World Brain Tumour Day - Brain tumours: Symptoms, Diagnosis, and Treatment

• Authored By: Dr Nigel Peter Symss, Senior Consultant – Neurosurgery, Gleneagles Global Health City, Chennai.
• World Brain Tumour Day is celebrated annually on June 8 across the world.

Chennai: The day is aimed at raising awareness about brain tumour to the public by educating them on the condition, including its signs and symptoms, management, and treatment, etc. The incidence of brain tumours in India ranges from 5 to 10 per 100,000 of the population. Brain tumours occur in both adults and children.  Brain tumours can occur in both males and females but are more commonly seen in males.

Dr Nigel Peter Symss, Senior Consultant – Neurosurgery

A brain tumour is an abnormal mass of cells within the brain. Brain tumours can occur within the brain or can be located on the surface of the brain when they arise from the covering layers of the brain called meninges. There are two types of brain tumours, benign or non- cancerous tumours, and malignant or cancerous tumours. The common types of cancers that spread to the brain include breast, lung, colon, kidney, and skin cancer. Some of the more common tumours in children are medulloblastoma, pilocytic astrocytoma, and ependymoma to name a few. 

Risk factors: 

The cause of brain tumours is complex and has multifactorial risk factors. However, in most people, the risk factors that cause brain tumours are not clear. Lifestyle, dietary habits, and environmental exposure are among the many factors yet to be thoroughly evaluated. But some known factors may increase your risk of getting a brain tumour. These include exposure to some form of ionizing radiation, such as radiation therapy used to treat cancer. Also, a small portion of brain tumours occurs in people with a family history of brain tumours or a family history of genetic syndromes that increase the risk of brain tumours, such as neurofibromatosis

Symptoms: 

The symptoms and signs of a brain tumour depend on the part of the brain which is affected. The first and commonest symptom is headache, which may be severe and persistent, and associated with vomiting that relieves the headache. The other symptoms are seizures, weakness or one-sided paralysis of limbs, vision, hearing or speech impairments, and memory problems or behavioral changes. Difficulty with balance and frequent falls may also be present and such symptoms should not be ignored.

Diagnosis and treatment options 

If a person is suspected to have a brain tumour, the doctor recommends several tests and procedures, including a neurological exam, magnetic resonance imaging (MRI) scan, CT scan, etc. MRI and CT scan are the two types of brain scans: Magnetic resonance imaging (MRI) scan is commonly used to help diagnose brain tumours. In some cases, a dye or contrast agent may be injected through a vein in your arm during your MRI study. This dye helps to better visualise the tumour on the scan. The other brain scan is a computerized tomography (CT) scan. This scan may also be done using a dye or contrast. In patients suspected of having secondary or metastatic brain cancer a Positron Emission Tomography (PET) scan may be required to look for cancer elsewhere in the body.

The treatment of brain tumours depends on the type, whether benign or cancerous, and location of the brain tumour, as well as the age of the patient. The primary treatment for benign tumours is surgery, which is called craniotomy and excision of the tumour. Cancerous tumours are graded from grade I to grade IV - according to how fast they grow or multiply and how likely they are to recur after treatment. Grade I being low grade, and grade IV high grade. Surgery is also the main treatment option for these brain tumours. But it is not always possible to remove the entire tumour via surgery, and in such cases, chemotherapy and radiotherapy are recommended. Doctors will also prescribe steroids to help reduce swelling around the tumour.

For patients where the tumour is in important functional areas called eloquent areas, like speech or motor area, patient will have to be awake when the surgery is conducted. This is called an awake craniotomy, and during the surgical procedure, the patient is required to perform activities such as moving limbs and talking. In some patients, the tumour may be in the depth of the brain and is not easily accessible. In such a case only a biopsy of the tumour can be done using special equipment called Navigation or a Stereotactic frame.

Recovering and Outcome: 

It is important to have supportive family and friends during the recovery period. Physical and occupational therapy can help patients and families adapt to physical limitations if they occur. Neuropsychologists, rehabilitation, and occupational therapists who specialize in neurological rehabilitation can help patients deal with memory, speech problems, or physical disabilities. In most of the cases, patients return to their baseline preoperative status by around six to eight weeks. The survival rates after brain tumour surgery vary widely and depend on several factors, including the type of brain tumour whether benign or cancerous and the location.

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