World Brain Tumor Day 2020 is aimed at raising awareness about brain tumor and educating people from all sections of the society about this kind of cancer which is not very common. The day is also meant for people who are suffering from brain tumor and help them deal with the condition in a better and more effective way.
Brain tumor occurs in brain cells, which multiply in an abnormal way or way in which it cannot be controlled. The tumor can be cancerous of non-cancerous. Depending on the tumor’s location, how fast the cells are multiplying and at what pace they are spreading to adjacent areas, patient develops symptoms.
Brain tumors may be primary (arising from cells in the brain, Nerve cells (neurons) Glial cells, blood vessels) or secondary (tumors deposited in the brain from other sites of the body breast, thyroid, bone etc)
Incidence
The incidence of central nervous system (CNS) tumors in India ranges from 5 to 10 per 100,000 populations with an increasing trend and accounts for 2% of malignancies
Causes
Causes of brain tumors are mostly unknown. Children who have got radiation in the head are at higher risks of developing brain tumors as adults. Also, people with some rare genetic conditions are also at higher risks of brain tumors. Age is another risk factor of brain tumor. People between ages 60 and 80 are more likely to develop brain tumor as per studies.
Symptoms and Detection
Brain tumor symptoms depend on the tumor’s size, location, type and if/how much the tumor has invaded other areas of the body
The most common symptom is headaches, which occurs in 35% of patients and can appear along with nausea, vomiting, and problems with a variety of specific nerve functions, called focal neurological deficit.
Changes in speech or hearing,
Balancing problems,
Weakness of limbs (hemi plegia)
Problems with walking,
Numbness or tingling in arms or legs,
Problems with memory,
Changes in vision
Personality changes.
Seizures
Investigations
CT brain
MRI brain
Brain angiography
MR spectroscopy
Treatment
Treatment of brain tumor includes maximal safe surgical resection. In some cases of malignant tumors, radiotherapy and oral chemotherapy are administered after surgical debunking.
Diagnosis of brain tumor does not always mean a very poor outcome. A lot of CNS tumors are benign and can be cured completely and for life by complete surgical removal. In many cases of malignant tumors also, long-term survival is possible with accurate surgery and other management. Outcome and survival rate depends mostly on the age of the patient, type of tumor, whether it is benign or malignant, and the extent of the surgical excision and molecular characteristics of the tumor. Recent studies on molecular markers have opened newer treatment modalities in brain and spine tumors. Now brain tumors are treated based on the molecular staging of the tumor.
Previously brain tumor resection was associated with poor outcome due to damage of surrounding normal brain which led to neurological deficits and poor quality of life. But with the advent of latest technology in surgical armamentarium like stereotaxic, brain mapping, neuro navigation, nerve monitoring, microscope, endoscope and intra operative MRI, tumors can be excised with precision without damaging normal brain.
Small brain tumors can be managed with Stereotactic radio surgery after stereotactic biopsy without anesthesia.
Tumors located on important structures can be subjected to awake craniotomy where patient is operated with special anesthesia when he is awake and is responding to verbal commands to identify the damage to normal brain.
The basic idea of celebrating the day and this write-up in the newspaper is to educate the common man (even well educated) to come for medical help and to accept surgery at right time and early stages as the neurosurgery is very advanced today with very good results and a good disease free life after surgery. People avoid expert opinion or surgery in the early stages and come at very advanced stages where the outcome is poor.
I also request the general prectioners and specialists to encourage the patients to take the opinion of neurosurgeon before telling bad prognosis.
Dr. K. Atchiyya Naidu
Consultant Neuro Surgeon,
KIMS ICON Hospital, Vizag.