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Brain Cancer Surgery

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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.

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