Brain tumour is a group of rapidly growing mass of abnormal cells found inside the brain. When brain cells go bad and start multiplying indefinitely it is known as primary brain tumour. When bad cells from other part of the body reach the brain through lymphatic route and start multiplying there it is called as metastatic brain tumour.
The mass can grow slowly or rapidly and start to compress vital structures in the brain. Benign tumours are slow growing and localised whereas malignant tumours are fast growing tumours that can spread to different parts of the brain. Benign tumours are relatively easy to treat as they are separated from the healthy brain cells by a thin membrane. Metastatic brain tumours occur when cancerous cells from breast cancer or lung cancer reach the brain and start growing there. Brain tumours like other tumours of the body are graded from stage 1 to 4 depending on the cells of origin and their speed of multiplication.
The signs and symptoms of brain tumour depend on the location of the mass as well as the structures compressed by it. Headaches, projectile vomiting, dizziness, loss of vision, slurring of speech, tingling and numbness in the hands or legs, loss of function of hands and legs, facial asymmetry, difficulty in walking, loss of balance etc. are some of the common symptoms.
• Primary Brain Tumors
Primary brain tumors are tumors that start in the brain. There are many types and subtypes of primary brain tumors; some are benign, others malignant. Examples include gliomas, meningiomas, medulloblastomas, pituitary adenomas, and central nervous system lymphomas.
Astrocytoma : Most Common type of brain tumor in children; originates in the brainstem, cerebellum, white matter of the cerebrum, or spinal cord.
Brainstem Glioma : Originates in the medulla, pons, or midbrain.
Ependymoma : Originates in the membrane that lines the bentricles ventricles and central canal of the spine.
Glioblastoma Multiforme : Most Common types in adults; originates in glial cells in the cerebrum. This is the most common aggressive primary malignant tumor.
Medulloblastoma : Second Most Common type in children; originates in the fourth cerebral ventricle and the cerebellum; often invades the meninges. It is also a highly malignant primary brain tumor.
• Secondary (Metastatic) Brain Tumors
A metastatic, or secondary, brain tumor is one that begins as cancer in another part of the body. Some of the cancer cells may be carried to the brain by the blood or lymphatic fluid, or may spread from adjacent tissue. In adults, the most common types of cancer that spread to the brain are:
• Breast Cancer
• Renal Cell Carcinoma
• Lung Cancer
The diagnosis of brain tumour is made with the help of physical and neurological examination followed by MRI and CT scan of the brain. Surgery followed by chemotherapy and radiotherapy is the only successful treatment option. After surgery, the cancerous tissue can be sent for biopsy to analyse the type and stage of the cancer. Medical science has developed in the recent years making it possible to remove tumours using minimally invasive procedures.
In the past the patient had to be sedated completely before opening up the skull and separating the brain tissue to reach the tumour cells. The recovery process was slow painful and with lot of postoperative complications.
With the advent of 3-D imaging techniques it has become possible to localise the tumour with great accuracy. A small hole in the skull is made through which small instruments are instruments are inserted through a thin camera carrying flexible tube called as endoscope. The endoscope shows the exact image of the tumour and surrounding cells which helps the surgeon to navigate through the brain tissue and reach the cancerous mass. Tumour near the pituitary gland can be accessed through the nose using a laparoscope.
Awake Surgery is a new procedure used while operating tumours that are located near the sensory, motor, speech, smell or hearing areas. The patient is awake during the entire surgery and constantly gives feedback depending on the functional area that is being operated on. Any slurring of speech or weakness in the arms and legs cautions the surgeon to proceed slowly or use another route. This helps to avoid postoperative loss of function.
Cyber Knife and Gamma Knife are the latest non-invasive procedures used to treat brain tumours that are located deep inside or near some vital portion of the brain.
In Gamma Knife Surgery there is no knife used. Around 190-200 focussed gamma rays produced from an external device are targeted at the mass of cells. The rays are directed in such a way that they all converge on the cancerous mass and produce lot of heat which destroys the cell DNA. The cells can no longer multiply. The blood supply to these cells is also cut off. The tumour mass shrinks and disintegrates. These rays do not affect the nearby healthy cells. The procedure is highly accurate with very less complications and low failure rate. The patient’s head is clamped to eliminate any movement. The recovery is faster and hospital stay is shorter. It can be done as an outpatient procedure.
Cyber Knife Surgery is another minimally invasive frameless procedure to destroy all types of cancers present anywhere in the body. It is a type of robotic surgery. An external device produces radiations that are directed with the help of robotic arms on the tumour mass. The large amount of heat generated destroys the mass completely. This is an image guided technique in which a rotator makes images of the patient’s brain anatomy. The radiation dose is given in doses spaced out over weeks to allow the healthy tissue to heal itself. The technique is accurate and painless. It is highly useful in children and aged people whose skull is fragile and cannot be fixed.
Endoscopic removal of tumor through nose (Expanded Endoscopic Trans-Nasal Approach)
Endoscpoic neurosurgery involves the insertion of an endoscope, or tiny video camera, through a small incision to treat a range of neurological conditions. The result is
The endoscopic trans-nasal approach is performed through the nostrils. A natural passage way exists at the back end of the nose leading into the sphenoid sinus (an air filled cavity in the depth of the skull), which can be enlarged so that the endoscope and instruments can pass into this air filled cavity. From this region the sella turcica is easily accessed, which is the location of pituitary gland. Neurosurgeons use this route normally to remove the tumor from pituitary (the master glad).
“I was all set to go to South Africa for an open surgery and it was my sheer luck that my brother discovered your website with details of Cyberknife Radiosurgery on it. In just one weeks time you arranged opinion from the hospital and also I could personally speak to the specialists on phone and clarify my doubts.
Thanks for guiding me step by step so well to prepare for my travel to India and receiving me at the airport in the middle of the night. It was so comforting to be in your safe hands. I have got a new birth it seems and shall ever remain grateful for your compassionate care”
Dr. Tatenda Masamvi, Zimbabwe, Advanced Brain Tumor Surgery
Please scan and email your medical reports for a Free, No Obligation Opinion from India’s leading Surgeons/ Specialist Doctors at India’s Best Hospitals with in 48 Hours of receipt.