Brain Cancer

Brain cancer arises due to abnormal growth of cells in the brain or when cancer cells from other parts of the body invade the brain. As the cancer grows inside the brain and exerts pressure to the surrounding brain tissues, it signals various signs and symptoms.

The exact cause of brain cancer is still unknown, however, doctors refer to genetic factors, radiation to the head, cigarette smoking, HIV infection, various environmental toxins as the reasons for the cancer. There are basically two types of brain cancer- primary and metastatic brain cancer.

Primary brain cancer arises from abnormal growth of cells that form into a mass or tumours inside the brain. Metastatic brain cancer, on the other hand, is composed of brain tumours elsewhere in the body. This is one of the most common types of brain disease and spread further through a process called metastasis.

The signs and symptoms of brain cancer include nausea, vomiting, sleepiness, blurry vision, change in the person’s alertness, memory problems, changes in speech, impaired voice, difficulty in speaking, personality changes, inability to speak, mental capacity reduction, weakness in one side of the body, fatigue, coordination problems, needles and pins sensations and reduced sensation of touch.

The team of professionals involved in the treatment of brain cancer include neurologists, oncologists, neurosurgeons, radiation oncologists, physical therapists, speech therapists, etc.

Diagnosis of brain cancer is done with several frequently used tests , such as CT scans, X-rays, MRIs, biopsies, etc., that help to determine the evidence of any tumours or abnormalities in the brain. Other tests are conducted to evaluate white blood cell counts, examination of cerebrospinal fluid for assessing any cancerous cells.

Treatment plan for brain cancer is individualized and varies widely depending upon the size, location, type of the tumour, patient’s age and the general health condition. Chemotherapy, radiation therapy and surgery are the common treatments for brain cancer. A surgery helps to remove tumours from the brain, but sometimes certain tumours are inoperable due to their inaccessibility. However, a brain cancer considered inoperable by a doctor may be operable by another doctor. Hence, a second opinion for the treatment is most important. Other treatment options like immunotherapy, hyperthermia, and steroids are used to minimize brain swelling and reduce inflammation.

Whichever treatment option is chosen for you, doctors suggest special preparations to be taken before the procedure.

• You have to undergo several tests like blood tests, an ECG test, breathing tests, an echocardiogram and a chest X-ray to check your health condition and whether your body can bear the aftermaths of the surgery. Your good health also suggests that you are likely to recover soon after the procedure.        Blood tests are performed to evaluate your hormone levels especially for pituitary tumours. An ECG or electroencephalogram is required to examine your brain wave patterns. During the procedure, several pads are attached with gel to your head that are attached with wires to an ECG machine. An angiogram is required to examine the blood vessels under X-rays to test if they are affected by tumours near them.
• After undergoing a series of tests, you go through pre-assessments a week or two before the surgery. You meet members of your professional team and talk to them regarding the types of treatment, its effects, and the side effects of the procedure. The surgeon will tell you about the operation you will be having, the possible risks, expectations post surgery and benefits of the surgery.
• You need to coordinate with a dietician, and a physiotherapist to learn about the recovery procedure, duration of recovery, how the surgery will affect your diet and other related questions.
• You are not supposed to eat or drink anything from the night of the day of surgery.

There are different types of surgeries performed, depending upon the size and type of brain cancer.

Surgery

Craniotomy- This is the most common form of brain tumour surgery. During the procedure, a portion of your scalp is shaved, while the area is number with anaesthesia. An incision is done in the skull and doctors remove a piece of bone by using specialized instruments for exposing the tumour. After the dura mater (uppermost crust of brain tissues) is opened, the tumour is located, sliced and removed. Once over, the bone is replaced and the open wound is stitched closed.

Shunt- When patients develop pressure to the skull due to accumulation of excessive fluid, surgeons use the ‘’shunt’’ procedure to minimize the pressure. A narrow, flexible tube is placed into the ventricle of the brain. The other end of the tube is threaded to your body cavity where the fluid is drained out and absorbed. The abdominal cavity or the right atrium of the heart is generally used for drainage. Some shunts are removed after the treatment, while other shunts are left in place after the surgery. The shunt procedure gives immediate relief from brain cancer symptoms, especially pressure and headaches.

Stereotactic surgery- This is a minimally invasive procedure that uses local anaesthesia to numb the area where the incision is done. The procedure produces three-dimensional pictures of the brain to detect the exact location of the tumour. This type of surgery helps to reach tumours located deep inside the brain.

Laser surgery- Lasers are used in addition to a brain surgery to direct laser beams at the cancer cells to destroy them. Laser rays are particularly used to treat tumours at the skull base or deep within the brain.

Chemotherapy

The purpose of chemotherapy is to destroy the cancer cells and crease its ability to grow. Chmeotherapy is given in the form of oral pills that are swallowed by the patient or it is given intravenously, that is injecting through an IV line in the arm. The idea is to help chemos reach the bloodstream and destroy tumours cells that are not possible to destroy with surgeries.

Targeted therapy

Targeted therapies are often combined with other brain cancer treatments to target specific abnormalities in the brain cells. Targeted drugs are given intravenously through a needle inserted into the arm.

The recovery time of brain cancer treatment varies from patient to patient. Certain factors like the location of the tumour in the brain, procedure used for the removal, areas of the brain affected and the patient health and age are the determining factors for recovery.

A week’s stay is necessary post surgery. However, this may extend depending upon the extent and type of surgery the patient goes through. During the hospital stay post surgery, the patient is kept under constant monitoring and observation. If required, the patient is given intensive care treatment round the clock.

Brain cancers often cause problems with behaviours, feelings and speech. Therefore, the patient meets physical therapists, speech language therapists and occupational therapists to overcome the barriers. Once the doctor feels that the patient is in a condition to go home, he/she is discharged. However, in case of any problem or emergency, the patient should inform the hospital right away.