Brain Tumor Day -8th June

Endoscopic surgery: An innovative approach to treat brain tumour

Dr Puneet Gulati, Consultant Neurosurgery, Saroj Super Speciality Hospital, New Delhi

Brain tumour is the tenth leading cause of morbidity in India. The incidence of this deadly disease is rising and different kinds of tumours manifest at different age groups. As per the Globocan 2018 report, issued by the International Association of Cancer Registries (IARC) associated with the World Health Organization (WHO), in India over 28,000  new case of brain tumour were reported annually.  Around 24,000 patients lost their lives battling this neurological ailment.

A brain tumour is a collection, or mass of abnormal cells in the brain. These tumours can be cancerous (malignant) or non-cancerous. When a benign or malignant tumour grows, they cause immense pressure in the skull. This can lead to brain damage and it can be life-threatening.

What are signs and symptoms of it?

Symptoms and signs of brain tumour depend on the size and location of the tumour. Some tumours can directly affect by invading the brain tissue while some cause pressure on the surrounding brain. Major symptoms of brain tumour include:

–      Headaches (worsens in the morning).

–      Vomiting

–      Blurred vision or double vision

–      A change in mental functioning

–      Seizures

–      Weakness of a limb or part of the face

–      Difficulty in physical movements

Types of Brain Tumours

Brain tumours are categorised as primary and secondary. A primary brain tumour is the one which originates in the brain. Many of them are benign. A secondary brain tumour is known as metastatic brain tumour. It occurs when the cancer cells spread to brain from the another organs such as lungs and breast.

Primary Brain tumours

These tumours can originate in your brain and can develop from:

• Brain cells such as gliomas
• Nerve cells such as schwanommas
• The membranes that surrounds the brain such as meningiomas
• Glands like pituitary gland

Primary brain tumours can be benign or cancerous.  In adults, the most common types of brain tumours are gilomas (which develops from glial cells) and meningiomas (that develops on the membranes of brain and spinal cord).

Secondary Brain Tumours

Secondary brain tumours are the most common brain cancers. They start from one part of the body and then metastasize to the brain.  The following are example of cancer that metastasize to the brain.

• Lung cancer
• Breast cancer
• Kidney cancer’
• Skin cancer

These tumours are always malignant as benign tumours do not spread from one to another part of the body.

Who are at risk?

The risk factors of brain tumour include:

• Family history- As per a recent study, only 5 to 10 percent of cancers are genetically inherited, or hereditary. It’s a rare that brain tumour can be inherited but if you have family history of the disease then you should get health screenings and consult the doctor at regular intervals of time.
• Age- Thoughthe frequency of this disease is likely to affect people above the age of 55 years, but many such cases have also been seen in children in the age bracket of 3 years to 15 years of age, irrespective of the gender.
• Exposure to radiations and chemicals- People who have been exposed to ionizing radiations and chemicals have an elevated risk of developing brain tumour.

Diagnosis of Brain tumour

Diagnosis of brain tumour begins with a physical exam and a look at the patient’s medical history.  After the physical tests, the doctor will recommend for the further tests which include:

• CT scan of the head- These scans helps the doctors get a more detailed scan of the body than X-rays. Using a special dye it helps them to view some structures like blood vessels more clearly.
• MRI (Magnetic Resonance Imaging)-An MRI is different than CT Scan  as it does not involve any ionising radiations and provides much more detailed pictures of the brain.

Why Endoscopic surgery over other conventional methods of treatment?

Endoscopic brain tumor surgery is minimally invasive treatment procedure that allows neurosurgeons to find and treat the conditions that are deep within the brain or access them through the nose.

During this surgical method, thin tubing that transmits the video images of the brain is inserted through one or two small incisions in the skull or through an opening in the body. This tube like instrument is called an endoscope which contains a small camera that allows the neurosurgeon to see the problem area of the brain.  The ultimate goal is to remove tumour without causing damage to healthy parts of the brain. It has revolutionized the treatment method as it provides crystal clear visualization of tumour.

Early treatment can prevent complications that can occur as a tumour grows and puts pressure on the skull and brain tissue.  If experiencing any symptoms then one should consult the doctor immediately.

Endoscopic Surgery is also commonly used by the surgeons in case of treating pituitary gland tumors, skull base tumors or those tumors that are deeply seated. This endoscopic surgery can be combined with robotic cyberknife radiation therapy for better outcomes in cases where the tumor parts are still left out after endoscopic treatment.

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Best Regards

Sakshi Jaiswal

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