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Brain Tumour Treatment

What is Brain Tumor?

A brain tumor is a mass of cells or an abnormal growth of cells in and around the brain. Brain tumors can happen in or near the brain tissue. Nearby locations may include the pineal gland, pituitary gland, nerves, and membranes that cover the surface of the brain. Brain tumors can be benign (non-cancerous) or malignant (cancerous). Some brain tumors multiply quickly, while others grow at a slow rate.

Brain Tumor Types

Researchers have identified more than 150 distinct types of brain tumors. The major brain tumor types are:

Benign Brain Tumor

Here are the types of brain tumors that are benign include:

  1. Meningiomas: Meningiomas are the most common type of primary brain tumors and develop slowly. They develop in the meninges (the layers of tissue that protect the brain and spinal cord.) In rare cases, meningioma can be cancerous.


  1. Pituitary adenomas: These slow-growing tumors form in the pituitary gland, located at the base of the brain. Pituitary adenomas may also release excess pituitary hormones.


  1. Schwannoma: This is a common type of benign brain tumor that forms in adults. They develop from the Schwann cells (conduct nerve impulses) in the cranial nerves or peripheral nervous system.

  2. Craniopharyngiomas: These types of tumors usually arise from a portion of the pituitary gland. These tumors are difficult to remove because of their location deep inside the brain.

  3. Chordomas: These are slow-growing tumors that begin at the base of the skull and the bottom part of the spine. These tumors are mostly benign.

  4. Gangliomas, gangliocytomas, and anaplastic gangliogliomas: Anaplastic gangliogliomas, gangliomas, and gangliocytomas are rare types of tumors that form in the nerve cells (neurons).

  5. Glomus jugulare: These tumors are located right under the base of the skull at the top of the jugular or neck vein. 


  1. Pineocytomas: As the name suggests, these slow-growing tumors form in the pineal gland, located deep in the brain, and secretes melatonin.

Malignant Brain Tumor

Approximately 78% of malignant brain tumors are gliomas. These tumors form in the glial cells, which surround and assist the nerve cells. Types of gliomas include:


  1. Oligodendroglioma: This is a less common type of malignant brain tumor that begins in cells that create myelin (a layer of insulation around the nerves of the brain.)


  1. Astrocytoma: This tumor is the most common type of brain tumor cancer. These tumors form in astrocytes (star-shaped glial cells) and most commonly occur in the cerebrum.


  1. Ependymomas: These tumors often form near the ventricles in the brain. Ependymomas develop from ependymal cells, also called radial glial cells.

  2. Glioblastoma: These tumors form in glial cells known as astrocytes and are the fastest-growing type of astrocytoma.

  3. Medulloblastoma: This is the most prevalent type of brain tumor cancer in children. These tumors form at the base of the skull and grow at a fast pace.

Metastatic Brain Tumor

Also called a secondary brain tumor, a metastatic brain tumor is a malignant tumor that originates elsewhere in the body and then spreads or metastasizes to the brain. These secondary brain tumors grow rapidly, invading or crowding the nearby brain tissue.


Some of the common cancers that can metastasize to the brain are:

Skin cancer (melanoma)

Lung cancer

Kidney cancer

Colon cancer

Breast cancer

Brain Tumor Symptoms

Different parts of the brain control various functions, so brain tumor symptoms vary depending on the location of the tumor.


For example, a brain tumor located in the cerebellum at the back of the head can cause trouble with movement, walking, balance, and coordination. Similarly, if the tumor affects the optic pathway responsible for sight, vision changes may occur. The size of the tumor and the pace at which it grows affect the signs of brain tumors a person may experience. The most common symptoms of head tumor cancer may include:


  • Seizures or convulsions

  • Headaches

  • Difficulty thinking, confusion, and memory loss

  • Behavioural changes

  • Weakness or numbness in one part or one side of the body

  • Dizziness and loss of balance

  • Hearing loss

  • Changes in vision

Note: Brain tumors do not always cause symptoms. Meningioma, the most common brain tumor in adults, often grows so slowly that its symptoms go unnoticed. Brain tumor warning signs may not be apparent until they become large enough to interfere with the healthy tissues.

Brain Tumors Causes

  • The reasons for brain tumor are unknown. However, brain tumors are thought to arise when certain types of genes on the chromosomes of a cell are damaged and can no longer function effectively. These genes regulate the rate at which the cells divide (if they divide at all) and repair genes responsible for fixing defects of other genes.

  • In a few cases, an individual may be born with partial defects in one or more genes. Certain environmental factors may also lead to further damage. 

  • While in some cases, an environmental injury to the genes may be the only cause of brain tumor, it is yet not known why some people in a specific “environment” are diagnosed with brain tumors, while others are not.

  • Once a cell is dividing at a rapid rate and internal mechanisms to check the growth are damaged, the cells can eventually grow into a brain tumor. In addition to this, tumors produce substances that block the immune system from identifying the abnormal tumor cells and eventually overpower all external and internal deterrents to its growth. 

  • Research is being done in this area, however, more extensive research is crucial to translate this knowledge about brain tumor causes into potential therapies.


Brain Tumor Risk Factors

Even though the cause of a brain tumor is unknown, several risk factors increase the chances of developing a brain tumor. A few important brain tumor risk factors can be as follows:

Age: The risk of brain tumors rises with age and a majority of brain tumors happen in older adults aged 85 to 89.

Radiation: Exposure to radiation accounts for a small number of brain tumors. Some types of brain tumors are common in people who have had radiotherapy, or in rare cases, X-rays or CT scans of the head. Avoiding excessive radiation exposure is significant for brain tumor prevention.


Family history and genetic conditions: Some genetic conditions increase the risk of a brain tumor, including Turner syndrome and tuberous sclerosis. 

Brain Tumor Diagnosis

Brain tumor diagnosis can be a complicated process and involves specialist care. In some cases, doctors may discover a brain tumor while performing imaging tests for a different medical issue. If an individual is experiencing a few or most of the brain tumor symptoms, a doctor will perform a physical examination. They may ask questions about:

-Past and present health conditions

-Surgeries and medical treatments

-Family medical history

They may also perform a: 

  • Neurological examination

A neurological examination assesses different parts of the brain to understand their functioning. This type of examination checks hearing, vision, coordination, balance, reflexes and strength. If an individual is facing trouble in one or more areas of the brain, this is a clue for a healthcare provider. A neurological examination doesn’t detect a brain tumor but it helps understand the part of the brain that might be having a problem.

  • Brain MRI/ Imaging

A MRI (magnetic resonance imaging) is the best imaging test to identify brain tumors. A CT scan (computed tomography scan) is a good alternative for an individual who is unable to undergo a brain tumor MRI. Before these tests are conducted, a contrast agent is injected into the veins. Sometimes, a special type of MRI, such as functional MRI, helps create more detailed pictures.

  • Biopsy

A brain biopsy helps identify the type of brain tumor and if it’s cancerous. In a majority of cases a neurosurgeon performs a biopsy during surgery in which they remove all or a part of the tumor. If a tumor is difficult to reach, a stereotactic biopsy may be performed, which involves creating a small hole in the skull using a needle to take a sample of tissue from the tumor.

  • Analysis of CSF

CSF (Cerebrospinal Fluid) is a colourless and watery fluid that flows in and around the brain and the spinal cord. A CSF analysis is a group of tests that utilises a sample of the cerebrospinal fluid to help detect diseases of the brain, spinal cord and other conditions affecting the central nervous system.

  • Skull X-ray

A skull X-ray shows alterations in the bones of the skull caused by a tumor. It can also detect calcium deposits present in some types of brain tumors.

  • Angiography

An arteriogram or angiogram involves a series of X-rays taken after a special dye is injected into an artery (usually in the area where the abdomen joins the upper part of the leg). The dye that flows through the blood vessels of the brain can be seen on the X-ray.  

Brain Tumor Treatment

Brain tumor treatment depends on a number of factors including; type of brain tumor, location and size of the tumor, symptoms, general health and treatment preferences. The major brain tumor treatment options include:

Surgery
Radiation therapy
Chemotherapy
Targeted drug therapy

If an individual is diagnosed with a brain tumor, the available brain tumor treatment options can be: 

  • Brain Tumor Surgery

Surgery is the most common treatment option for brain tumors, and in a majority of cases is the only treatment needed. Depending on the size and location, there are several surgical approaches to remove brain tumors such as:

  1. Craniotomy: The temporary removal of a piece of skull that allows surgeons to access the brain.

  2. Neuroendoscopy: In this type of procedure, surgeons access the brain through other parts of the body such as the nasal cavity, to minimise scarring.

  3. Neuronavigation Guided Brain Tumor Surgery: Neuronavigation is a computer-based technology that enables neurosurgeons to visualise the 3D surgical anatomy of the patient’s brain or spine prior to surgery. 

  4. Cyberknife Radiosurgery: This type of treatment helps manage both small, benign brain tumors and malignant or cancerous brain tumors. It works by damaging the DNA in tumor cells. This way, the cells cannot reproduce and the tumor may gradually become smaller.

  • Radiation Therapy for Brain Tumor

Radiation therapy for brain tumors utilizes X-rays and other forms of light energy to destroy cancer cells in a malignant brain tumor or slow the growth of a benign brain tumor. Following are the types of radiation therapy for brain tumor treatment:

  1. External beam radiation therapy: The most common radiation therapy for brain tumors, it can be directed directly to the tumor, nearby tissue or the full brain. Full-brain radiation is sometimes used to treat metastatic brain tumors.

  2. Stereotactic radiosurgery: This type of radiation therapy uses smaller, more targeted X-ray beams to spare the healthy surrounding tissue. It is often used for areas of the brain that are difficult to reach.

  3. Proton therapy: This type of therapy uses protons to deliver radiation. As compared to other methods, it delivers less radiation to the surrounding healthy tissue.

  • Brain Tumor Chemotherapy

Chemotherapy is rarely used as a stand-alone treatment for brain tumors. It is often used as a combination with radiation and/or surgery. Chemotherapy drugs are medicines that target and kill cancer cells. Over time, researchers have pioneered different ways to get the chemotherapy drugs into the brain, including surgically implanted wafers.

  • Targeted Drug Therapy for Brain Tumor

Targeted drug therapies involve brain tumor medicine that selectively attack certain cell traits to halt the tumor from spreading further. Unlike chemotherapy, targeted therapies spare the healthy tissues so they have milder side effects. These drugs are often used to treat metastatic brain tumors and are generally paired with other therapies like radiation or surgery. 

FAQs

Can brain tumors be cured?

A brain tumor can’t always be removed completely. When possible, the surgeon removes as much of the brain tumor as possible safely. A brain tumor surgery can be used to treat both benign brain tumors and brain cancers.

What is the most common brain tumor?

Meningioma is the most common primary brain tumor that accounts for over 30% of all brain tumors. This type of brain tumor originates in the meninges, the outer three layers of the tissue that protect the brain.

Are brain tumors genetic?

Yes, a small proportion of brain tumors are related to genetic conditions. People who have one of the rare syndromes; neurofibromatosis (NF) Type 1 and 2 are at a higher risk of getting a brain tumor.

What causes brain tumors?

It’s still not clear what causes the DNA changes that lead to a brain tumor. Sometimes, parents pass the DNA changes to their children, increasing the risk of having a brain tumor. Certain genetic conditions that predispose an individual to overproduce a certain type of cells and exposure to some forms of radiation can be a few of the risk factors.

What are the first signs of a brain tumor? 

The exact cerebral cancer symptoms depend on the size of the tumor, the part of the brain affected and the pace at which the tumor is growing. Early symptoms of brain tumor include: 


Headaches 

Changes in mood and personality 

Speech or vision problems 

Loss of balance and coordination 

Nausea and vomiting 

What is the success rate of brain tumor surgery?

The success rate of a brain tumor surgery depends on the age of the patient, type of brain tumor and the treatment option used. The cure rate for complete resection of a benign brain tumor is often 90-100%. As per the American Cancer Society, the survival rate for Meningioma (the most common type of brain tumor) is 84% for patients aged 20-44, 79% for patients in the age group category 45-54 and 74% for patients of ages 55-64.

Can brain tumors be prevented?

While it is not possible to prevent a brain tumor, one can lower the risk by avoiding environmental hazards such as excessive exposure to radiation and smoking. 

Why choose Artemis Hospital for brain tumor treatment?

Artemis Hospital, Gurugram features highly experienced neurosurgeons and oncologists specialising in brain tumor treatment. The hospital is equipped with state-of-the-art technologies for brain tumor diagnosis and treatment, including advanced imaging and minimally invasive surgical procedures. What differentiates us is a multidisciplinary approach, providing comprehensive and personalised care including surgery, radiation therapy, and chemotherapy tailored to each patient's needs.

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