Neuro Oncology in India

by Rishabh

What is Neuro-Oncology?

The branch of medicine that study tumors of the nervous system is termed as neuro-oncology.

Following are several objectives of neuro-oncology –

  • To know the prognostic factors that are influencing glioma outcome.
  • To treat primary peripheral and central nervous system tumors
  • Careful study of typical radiological appearance, prognosis and treatment options for the neurological complications of cancer such as epidural spinal cord compression and brain metastases.
  • Careful study of signs and symptoms of brain tumors in children and adults
  • Neurological complications associated with systemic cancer
  • Careful study of typical radiological appearance, prognosis and treatment options for primary brain tumors such as brain stem glioma, lowgrade glioma, medulloblastoma and glioblastoma.

Brain Cancer

Cancerous growth or tumor in the brain is termed as brain cancer. A tumor is usually a mass of cells that reproduce themselves in an abnormal manner. Brain tumor can be categorized into two types- metastatic brain tumor and primary brain tumor. A metastatic brain tumor can begin from any part of the body and travels to the brain. Whereas, a primary brain tumor begins within the brain. These brain tumors can be malignant with cancer cells or benign with no cancer cells.

Symptoms of Brain Cancer

  • Tingling or numbness in legs or arms
  • Headaches that get worse in the morning
  • Problems with walking or balance
  • Muscle twitching or jerking
  • Drowsiness
  • Vomiting and nausea
  • Problems with memory or thinking
  • Personality changes
  • Irritability
  • Altered mental status

Brain tumor symptoms when the tumor is in the front of the brain (cerebrum)

  • Personality changes
  • Seizures
  • Increased intracranial pressure
  • Visual changes
  • Weakness or paralysis on face or half of the body
  • Confusion or drowsiness
  • Slurred speech

Brain tumors symptoms when the tumor is in the middle of the brain

  • Increased intracranial pressure
  • Seizures
  • Headaches
  • Respiratory changes
  • Endocrine problems (hormone regulation and diabetes)
  • Paralysis of muscles or nerves of the half of the body or the face
  • Double vision or visual changes

Brain tumors symptoms when the tumor is in the back of the brain (cerebellum)

  • Problems while walking
  • Headache
  • Increased intracranial pressure
  • Uncoordinated muscle movements
  • Vomiting

What Causes Brain Tumor?

The causes of primary brain tumors are not known. However, some researchers believe that these tumors can be due to combination of events. Researchers are now working on certain areas that include –

  • Environmental factors
  • Genetic cell mutations
  • Injury
  • Occupational factors
  • Defects
  • Hormones
  • Viruses
  • Chemicals

Secondary brain tumors are responsible for causing a large portion of brain tumors.

Diagnosis of a Brain Tumor

The following tests are performed for diagnosing brain tumor –

  • Computed Tomography Scan (CAT or CT scan)
  • Magnetic Resonance Imaging (MRI)
  • Angiogram
  • MR Spect
  • Bone Scan
  • Stereotactic Biopsy
  • Functional Magnetic Resonance Imaging (MRI)

Brain Tumor Treatment Options

Surgery: Surgery is performed for treating adult brain tumor. After diagnosing, the surgical procedure is performed for removing the tumor. A part of the skull is removed and sample of the brain tissue is also taken by using a needle for the purpose of biopsy. Tissues are then viewed under the microscope for seeing the presence of cancer cells. If the tumor is suspected, then surgical procedure is performed safely for removing the tumor as much as possible.

Chemotherapy: This is another treatment option for brain tumors in which drugs are used for stopping the growth of cancer cells. The purpose of these drugs is to either stop the cells from dividing or to kill these cells. Chemotherapy is either injected into a muscle or vein or is taken by mouth. These drugs then travel into the bloodstream and reach to the cancer cells in the entire body (systemic chemotherapy). Regional chemotherapy is the procedure where chemotherapy is positioned into a body cavity such as abdomen or into the spinal column. The drugs then may affect cancer cells in those areas. An anticancer drug can be delivered by using a dissolving wafer directly at the brain tumor site when the tumor has already been removed by surgery. Chemotherapy is given to the patient depending on the stage and type of the cancer.

Biological Therapy: In this therapy, the immune system of a patient is used in order to fight with cancer. The natural defenses of the body are restored to fight against cancer by using substances that are either made in the laboratory or are made by the body itself. This entire procedure is known as immunotherapy or biotherapy.

Hyperthermia Therapy: During this therapy, the tissue of the body is exposed to high temperatures to kill and damage cancer cells or these cancer cells can also be made more sensitive to the effects of radiation.

Gamma Knife Radiosurgery: Neurological diseases or disorders can be treated with the help of this surgery. In this non-invasive method, the brain is operated without using general anesthesia or by making any type of incisions.

Radiation Therapy: Some of the new methods are developed for delivering radiation therapy –

  • Hyperfractionation: In this, small doses of radiation therapy are given 2-3 times a day instead of one.
  • Radiosensitizers: In this, drugs are used for making cancer cells further sensitive to radiation. When radiosensitizers and radiation are combined together then it can damage more tumor cells.
  • Stereotactic Radiosurgery: This type of therapy damages less healthy tissues and the radiation is delivered directly to the tumor. The exact location of the tumor is diagnosed with the help of MRI or CT scan.

Cost of Brain Cancer Surgery

The cost of brain cancer surgery in India is relatively lower than other developed countries. However, the cost of the treatment depends upon the type, location and stage of the brain cancer.

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