Brain Tumour Treatment: What Are The Surgical & Non-Surgical Options?

Tumours are abnormal masses of tissues formed due to rapid and unprecedented cell division. They may be malignant (cancerous) or benign (non-cancerous). When these tumours start in the brain or spread to the brain from other body parts, they are called brain tumours. Brain cancer is the condition when brain tumours turn malignant. About 3.7 per 100,000 males and 2.6 per 100,000 females worldwide get affected by brain tumours annually. The principal methods of brain tumour treatment are surgery, radiotherapy, and chemotherapy. The five-year survival rate after treatment is 36%. The recovery depends on the individual's health, age, presence or absence of comorbidities, and the efficacy of the brain cancer treatment plan. This article explores the details of surgical and non-surgical approaches tobrain tumour treatment.

Explanation of Brain Tumours

An abnormal mass of cells in and around the brain is called a brain tumour. 78% of adult malignant brain tumours are gliomas (originating in the brain or spinal cord). Brain tumours can be of two types:

• Primary brain tumour:Tumour originating in the brain
• Secondary brain tumour:A metastatic tumour caused by the spread of cancerous cells to the brain from other organs

Types of Brain Tumour Treatment Options

Although only one-third of brain tumours are cancerous, all brain tumours can affect brain function. The two main approaches to brain tumour treatment are:

• Surgical:It follows the invasive approach to remove the tumour cells.
• Non-surgical:It includes non-invasive surgical procedures without needing an invasive brain tumour surgery.

Overview of the Importance of Identifying Treatment Options

Brain tumour or brain cancer treatment methods differ from individual to individual. It depends on the following significant factors:

• Age
• Type
• Location
• Size
• Overall health
• Possible side effects

Brain tumour treatment schedules differ for children and adults. Choosing the correct treatment approach based on the above factors is crucial to ensure the best outcomes.

Surgical Treatment Options for Brain Tumours

Brain tumour surgery is usually the first line of treatment for brain tumours. It involves removing the tumour along with surrounding tissue. Surgical options improve the prognosis of individuals with brain tumours. Recent advancements in surgery (like using cortical mapping, enhanced imaging, and fluorescent dyes) and neuronavigation tools that help achieve maximum resection (cutting out affected tissue) have boosted recovery rates.

Craniotomy

Craniotomy involves surgically removing an area of bone from the skull. The opening created enables the surgeons to operate and remove the tumour. MRI or CT scans give the exact tumour location before starting the craniotomy procedure. After it is over, the surgeons reconstruct and place the bone flap back into the skull (cranioplasty).

Endoscopic Surgery

This minimally invasivebrain tumour surgeryinvolves inserting a thin tubing (endoscope) through tiny incisions in the skull. The tubing/endoscope relays video images of the brain to help surgeons examine the tumour location and remove it. The procedure is termedendoscopic endonasal surgery, when surgeons insert thin tubing through the nose or sinuses to access the brain tumour.

Stereotactic Radiosurgery

Stereotactic Radiosurgery surgical method involves using radiation to destroy the DNA of the tumour cells. Once these tumour cells lose the ability to reproduce and replicate, the tumour size starts shrinking. There is minimal damage to the surrounding healthy tissues through this technique.

Neuroendoscopy

Like endoscopic surgery, neuroendoscopy is a minimally invasive procedure to treat brain tumours through tiny incisions in the skull or nose/mouth. Doctors recommend this procedure if the tumour is not easily accessible through traditional surgical methods. Using HD cameras provides a clear image compared to SD cameras.

Biopsy

Removing a small amount of the affected tissue and examining it offers a proper diagnosis before beginning the brain cancer treatment. This method is called a biopsy. After conducting a biopsy, the patient may receive steroidal doses to relieve brain swelling caused due to the biopsy.

Side Effects of Surgical Treatment

Most side effects after brain tumour surgery depend on the tumour location in the brain. Surgical complications like retention of foreign objects, wrong-side surgery, and neurological issues may lead to post-surgery complexities. Although surgery is a relatively safe procedure for brain cancer treatment, individuals may develop some after-effects, as described below.

Infection

Intracranial infections, such as meningitis or brain abscess, may occur after brain tumour treatment via surgery. Immediate diagnosis can save further complications. Some common signs of infection post-surgery are:

• Pus oozing out of the incision
• Swelling and redness in the incision area
• Fever
• Swollen lymph nodes

Bleeding

It is a common occurrence after a brain tumour surgery. In some cases, a haemorrhage may occur. Excessive bleeding may also result in post-operative epidural haematoma if not treated timely.

Swelling

A persistent swelling in the brain post-surgery may increase the pressure inside the skull. Doctors may prescribe steroids to reduce the inflammation if it does not subside in a few days. Recurrent headaches are the common symptoms of swelling in the brain.

Non-Surgical Treatment Options for Brain Tumours

Many innovative therapies have made treating brain tumours without surgical intervention easy. Most benign brain tumours are curable through non-invasive methods. For malignant ones, surgery may be necessary. However, post-surgery, non-surgical treatment options help ensure there is no relapse. The following section describes some popular non-surgical options for brain tumour treatment.

Radiation Therapy

It involves introducing radioactive components in the tumour site and using radiation to stop or slow the tumour growth. The chief applications of radiation therapy in brain cancer treatment are:

• Reducing the tumour size
• As a part of palliative care
• Reducing the risk of recurrence of tumours post-surgery

Chemotherapy

It involves introducing cytotoxic (anti-cancer) drugs into the bloodstream to destroy the tumour-causing cells. Chemotherapy can prevent the recurrence of brain tumours to some extent. It cantreat several brain tumours, such as metastatic cancer and gliomas.

Electro-Field Therapy

This innovative non-invasive technique involves applying mild electrical fields through the skin of the scalp. The goal is to disrupt the cancerous cell division at the tumour site. It arrests the tumour's ability to spread or metastasise. Studies show that this alternating electric field therapy can inhibit cancer cell growth effectively.

Symptomatic Treatment

Managing the symptoms and conservatively treating brain tumours are other novel ways of treating this condition non-surgically. Doctors recommend this approach in cases where the brain tumour is not curable through surgery. Anti-epileptic medicines, hormonal treatment, painkillers and steroids are instrumental in controlling the symptoms and managing tumour growth.

Target Therapy

Target therapy involves administering medicines that target the tumour-causing cells' genes or proteins. It arrests the growth of tumour-causing cells and minimises damage to the surrounding healthy tissues. This therapy uses anti-cancer drugs that breach the blood-brain tumour barrier and prevents further tumour cell growth.

Side Effects of Non-Surgical Treatment

Non-surgical brain cancer treatment options like radiation therapy and chemotherapy can cause short-term effects. They usually subside in a few weeks. However, some individuals may develop lifelong complications like hair loss or thinning, skin reddening, and worsening symptoms.
Here are some common after-effects of non-surgical treatment of brain tumours.

Fatigue

Sometimes, radiation therapy and chemotherapy may damage the surrounding healthy cells, along with the cancerous cells. It leads to unexplained tiredness and energy depletion. This fatigue may exist for weeks or months after non-surgical brain tumour treatment.

Nausea and Vomiting

Chemotherapy and radiation therapy to the brain can cause an unpleasant feeling in the throat and nasal region. If not controlled, nausea and vomiting can cause additional health issues, such as appetite loss, dehydration, and chemical changes in the body. Relaxation techniques, acupuncture, and dietary changes help in controlling this side effect.

Cognitive Changes

Some individuals may have trouble concentrating and memory after undergoing non-surgical brain tumour treatment. Radiation, immunotherapy, or chemotherapy-induced cognitive decline induces verbal and spatial memory loss and mental fog. These problems may arise during or after treatment.

Conclusion

Although brain tumours are curable, if diagnosed early, they may recur. Abrain tumour surgeryis the standard treatment option to remove the tumour and surrounding tissue. Non-surgical methods like chemotherapy and radiation therapy may be applicable to arrest the further growth of cancerous cells post-surgery or to treat benign tumours. The most effective treatment option differs based on factors like age and the individual's health.

Frequently asked questions

1) What is the survival rate for brain tumours?

Survival rates vary by age. According to statistics, the average five-year survival rate is about 36%. The ten-year survival rate is around 30%.

2) What is the prognosis for a brain tumour?

Some individuals recover well after a brain tumour surgery. Others may experience long-term complications post-surgery or treatment. Brain tumours are among the most lethal tumours. Brain tumours of glial (supporting cells of the brain and spinal cord) origin have an average survival rate of 12-15 months.

3) What is the follow-up of a brain tumour?

Since brain tumours are likely to recur, a routine follow-up is necessary for further investigation. The doctors monitor the patients for new symptoms and may ask for blood tests or MRI scans. It helps them determine if the tumour is growing back again.

4) Is radiation therapy an effective treatment option for all types of brain tumours?

Radiation therapy can treat most metastatic brain tumours since it destroys the cancerous cells. It can cure small, benign and low-grade brain tumours effectively. For high-grade tumours, it can only restrict the growth of cancerous cells.

5) Can a patient choose a non-surgical treatment option for a brain tumour instead of surgery?

Yes. In some cases, brain tumour surgery may not be necessary. Non-surgical options like chemotherapy or radiation therapy will suffice. Non-surgical methods can effectively treat or shrink benign brain tumours and kill the tumour cells.