The occurrence of brain tumours in India is steadily rising. More and more cases of brain tumours are reported each year in our country among people of varied age groups. In 2018, brain tumours was ranked as the 10th most common kind of tumour among Indians. The International Association of Cancer Registries (IARC) reported that there are over 28,000 cases of brain tumours reported in India each year and more than 24,000 people reportedly die due to brain tumours annually. A brain tumours is a serious condition and can be fatal if not detected early and treated. In this article, we tell you all you need to know about brain tumours and brain tumour treatment.
Uncontrolled and abnormal cell growth in the brain is called a brain tumour. The space in our skull is restricted. Therefore, this extra growth inside our brain causes more pressure inside the skull, causing life-threatening complications, and also damaging our brain.
Tumours can be either benign or malignant. The benign ones are not cancerous and cannot spread to other parts of the brain or body. The malignant ones are cancerous, grow uncontrollably and can spread to other parts of the body.
There are two main brain tumour types – primary and metastatic or secondary. Primary brain tumours originate within the brain. They may be either benign, without cancerous growth or malignant, with quickly-growing cancerous cells. Secondary or metastatic brain tumours are ones that start in other parts of the body like the breasts or lungs but later spread to the brain through the blood. These are always cancerous and never benign.
Primary tumours are further categorised into glial and non-glial tumours. Glial tumours or gliomas are ones that arise in the glial cells. These cells support the nervous system by surrounding and holding neurons in place, supplying nutrients and oxygen to the nerve cells, removing dead neurons, and insulating neurons from each other. Examples of gliomas are:
Non-glial tumours are ones that develop in structures of the brain like blood vessels, nerves, meninges or glands. Examples include meningiomas, pituitary tumours, schwannomas, pineal gland tumours, craniopharyngiomas, etc.
Secondary or metastatic brain tumours are the most common type of brain tumours and they usually spread via the bloodstream. Cancers of the breast, lungs, kidney, and skin are the ones that most commonly spread to the brain.
Are you wondering what causes brain tumours? Extensive research is being done to determine the exact cause of brain tumours. However, brain tumour causes are not yet clearly known.
Tumours are caused by uncontrolled cellular multiplication. This is caused by a change or mutation in our DNA. Genes that control cell division and make cells die at the correct time are affected by this mutation, and this makes the cells to grow uncontrollably, resulting in brain tumours.
Several risk factors can increase your chances of developing a brain tumour. These include:
Symptoms of a brain tumour vary based on where the tumour is located and how big it is. When a tumour is big enough to put pressure on the rest of the brain tissue, you will start to notice the symptoms.
The most common ones are:
Apart from these, there are specific brain tumour symptoms in men, like development of breast tissue. Warning signs of brain tumour symptoms in women include nipple discharge, excessive body hair, and lack of menstruation.
If your doctor suspects that you may have a brain tumour, then she may recommend diagnostic tests to confirm this, such as:
There are various options available for treating brain tumours:
Brain surgery is a complicated and serious process. It is the main treatment option for brain tumours. Advanced medical technology these days allows surgeons to operate using minimally invasive methods. However, brain surgery is a critical medical procedure and carries some extra risk. Complications during and after are rare, but they may occur. Here are the risks associated with brain tumour surgery:
However, surgeons take utmost care to ensure that they are thorough and attentive so that the surgery is successful and no complications arise.
A brain tumour surgery requires a lot of preparation. Your doctor will give you advice to prepare for this. You will have a team of neurosurgeons performing the procedure. Depending on the type of surgery, the preparation and procedure can vary. There are various methods of brain tumour surgery such as microsurgery, ultrasonic aspiration, etc.
For a minimally invasive surgery, a small keyhole incision is made and with the help of brain imaging specialists, the surgeon removes part of or the entire tumour.
In case of a craniotomy, the surgeon cuts out an area of your skull to create an opening to access the brain. Using imaging systems, the surgeon will remove the tumour. After this, the small area of bone is put back into the skull. A craniotomy can be done under general anaesthesia or using local anaesthesia while keeping the patient awake. The latter method is used if your tumour is close to a part of your brain which controls an important function like speech, hearing, movement or sight. Keeping you awake during the surgery will help the surgeon check the functions of different parts of the brain. He does this by asking you to speak or move a specific part of your body. This way, the surgeon can make sure such functions are not harmed when removing the tumour.
After the surgery, rehabilitation is necessary for proper recovery. Your doctor may recommend therapies such as:
Post-operative care after a brain surgery is extremely important. After the operation, the patient is closely monitored to make sure that the body is functioning properly. You will also be given pain medication and may have to remain in the hospital for some time while you recover. Post-surgery, you will be kept in a raised position to prevent swelling in your brain and face. Your doctor will also give you a detailed diet and nutrition plan to make sure you recover quickly. Your doctor will also give you instructions on how to take care of the surgical wound.
Your diet and nutrition have a significant impact on your recovery after brain tumour surgery. Eating healthy, nutritious food can help you heal faster and prevent complications like high blood sugar or constipation. Here are some tips that will help:
Below are the answers to some frequently asked questions about brain tumour surgery:
Brain surgery is a lot more risky than other surgeries. However, neurosurgeons are experts who are very thorough and ensure that no complications arise. Make sure you choose an expert neurologist near you and the best neurology hospital to get the best care possible.
Your doctor will give you detailed instructions about how to prepare for the brain tumour surgery. Inform the doctor about medications that you are on, including over-the-counter medications and supplements. Let your doctor know about any allergies you have, surgeries you had in the past, and if you have been drinking alcohol.
The outlook after a brain tumour operation depends on the size, type, and location of the tumour, and your general health. It also depends on whether there were any complications during or after the surgery. The earlier the brain tumour is detected and operated upon, the better your chances of survival are. With advanced medical technology, surgical complications have become rare, and the outlook is positive.
An awake craniotomy will not hurt. You will be given a drip to make you feel relaxed and comfortable. A local anaesthetic will be administered around the site of incision. You will be able to see your team of doctors and talk to them. While removing the tumour, the surgeon will continuously test your function like speech, movement, sight, hearing, etc. If anything changes, the surgeon can stop the surgery to ensure that your vital body functions are not affected.
In the days before the surgery, you may have to stop taking medication. Your doctor will let you know when you should stop taking them.
Ideally, you should not eat or drink anything after midnight the night before the surgery. You can eat something light before midnight so that you will not feel hungry in the morning. You can have small sips of water until 2 hours before the surgery, if your surgeon permits.
A team of specialised neurosurgeons and anaesthetists will perform the operation. Keyhole surgery for brain tumour can take upto 3 hours, while a regular craniotomy can take 3-5 hours. An awake craniotomy can take 5-7 hours.
You will be on intravenous pain medication after the surgery, and will therefore not feel any pain. You may get headaches, and the operated area may feel tender. This can be managed with pain medication prescribed by your doctor. Once the IV medication stops, your doctor will give you pain pills to manage the pain.
The duration of stay for brain surgery is about 3 days. Your stay may be longer if you have any post-surgical problems.
After discharge, you will need to avoid lifting heavy objects for 4 weeks. You will also have to avoid getting constipated and pushing hard during bowel movements for 4 weeks. You also need to avoid physical exertion caused by working, running, exercising, etc.
You will have to keep an eye out for symptoms such as:
If you experience any of these problems, you should call your doctor right away.
It is best to be well-informed before your brain tumour surgery. Ask your doctor questions like:
Cancer that has spread to the brain from another part of the body is called a metastatic brain tumour, which is much more common than primary tumours. Depending on the type, size, and exact location of the tumour in the brain, the early signs may vary. Following are some general signs and symptoms.
If you feel any of the above-mentioned symptoms in your day to day life, then go visit a doctor. They can guide you the best.
If you have signs and symptoms of brain tumour, then your doctor will do a physical exam, ask about your and your family's medical history and ask you to do one or more of the following tests.
For a low-grade tumour, like Glioma, the doctor usually keeps the patient under observation. For a high-grade tumour, the treatment could be radiation or chemotherapy. For metastatic tumour, the patient has already known or suffered cancer somewhere else in his body, the treatment involves surgery followed by focus radiation. For Meningioma, the treatment after surgery involves observation. There are certain meningiomas that need more treatment than just surgery. They may regrow or they may have biological potential and are little more aggressive. Those might need radiations.
Adult brain tumours are masses of abnormal cells that generally occur in adults and results from the uncontrolled growth of those cells within the brain. Causes of brain tumour is not fully understood in medical science but there are few well-established risk factors for the cause. When the human body cells grow, divide into new cells oncogenes help them stay alive. Tumour suppressor genes are those which help keep cell division under control or make cells die at the right time. Cancers can be caused by DNA changes that turn on oncogenes or turn off tumour suppressor genes.
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