Early detection of brain tumours, key to survival

Tumours of the Central Nervous system account for to 2 per cent of all the cancerous tumours. Only 35 per cent of people survive for five years after being diagnosed with brain tumour and the survival depends on several factors, including how early it is diagnosed, size, the location, type of the tumour and treatment. With the advent of modern medical imaging technologies, advanced surgical techniques, state of art radiation therapies and targeted medicines, survival rate has vastly improved.

Awareness and early detection of brain tumours play a crucial role in controlling them and saving lives through early treatment. Following are some of the warning symptoms of brain tumour which should warrant immediate consultation with a neurosurgeon:

1. Any persistent/recurring headache with vomiting or nausea

2. Seizures

3. One sided weakness of limbs or difficulty in walking

4. Blurry of vision and double vision

5. Difficulty in speech and hearing disturbances

6. Very rarely abnormal psychological behavioural changes.

A tumour that starts in the brain tissues is called primary brain tumour and it accounts for 85 per cent-90 per cent of the brain tumours. 10-15 per cent of the cases that are affected by a tumour that starts elsewhere in the body and spreads to the brain called as secondary brain tumour or brain metastasis. 

Primary brain tumour can be benign (slowly growing) or malignant (highly aggressive). Roughly one fourth of brain tumours (23.2 per cent of Indian population) are benign in nature. The highly aggressive malignant types called as glioblastoma accounts for the next 15.5 per cent. Other tumours include low grade gliomas, nerve sheath tumours, pituitary tumours and rarer tumours in decreasing incidences. 

Brain tumours can occur at any age. In very young children of less than 10 years of age, normally malignant tumours are found in one third of cases. As the age increases, low grade and benign tumours are common, except above 50 years when malignant tumours again rise in incidence to up to 35 per cent. And incidentally malignant tumours are more common with males in comparison to females with a ratio of 1.86:1.

The exact cause of brain tumour is not clear. Most cases have unknown causes, some are linked to genetic diseases with family history and recently the emergency threat of exposure to ionising radiation and radio frequency waves from mobile phones cannot be discounted. Brain tumours can be easily suspected with symptoms and confirmed with MRI scanning. Technical advances in imaging have helped to detect brain tumour in a very early stage when it is small and curable.

Most of the benign tumours are curable by surgery alone. Malignant tumours are treated with surgery followed by chemotherapy and radiotherapy. Following advances in surgical techniques like high magnification microscopes; awake craniotomy (where patient is awake during the entire operation); intra operative dye injection for differentiating the tumour tissues from normal tissues; scanning and neurological monitoring during surgery helps in safe complete removal of the tumour without neurological deficits. 

Radiation therapy and chemotherapy plays a critical role in arresting the tumour progression in malignant cases and increasing the survival of the patient. Modern treatments like targeted gene therapy, stem cell therapy and antibodies are in the phase of clinical trial. Proton therapy in radiation therapy is a new adjunct in our arsenal.