiation Therapy
Conventional Radiation Therapy – The site of a tumour is determined based on anatomic landmarks and X-rays. This technique is appropriate in situations for brain metastases where the entire brain undergoes radiation therapy.
Stereotactic Radiosurgery – Stereotactic radiosurgery is a highly precise treatment that uses a single, high dose of radiation directly on a tumour. It avoids damaging the healthy tissues.
This radiation therapy works well for a tumour that affects only a single area of the brain. Since it is a specific form of radiation therapy, it can also be used when a person has more than one metastatic brain tumour in distinct parts. There are several types of stereotactic radiosurgery equipment, including:
- Modified Linear Accelerator – It is a machine that creates high-energy radiation by using electricity to form a stream of fast-moving subatomic particles
- Gamma Knife – It concentrates high focused beams of gamma radiation on the tumour directly with precision
- CyberKnife – It is a robotic device which guides the radiation to the site of a tumour in the brain
Chemotherapy is used in some cases of brain tumours (high grade) along with the treatment options mentioned above (grade II to IV). Chemotherapy requires the use of drugs to destroy tumour cells. Usually, the tumour cells left after surgery are destroyed by using chemotherapy. A patient with a brain tumour will undergo various sessions of chemotherapy set over a period.
Brian Tumor can be treated if diagnosed early. As the best neurosurgery hospital in India, we at Max Institute of Neurosciences offer a broad spectrum of services.