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A diagnosis of a brain tumour can surely be overwhelming. Breast, oral, cervical, lung, and colorectal cancers make up nearly half of all cancer cases in India – around 44% of the total cancer burden. However, brain tumours remain a serious but less common form, with an estimated 32,000 new cases and 28,000 deaths, according to GLOBOCAN 2022.
Synopsis
Brain Tumour - Causes and Symptoms
A brain tumour is an abnormal growth of cells within the brain, also called an intracranial tumour. There are over 150 types, mainly classified as primary (originating in the brain) or metastatic (spreading from other parts of the body). The former can be benign or malignant, depending on how invasive they are.
Causes generally point to genetic mutations, although many environmental factors, such as radiation exposure or environmental damage to genes, may contribute to brain tumours. Only a small percentage of people have a family history of brain tumours.
Symptoms of a Brain Tumour
Signs and symptoms can differ based on the characteristics of the tumour—location, size, and type. These include:
How is a Brain Tumour Diagnosed?
Brain tumour diagnosis is generally complex. In certain cases, especially when the tumour size is small, brain tumours do not exhibit any symptoms.
An initial diagnosis often includes a physical exam, neurological exam, and diagnostic tests like MRI, Magnetic resonance imaging, CT scans, angiograms, or procedures like biopsy or lumbar puncture. Doctors may also use cerebrospinal fluid samples to confirm tumour markers or genetic abnormalities.
When is Brain Tumour Surgery Recommended, and Types of Surgeries
Surgery is considered the first-line treatment, and the primary goal is to remove as much of the tumour as safely as possible. Depending on the case, the procedure may involve removing the entire tumour, taking a biopsy, or draining fluid buildup. Surgery also helps relieve symptoms such as headaches, pressure, and seizures.
Surgery is typically not recommended if the tumour is not aggressive and does not cause any symptoms. In such cases, oncologists suggest watchful waiting.
Types of Brain Tumour Surgeries
There are two types of brain tumour surgery - Craniotomy and Neuroendoscopy
Craniotomy: To gain access to the brain, a portion of the skull is temporarily removed. Performed under general anaesthesia, it involves pre-surgical imaging to map the tumour’s location. Surgeons use precision tools like microscopes, scalpels, ultrasound, and suction devices to differentiate and remove tumour tissue.
Neuroendoscopy: This minimally invasive procedure is used for tumours within fluid-filled areas of the brain or for relieving hydrocephalus. A small hole is made in the skull to insert an endoscope (a thin tube with a camera). Through this, surgeons use tiny instruments to remove the tumour while minimising its impact on healthy brain tissue.
There are other types of surgeries, such as surgery to remove a pituitary tumour via the nose, surgery to administer chemotherapy, and surgery to remove fluid buildup.
Types of Brain Tumour Treatment Without Surgery
Some of the brain tumour treatments without surgery include:
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Radiation Therapy: This treatment destroys tumour cells by using strong energy beams, including X-rays. The treatment is done in multiple sessions. There are two types: External Beam Radiation Therapy (EBRT) and Brachytherapy. The former directs radiation from outside the body, avoiding contact with the patient, while the latter involves therapy inside the body.
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Radiosurgery: Multiple weak radiation beams are focused at the tumour from different directions. These beams aimed at the tumour combine to become strong enough to destroy the tumour cells. Healthy brain tissue is mostly protected. It is mostly done in a single or a few sessions.
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Chemotherapy: Chemotherapy, these drugs are cancer-killing (cytotoxic) and are used post-surgery to lower the chances of recurrence, or if recurrence occurs.
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Immunotherapy: Immunotherapy medications aid in boosting the body's immune system against cancerous cells.
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Targeted Therapy: This type of treatment destroys cancerous cells while sparing healthy ones. As the name suggests, the drug targets cells having abnormal genetic pathways or molecules.
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Symptomatic Treatments: Drugs like steroids and other symptomatic treatments are prescribed to relieve symptoms of the tumour or side effects of treatments. These can include corticosteroids, anticonvulsants, and supportive therapies like physical therapy.
What Does Life Look Like After Brain Tumour Treatment?
Life after brain tumour surgery can be complex for some individuals. Recovery can take time after treatment, and patients may require help to regain basic functions like speaking, moving, thinking, etc. Based on patient needs, therapies like physical, occupational and speech therapies are recommended.
Some problems may persist after brain tumour treatment, such as difficulty walking, weakness, difficulty remembering, speech problems, behavioural changes, fatigue, epilepsy, and so on. In most cases, it might take 6 to 12 weeks for a person to recover, although this can vary based on factors like age, general condition, and any complications post-surgery.
Conclusion
Global research is uncovering new ways to treat brain tumours. Ongoing studies are exploring genetic mutations like IDH and BRAF 4600, which are leading to targeted therapies to slow tumour progression. Efforts are also being made to make radiation therapy more precise and to enhance quality of life through better symptom management. Book an appointment with Manipal Hospital Mukundapur to get expert neurosurgeon advice.
FAQ's
Complete removal of benign brain tumours is likely to result in a cure. However, malignant brain tumours may not always be curable and can be challenging to treat. Nevertheless, recent advancements are improving survival rates and quality of life.
Some people live a relatively normal life with a brain tumour, especially if the tumour is benign, slow-growing, or effectively treated. Even in aggressive cases, patients can have a good quality of life with good supportive care and treatments.
There are ways to cope with brain tumour anxiety, such as talking with your loved ones, distracting yourself with hobbies, listening to music, practising mindfulness, and speaking to a psychologist or counsellor.
While family history plays a role in only a small percentage of cases, brain tumours can result from genetic mutations triggered by environmental factors. These may include previous radiation therapy, occupational hazards, age, sex, race, and inherited conditions like neurofibromatosis (NF1 & NF2) or Turner syndrome.
You can schedule an appointment at the Neurology Department of Manipal Hospitals, Mukundapur, by contacting us or visiting our website.
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