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Making a decision about cancer treatment can be distressing. Some types of brain tumors grow and spread rapidly while some develop slowly. For every person, the effects of cancer can be different, depending on the type of cells that are affected, the stage of cancer, personal health and many other factors. Therefore, the treatment approach is also varies based on the individual condition. A multidisciplinary team consisting of neurologists, neurosurgeons, medical oncologists, surgical oncologists, radiation oncologists, special nurses, counsellors and social workers are involved in the care of brain tumor patients. After complete diagnosis and staging, the medical team works on a treatment plan that will be most effective and successful for the patient.
This is based on many factors, such as:
- Patient’s age, overall health, and medical history
- Type, location, and size of the tumor
- Whether the tumor has spread or metastasized to other parts
- The cells that are affected by the cancer
Personal tolerance for specific types of medications, procedures, or therapies
Treatment for symptoms usually involves certain medications such as:
- Anti Seizure/Antiepileptic Drugs (AEDs)
- Painkillers for headaches
- Antiemetic medications to prevent vomiting
The low-grade tumors (grade I and II) are not very aggressive and can be treated with careful monitoring or surgical intervention alone. All tumors are regularly monitored through repeat scans. Grade II tumors are observed more closely after surgery to look out for chances of recurrence.
The tumors of higher grade (grade III and IV) are malignant and can grow quickly. These are more difficult to treat and need additional therapies along with surgery, such as radiation, chemotherapy, or even a clinical trial if available. There are chances that microscopic tumor cells may remain after surgery that can eventually grow back. Therefore, all treatments methods intend to prolong and improve the quality of life of the patients for as long as possible.
Brain tumor treatment mainly involves the following:
Surgical removal of tumor:
Surgery is usually the primary treatment for brain tumors. To remove a brain tumor, the neurosurgeon makes an incision in the skull, this is called a craniotomy. The surgeon attempts to remove entirely. If the tumor cannot be removed completely without damaging other vital brain tissues, the surgeon may remove as much of the tumor as possible. The partial removal of the tumor will help in relieving certain symptoms by reducing pressure on the brain (intracranial pressure) and reduce the size of tumor. Additional methods such as radiation therapy or chemotherapy are then used to kill cancer cells.
Radiation therapy (radiosurgery techniques):
Radiation therapy involves the use of high-energy beams, such as X-rays or protons, to destroy tumor cells. It can be delivered from a machine outside of the body (external beam radiation), or radiation source can be placed inside the body, near the brain tumor (brachytherapy).
Stereotactic radiosurgery is also a type of radiation therapy and is not actually surgery in the traditional sense. Radiosurgery techniques such as Gamma knife, CyberKnife and Novalis, use multiple beams of high-precision radiation to target the tumor cells with pin-point accuracy. This minimizes the damage to surrounding healthy tissues. The beams of radiation are not particularly powerful, but they are all focused at the brain tumor to provide a large dose of radiation to destroy the tumor cells.
Chemotherapy uses anti-cancer drugs to kill tumor cells. This usually is to halt the growth, division and proliferation of the tumor cells. Chemotherapy is usually delivered in a specific number of cycles over a set period of time. The patient may receive one or a combination of different drugs at a time. The goal is to kill tumor cells that remain after the surgery, or slow their growth.
Targeted therapy uses certain drugs that targets the tumor’s specific genes and proteins which contribute to the growth and survival of the tumor. This treatment method has an advantage of blocking the growth and spread of tumor cells while restricting the damage to healthy cells.
The target is not for every type of tumor, and some might have more than one target. For the most effective treatment, many tests are done to identify the genes, proteins, and other factors in the tumor that can be targeted. For brain tumors, two types of brain tumor therapy are used - Bevacizumab (Avastin, Mvasi), an anti-angiogenesis therapy and Larotrectinib (Vitrakvi), a type of targeted therapy not specific to a certain type of tumor.
The best hospitals for brain tumor in India offer all types of treatment for all-round, quality patient care. These hospitals are accredited by national and international organizations for their standard of services and facilities. The cancer specialists in India are renowned and highly experienced doctors with expertise in various types of cancer treatments.