A brain tumour is an abnormal growth of cells/tissue within the brain or the skull vault. It is created by an unusual and uncontrolled cell division, usually in the brain itself, but also sometimes in the lymphatic tissue, blood vessels, cranial nerves, brain meninges (skinny layer of tissue covering the spinal cord and brain), the skull, pituitary gland, or pineal gland and from congenital vest cells.
There are many types of brain tumours, combined they fit into one of the following categories:
Benign Tumour: It is non-cancerous in nature. A benign tumour must be evaluated closely to determine whether it is close to vital structures such as blood vessels, nerves or the brain stem.
Malignant Tumour: It is cancerous in nature. It is important to determine if a malignant tumour is primary or metastatic in nature. The tumour’s size, type and location is important in planning the optimal treatment.
Metastatic Tumour: A malignant brain tumour that is caused by the spread of cancer cells from another area of the body is a metastatic tumour. The original source (primary site) of metastatic brain tumours is often the lung, breast, kidney, colon or metastatic melanoma. Metastatic brain tumours may cause symptoms in some patients before the primary site is diagnosed. The primary source of the metastatic tumour is possible to be determined in approximately 90% of the patients.
While the doctors are still unable to find the cause of the primary brain tumours, they have identified several risk factors that make you vulnerable to brain tumours.
Radiation: Exposure to radiation is one of the most known risks of a brain tumour. People who had a cancer history and have undergone radiotherapy, repeated computerised tomography (CT scans) or X-rays to the head are more prone to developing brain tumours.
Genetic Diseases: There are some genetic diseases that can put you at risk of brain tumours. Some of them are Neurofibromatosis which is a tumour-causing genetic disorder, Turcot syndrome that is characterised by abnormal cells, Von Hippel-Lindau syndrome, and Li-Fraumeni syndrome.
HIV or AIDS: Those who have HIV or AIDS are more vulnerable to a brain tumour as compared to other people as they have low immunity
The type and severity of symptoms depend upon the size, type and location of the brain tumour. Some of the common symptoms include:
Confusion Difficulty with memory or the ability to understand
Decreased level of consciousness
Difficulty in writing or reading
Lack of bladder/bowel control
Change in personality, mood, behaviour or emotional changes
Hearing loss with or without recurrent giddiness
The Max Institute of Neurosciences at Max Hospitals, India provides world-class super speciality tertiary care for all kinds of neurological disorders, conditions and diseases, including brain tumours. Apart from an array of services like Advanced Brain Tumour Centre, Minimally Invasive Spine Surgery Centre, Stroke Centre, it has India's first Intraoperative MRI. It is one of the leading neurology centres in North India, with presence in Delhi NCR (Saket, Patparganj, Shalimar Bagh, Vaishali, Pitampura, Noida, Gurgaon & Panchsheel Park), Mohali, Bathinda and Dehradun.
Each of the institutes is run by a dedicated team neurosurgeons, neurologists, neuropsychologists, neurophysiologists, intervention neurologists and neuro anaesthetists who work together and create a tailored treatment plan for patients.
Their quick, accurate diagnosis and treatment of brain tumour has led to high success rates and saved the lives of countless patients.
For brain tumour patients, Max Institute of Neurosciences runs the following specialised surgical programmes:
Today, brain tumours have affected the lives of millions of people through their agonising and distressing condition. The doctors at Max Institute of Neurosciences believe in diagnosing them early and providing effective treatment. Such prompt action increases the chances of success.
Diagnosis of a brain tumour is done by a neurologic exam (by a neurologist or neurosurgeon), magnetic resonance imaging (MRI) and/or CT scan, and other tests like an angiogram and spinal tap. When a brain tumour is diagnosed, a team is formed to assess the treatment options which are presented to the patient and his/her family. The size, location, shape and appearance of the tumour on an MRI or CT scan can often aid in determining the type of tumour. If these tests are unable to detect the type of tumour, the doctors perform a biopsy. Treatment begins once the diagnosis is complete.
Treatment depends on many factors, including:
Patient's age at the time of diagnosis
Patient's overall health
Type, size, location and characteristics of the tumour cells and blood vessels
Depending on the patient's condition, treatment can be a single procedure or a combination procedure.
When it comes to brain tumours, Max Institute of Neurosciences offers a wide array of treatment options. These include:
A) Surgery: Following are the surgical options for brain tumour:
Partial surgical removal of tumour: When the tumour cannot be reached (like vital areas of the brain), or the surgery would cause a significant risk to the patient, partial surgical removal of the tumour is the preferred mode of treatment.
Complete surgical removal of the tumour: Here, the surgeon removes the entire tumour without damaging vital brain tissue.
Endovascular surgery: This procedure is used to treat an aneurysm (swelling or 'ballooning' of a blood vessel). The surgery involves using inserting and positioning an endovascular graft inside the aorta. Once in place, it expands and seals off the aneurysm, preventing blood from flowing into the aneurysm. The graft remains there permanently.
B) Radiation therapy - in radiation therapy, ionising radiation and particles are used in the treatment of malignant neoplasms (tumour). A therapeutic dose is delivered to the area. Sophisticated electronic techniques have been developed to deliver the radiation at one angle and then to rotate the source so that the dose to the overlying and adjacent normal tissue is minimised.
C) Stereotactic radiosurgery - gamma knife, peacock therapy, linear accelerator-based treatment
D) Chemotherapy - in this, specific chemical agents and drugs that are selectively destructive to the malignant cell, tissues are used to treat cancer
E) Medications - steroids to reduce brain swelling, anticonvulsants to prevent seizures and pain medication
F) Wait & Watch Approach: This treatment involves observation (monitoring) of slow-growing, benign (non-cancerous) tumours.
Selection of the treatment procedure also depends on the type of tumour:
Benign tumours are most often removed completely. But in certain circumstances, some part of a benign tumour is left behind to preserve vital nerves which involves a second stage therapy in the form of radiation therapy, gamma knife or cyberknife therapy and chemotherapy for the residual tumour will certainly cure the disease. Benign tumours that are slow-growing and difficult to access surgically, or are not causing significant symptoms, may be monitored by MRI or CT scans on a regular basis.
Treatment of malignant tumours involves a complete approach (three-fold-surgery and radiotherapy with or without chemotherapy) depending upon the stage of cancer. Many times chemotherapy or radiation therapy is performed, in addition to surgery, to ensure that remaining tumour cells do not regrow or do so at a slower rate. With advanced radiotherapy machines, this modality is very well tolerated and has very fewer side effects.