Treatment options for the brain tumour depends on the varios factors including general health status of the patient, age of the patient, location, size, type, grade and growth rate of the tumour. Treatment options for brain tumors are surgery, radiaotherapy and chemotherapy. For both low graded and high graded brain tumors treatment starts with surgery. In benign tumors patients can be copmletely cured by the surgery if the tumor can be removed totally. Sometimes it is difficult remove the tumor totally if it is located at the sensitive parts of the brain. Depending on the size and location of the tumor if it is not possible to remove it totally by the surgery, the treatment continious with radiaotherapy and chemotherapy. Mostly malignant tumors in the brain are spread from other cancerous tumors in the body. For malignant tumors even after the totally removal of the tumor there can be remaining parts wich are too small to be seen.
Brain tumors can destroy the brain tissues and causes pressure in the brain. Seizures and weakness at the some parts of the body are common symptoms of the brain tumors. It can also affect hearing and vision quality of the patient.
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BRAIN TUMOR SURGERY
Surgery is the most common and successful treatment option for the brain tumors. Brain tumor surgery aims to remove the tumor and some healthy tissue around the tumor. Surgery is the first treatment to cure the brain tumour. For the surgery some part of the skull should be removed, this procedure calls craniotomy. Craniotomy enables the surgeon to locate and extract the tumor. After the extraction of the tumor the skull part which was removed by craniotomy is placed back to close the opening part of the skull. Extraction of the tumor can improve neurological symptoms and procure a tissue sample to diagnose the type of brain tumour. Determination of the type of the tumor helps to ensure if the chemotherapy and radiaotherapy treatments will be useful for the patient.
There are different types of surgery to remove the brain tumor.
- Stereotactic Brain Biopsy: Stereotactic biopsy is a minimally invasive procedure. This procedure is used to remove a small amount of brain tissue from a small hole in the skull to determine if the the tumor is cancerous or benign.
- Craniotomy: Temporary removal of a small part of skull bone to enable the surgeon to locate and extract the tumor. The skull bone is replaced after the surgery
- Craniectomy: this is the same procedure as craniotomy but skull bone is not replaced after the surgery.
- Shunt: The surgical insertion of a drainage system into a ventricle in the brain to drain excess or blocked fluid to relieve the intracranial pressure.
- Transphenoidal Surgery: This procedure in which an endoscope or surgical instruments are inserted through the nose and the sphenoid bone to remove the tumours near the pituitary gland.
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RADIOTHERAPY FOR BRAIN TUMORS
Radiotherapy uses low dose radiation rays to destroy and stop or slow the growth of the tumor in the brain. Radiotherapy may be used on its own or after a surgical removal of the brain tumor. The treatment is providng with a machine called linear accelerator. Radiation treatments usually stars two weeks after the surgery.
Radiotherapy is used for;
- If the surgery isn’t possible
- to destroy remaining tumour cells after the surgery
- to prevent the recurrent of the tumor
- to reduce or stop the growth rate of the tumour.
IMRT (Intensity modulated Radiotherapy) for brain tumors
Intensity modulated radiation therapy is done by a machine called a linear accelerator which delivers radiation rays from different directions to the target tumor while avoiding nearby healthy tissues. IMRT allows to reduce the damage to healthy tissues and minimize the side effects. IMRT is very useful when treating tumors which are in the critical structures of the brain It’s often used with chemotherapy to treat the brain tumors. Treatment is delivered once in a day and five days in a week, for six weeks.
Stereotactic Radiosurgery for brain tumors
Stereotactic radiosurgery (SRS) is a a type of non-surgical radiotherapy used to treat small tumors in the brain. SRS can deliver a very high dose of radiation into the target tumor in only a single or few sessions. SRS is sometimes called Gamma Knife or Cyberknife treatment depending on the type of machine that is used.
There are three kinds of devices used to provide stereotactic radiosurgery.
- Gamma Knife Radiosurgery:
Gamma Knife is a stereotactic radiosurgical machine which is used to treat malignant and benign brain tumors. This machine delivers a single, focused, high dose of radiation to the tumour while causing little or no damage to healthy tissues. Patients can be treated with this noninvasive procedure in one day withiout needed to stay at the hospital. It is bloodless, painless and a patient can return to normal life rapidly. Gamma Knife can replace brain surgery for some patients. The patients who would be at risk for complications from the surgery may be a candidate for Gamma Knife radiosurgery.
- CyberKnife Radiosurgery:
This is is a noninvasive treatment option for patients who have inoperable cancerous and non-cancerous tumors. Cyberknife uses computer controlled robotics to deliver high dose of radiation to the target tumors throughout the body while causing less damage to surrounding healthy tissue. Patients can be treated with this noninvasive procedure in one to five days depending on the location and type of tumor. CyberKnife radiosurgery has been used to successfully treat brain tumors. The patients who would be at risk for complications from the surgery may be a candidate for CyberKnife radiosurgery.
It is a is an advanced medical linear accelerator and radiosurgery treatment system that allows to treat brain tumors while avoiding surrounding healthy tissue. TrueBeam radiotherapy system offers stereotactic radiosurgery (SRS), stereotactic body radiation therapy (SBRT), image-guided radiotherapy (IGRT) and intensity-modulated radiotherapy (IMRT). TrueBeam designed to deliver high dose of radiation to the target tumors throughout the body. It has been used to successfully treat brain tumors.
CHEMOTHERAPY FOR BRAIN TUMOURS
Chemotherapy uses anti cancer medications to destroy cancer cells. The medications circulate throug the body in the bloodstream and destroy the fast-growing cancer cells while causing least possible damage to healthy cells. It is hardly to treat brain tumors with chemotherapy drugs because of the blood brain barrier. Brain is protected by the blood brain barrier from harmful substances which are circulating in the blood. This protection system lets only a few types of medications such as temozolomide, procabazine, carmustine, lomustine, vincristine which are commonly used for the treatment of brain tumors.
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