Contributed by Dr. Ashish Bhange, Consultant Radiation Oncologist, HCG NCHRI Cancer Centre Nagpur
Brain tumor has always been a major challenge to medical science pertaining to its critically delicate location and impairment of important functions. Brain tumor is caused by abnormal growth of cells inside the brain or skull. As per studies, brain tumors comprise of 2.4 percent of all tumors diagnosed, though all brain tumors are not cancerous. Hence, we must have a necessary awareness regarding it.
The exact reason for occurrence of brain tumor is yet not established. Few factors have been correlated such as hereditary disorders, excessive exposure to radiation therapy, fertilizer, pesticides and radiation of cellular devices. Brain tumors are generally of two types, Benign tumors (non-cancerous) and malignant tumors (Cancerous). Adult brain tumors are 70 percent times benign in nature whereas children have similar percentage inversely of malignant tumors. In children, it is second most diagnosed cancer after blood cancer.
Benign tumors such as meningioma, schwannoma etc. are such where the tumor growth is slow and hence mostly diagnosed only when it produces pressure symptoms. It needs treatment only if symptoms are progressive or tumor location is in eloquent area. Whereas malignant tumors are aggressive in nature with rapid growth in size and number. There are two types of malignant tumors, one which primarily originate in brain tissue such as Glioma whereas second which is metastatic tumors which originates from elsewhere cancer tissue in body such as lung, breast, kidney. The malignant tumors need aggressive treatment intervention as delay in treatment can be life threatening.
Signs & Symptoms
The progressive and relapsing headache is the most frequently seen symptom of brain tumor patient. But every headache cannot be linked to brain tumor as it is the rarest cause of it. Brain tumor headache usually worsen at night or early morning and often associated with nausea and vomiting. Other common symptoms are seizures, behavior change, weakness in limbs, vision or hearing deterioration. If any of such symptoms are observed, consultation with specialist should be sought without delay.
Diagnosis & Treatment
Brain tumors are usually diagnosed with MRI scan or CT scan. Recent advances in imaging techniques such as MRS, Functional MRI, PET scan have redefined diagnostic modality for brain tumors. Neurosurgery, Radiation therapy and chemotherapy are three pillars of brain tumor treatment. Neurosurgery advances such as microscope as well as navigation guided neurosurgery has resulted in more efficient removal of brain tumors.
Radiation therapy is an essential cornerstone of brain tumor treatment. The state of art conformal radiation therapy advances has resulted in more precise, accurate and effective treatment of critical location of brain tumors. Radiation therapy is usually implemented either post operatively to prevent recurrence or upfront when brain tumor surgery is not possible.
With advancing radiosurgery techniques such as Gamma knife/Cyberknife/Linac X-knife, very high tumoricidal doses of radiation beams can be accurately and precisely focused on tumor in an efficient way. With such evolved radiation techniques, certain brain tumors can be treated without any surgical intervention. Chemotherapy is another important treatment modality for brain tumors especially optic glioma, lymphoma or progressive malignant tumors.
With the advancement in treatment modalities, there is a paradigm shift in treatment of brain tumors. It is crucial to diagnose cancer at an early stage. One should not neglect the symptoms of cancer and should immediately consult cancer specialist if they experience any of the symptoms.