Information Note - World Brain Tumor Day, June- 8th - Dr. Savitr Sastri BV, KIMS Hospitals, Kondapur

Dr. Savitr Sastri BV

Consultant Neurosurgeon & Minimally Invasive Spine Surgeon

KIMS Hospitals, Kondapur.
 
The 8th of June is World Brain Tumor Awareness Day. This was first instituted by the German Brain Tumor Association in the year 2000 and is an annual tribute to patients with brain tumors and their families.

A diagnosis of a brain tumor is often one of the scariest things that anyone can hear. It is commonly thought of as a disease with extremely poor recovery and a debilitating future.

The truth, thankfully, is far from this. In today’s era of modern technology-assisted neurosurgery, with advancements in surgical technique, radiotherapy, and chemotherapy and a growing understanding of brain tumors, many patients recover fully and have a good quality of life.

The phrase, brain tumor, however, is a very broad one. It may mean tumors that arise from inside the brain, or tumors that press on the brain from adjacent or nearby structures like the coverings of the brain or the nerves that come out of the brain. It may mean benign tumors which grow very slowly or malignant, aggressive tumors that grow extremely fast. It may mean a very small tumor that was diagnosed incidentally or a symptomatic tumor that may be large.

The good thing is about 70 percent of all brain tumors are benign, the commonest being a tumor that arises from the coverings of the brain called a meningioma. Of the remaining, the commonest cancerous or malignant tumor is glioblastoma (about 15% of all brain tumors). Other less common tumors may include those arising from the pituitary gland, from the insulation around nerves (schwannoma), etc.

A question that most patients have is why they got the tumor in the first place. The exact causes of brain tumors are not clearly known but there are some risk factors. Exposure to high levels of radiation is one of the important causes. But the radiation we are talking about is the kind at Hiroshima or Chornobyl. There is no evidence that X-rays, modern CT scans, or even cell phone usage can increase the risk of brain tumors in adults. There is however some risk in growing brains and this is why CT scans are avoided in children unless absolutely necessary. The WHO has also recommended limited cell phone use in children since the data available is inconclusive.

Several genetic mutations are associated with brain tumors, and rarely, these can be hereditary or run in families. There is also no role that head trauma may have in the development of brain tumors.

The common symptoms of brain tumors are progressively worsening headaches or headaches of recent onset. Seizures, especially in adults, may be a sign of a tumor. Loss of memory, or speech, weakness of one-half of the face or the body, incoordination, and loss of sight or hearing, are other symptoms of brain tumors. In today’s practice, any of these would indicate the need for an MRI scan of the brain.

But do all brain tumors need surgery? The answer is no. For small tumors which are benign in appearance, a simple follow-up up with MRIs is usually enough. Some other small tumors can be treated with focused radiation like gamma knife or stereotactic radiation. Surgery is reserved for tumors that appear aggressive, or for larger tumors that may be causing problems by pressing on important parts of the brain.

Surgery of brain tumors is a frightening prospect for anybody. Neurosurgery, however, has advanced substantially in the last 50 years and brain surgery, today is safe and effective. Newer imaging techniques tell us the location of the various pathways in the brain and which part of the brain controls speech or movement. The use of neuronavigation, which is a machine that acts like a GPS that helps us locate tumors and choose the safest, shortest route to reach them, has increased the safety and precision of neurosurgery. Minimal access/minimally invasive techniques have evolved with the use of endoscopes and microscopes, to the extent that most tumors are now approached through smaller incisions and smaller openings in the skull. There are rapidly evolving techniques to gauge the amount of tumor removed like Intraoperative fluorescence, Intraoperative 3D ultrasound, and Intraoperative MRI. We also have methods to check the integrity of brain pathways during surgery. All these neurosurgeons can safely remove large tumors with few side effects.

Research into various genetic markers and treatments that are targeted and improved radiotherapy have increased the survival rate of cancers of the brain.

A diagnosis of a brain tumor in today’s world is not as scary as it was before.