Description

Brain Cancer Surgery

What is Brain Tumor?

Brain cancer or tumor is a lump that forms due to abnormal division and accumulation of cells in brain.

There are various series of cells in the brain. A wide range of tumors that originate from these cells are
either benign or malignant in nature.

As is the case with all cancers, tumors originating from native cells of the brain are called primary
tumor. Secondary or metastatic brain tumor implies a tumor that develops in
another organ or tissue and spreads to the brain.

Accordingly, brain tumors can be classified as primary or metastatic tumors and benign or malignant
neoplasms.

Another classification is based on the type of cell that forms the tumor. Examples of this classification
are as follows:

Astrocytoma

Glioma

Glioblastoma

Acoustic neuroma

Choroid plexus carcinoma

Ependymoma

Meningioma

Oligodendroglioma

Pituitary gland tumors

Oligodendroglioma

Your doctor will inform you
about the type of your cancer based on these classifications.

Symptoms

Brain tumors are manifested by
a very wide range of signs and symptoms depending on the cell that forms the
tumor, location, size, spread and the anatomic structures compressed by the
tumor.

In this end, the most rational
approach is that a person recognizing signs and symptoms that are listed below
should immediately visit a neurologist or a neurosurgeon.

Recent-onset headache or
changes in nature of headache or a very severe headache

Visual impairments

Hearing disorders

Balance disorders

Nausea and vomiting

Epileptic seizures

Certain dysfunctions
(inability to calculate or write)

Symptoms secondary to hormone
disorders – thyroid dysfunction, menstrual changes, abnormal growth of hands
and feet

Mood fluctuations

Concentration disorder

Memory impairment

Generalized numbing,
prickling, sensorial deficit, loss of muscle strength

Such symptoms should be kept
in mind and a person with such signs and symptoms should immediately visit a
doctor, as early diagnosis and treatment are extremely important regarding the
outcomes.

Risks

Although the underlying cause
is not clear in most cases, following risk factors are suggested for primary
brain tumors:

• Age
• Family history
• Exposure to radiation,
• Male gender
• White race

Diagnosis

If a brain tumor is suspected,
the first step should be a comprehensive neurological examination. All your
senses (hearing, sight, taste, smell, touch), your muscle strength, abnormal symptoms
such as tingling and numbing, your posture, gait pattern and reflexes will be
examined in detail. Such examinations will be supported by certain special
scales.

If physical examination
supports the suspicion, imaging modalities, especially magnetic resonance
imaging, will be instituted in order to determine size and location of the
tumor. A special dye, also called contrast agent, may, sometimes, be
administered into your vein to locate the tumor. After the tumor is visualized,
extra imaging studies can be required to review blood supply to the tumor and
its reactions to certain substances.

If biopsies and other
examinations suggest or reveal out that the tumor originates from other organs
of the body, computerized tomography and position emission tomography (PET) can
be instituted to determine the primary tumor focus.

Although biopsy specimen is
usually taken in the surgery for brain tumors, your doctor may decide to take a
piece of tissue from the tumor using a needle.

Treatment

Treatment options for brain
tumors are planned according to certain factors, such as origin of tumor, size,
location, spread and the anatomic structures compressed by the tumor.
Therefore, treatment of brain tumor is an extremely personalized one.

Treatment options of brain tumor
include surgery, chemotherapy, radiation treatment, radio-surgery and targeted
medications.

Surgical Treatment

If the location of brain tumor
allows access by conventional surgery, a hole is drilled on the skull and the
brain tumor is completely removed or maximum part of the tumor is excised, if
it is located nearby sensitive structures.

Radiotherapy

Radiation therapy aims to kill
cancer cells by using high-powered energy beams.

If the radiation source is out
of the body and beams are directed to cancer, this treatment is called external
radiotherapy.  On the other hand, if the radioactive agent is put into the
area that cancer is present by a needle or catheter, method is called internal
radiotherapy (brachytheraphy).

Although radiation therapy can
also be used as first order therapy of cancer, generally it is used to kill
cells that are not removed by surgery. In the first-line treatment, mostly
radiotherapy and chemotherapy are administered together and this treatment is
also known as chemoradiotheraphy.

The side effects of
radiotherapy take place in a very wide range depending on the body region where
the radioactive rays are transmitted. The risks apply to you will be explained
by your doctor.

Stereotactic radiosurgery

As a definition, stereotactic
radiosurgery is a treatment option that combines highly advanced radiation
therapy, imaging method, image processing programs and robotic systems.
Although the term “surgery” is expressed in the definition, it does not require
incision and anesthesia. After the location of the target is determined and
three dimensional images are created, high-dose radiation is delivered. Since
CyberKnife can deliver radiation beams with very high precision, healthy tissue
around the diseased area is exposed to minimal dose.

Chemotherapy

Chemotherapy uses drugs to
cure cancer. The active ingredients in these drugs kill cancer cells.
Chemotherapy drugs can be administered intravenously or by mouth. If the drug
is administrated through a vein, a thin tube, called a catheter, is inserted
into a large vein and chemotherapy drug is delivered from this catheter
throughout the course of the treatment.

One or more chemotherapy
medicines may be administered according to the response of the cancer to the
treatment and the type of cancer. After chemotherapy is given for a certain
period, treatment is paused. After the completion of this defined “break”
period, treatment resumes. Each of these periods is called cycle.

Side effects of chemotherapy
are secondary to the chemotherapeutic agent and dose. Most common side effects
seen in chemotherapy drugs include; malaise, nausea, vomiting, mouth sores,
hair loss and inflammation in the digestive system. Side effects caused by
chemotherapy will also be treated by your doctor. In case of the side effects
become severe to threaten your health, your doctor may advise to suspend the
treatment or to take another chemotherapy medicine.

Targeted Therapy

Targeted therapies are newer
anti-cancer treatments compared to chemotherapy. These medicines target specific
abnormalities that are present in cancerous cells. Before these medicines are
started, cancer cells are first analyzed in laboratories to determine whether
they have particular mutations or not.

Results

The percent of tumor removed
and injury to other nervous structures determine the outcome of surgical and
non-surgical treatments for brain tumor.

Benign tumors can usually be
removed completely, while it is not always valid for malignant tumors.

Even partial removal of the
tumor will help regression of signs and symptoms.

However, your doctor may refer
you to physical therapy and rehabilitation to ensure restoration of motor
skills, elimination of sensorial defects, correction of sight and hearing
problems and management of balance problems and memory impairments following
the treatment of brain tumor.

The most appropriate therapies
are planned in the light of post-treatment signs and symptoms in order to
eliminate problems and increase quality of life.