Cutting Edge Technologies fight brain tumours into remission

A brain tumour is a mass of abnormal cells in the brain. It can be benign or malignant. A malignant tumour can be a primary one, beginning in the brain, or secondary where cancers spread to the brain from other parts of the body. The size, location and rate of growth of a tumour will determine the severity of symptoms and the treatment options.

Symptoms of brain tumours
There are many types of brain tumours. The symptoms are common to all and they include:

• New headache or changing pattern of headaches
• Gradual increase in frequency and severity of headaches
• Unexplained nausea or vomiting
• Vision/ Speech/ Hearing problems
• Gradual loss of arm/ leg sensation or movement
• Balance problems
• Confusion
• Behavioral changes
• Sudden onset of seizures

Modern diagnostic tests for brain tumours
A neurological exam is the first step in diagnosis. A neurologist will examine your vision, hearing, balance, coordination, reflexes and strength. This will help identify the areas that are affected by the tumour.

Imaging tests
Magnetic resonance imaging (MRI)
MRI scans including functional MRI, perfusion MRI and magnetic resonance spectroscopy are used to detect and stage the tumour and plan treatment

Computerised tomography (CT) and Positron emission tomography (PET) may be used to check for cancer in other parts of the body if the tumour is suspected to be a secondary tumour.

Stereotactic biopsy
Tissue is removed from the tumour through regular biopsy or a stereotactic biopsy. Stereotactic biopsy may be done for tumours in hard to reach or sensitive areas. A small hole is drilled in the skull and a thin needle is inserted through it. Tissue is removed using the needle. The process is guided by CT or MRI scanning. The sample is studied to determine if it is cancerous.

Molecular diagnostics, sophisticated lab tests, advanced imaging technologies such as high-powered (7-tesla) MRI scan and magnetic resonance elastography (MRE) enable doctors to plan individualized treatments. This reduces the need for follow-up surgery.

Advanced treatment methods
Doctors base the treatment on the type, size and location of the tumour. Treatment options include:

Surgery
Surgery is performed to remove the tumour or a part of the tumour if it is easily accessible. This will provide relief from symptoms. Neuroradiologists, specialists in brain imaging, use advanced surgical navigation and mapping equipment for greater accuracy during complicated surgeries.

Advanced surgical procedures include

• Awake brain surgery (Awake craniotomy)
• Minimally invasive surgery

Awake Craniotomy
If a brain tumour that causes seizures has to be removed, awake craniotomy is performed to ensure the safety of language, speech and motor centres of the brain. This requires your active participation so you have to be awake during a portion of the surgery. The anesthesiologist puts you to sleep when a portion of the skull is removed. He then stops administering sedative and allows you to wake up. The neurosurgeon will conduct brain mapping to determine the control centers of your brain. During surgery, you will be asked questions, shown pictures to identify, make simple movements. Your responses will further help the surgeon identify the functional areas of your brain.   Based on this and the brain mapping the surgeon safely removes as much of the tumour as possible while preserving maximum brain function. Once the surgery is complete, the anesthesiologist will put you to sleep and the surgeon will reattach the skull.

Brain mapping
Brain is filled with electrical impulses. During brain mapping, these electrical impulses are measured with an Electroencphalogram (EEG). Functional MRI (fMRI) is used to map unusual blood flow in an area of the brain. Positron Emission Tomography (PET) is used to image brain tissues and their activity after administering a radioactive drug. Brain Mapping mainly to find the main motor, sensory and visual areas of brain to minimize the damage during surgical removal of brain tumour with maximum tumour removal.

Radiation Therapy
High-energy beams such as X-rays of protons are used to kill tumour cells. External radiation source or a radiation source placed inside body close to the brain (brachytherapy) may be used.

Radiosurgery
A Gamma Knife or linear accelerator is used to deliver radiation therapy. Multiple beams of moderate radiation are focused on a small area to give a large dose to kill tumour cells.

Chemotherapy
Drugs are given either orally or through IV to kill tumour cells. The type of brain tumour is determined and if suitable chemotherapy is used.

Targeted drug therapy
Certain drugs can target specific abnormalities present in the cancer cells to kill them.  Targeted drug therapy is available for some types of cancers.

Advanced technologies available today give you a more than fighting chance to overcome brain tumours. Coupled with rehabilitation therapy, they provide you with a good chance at regaining a better quality of life after beating cancer into remission.