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Brain Tumor – Frequently Asked Questions

What is Brain Tumor?

Brain tumor is a mass of abnormal cells in a part of the brain. Brain tumour may be benign tumour (not a cancer) or malignant (cancer). They are found in both adult & children.

How do I know that I have brain tumor? What are the signs & symptoms? 

Signs & symptoms of brain tumors depend on the part of the brain involved. According to a renowned neurosurgeon in Gurgaon from Fortis Memorial Research Institute (FMRI), the early signs of brain tumor include

  • Headache that gets worse with time may be an early sign of brain tumor. It may or may not be associated with vomiting. Moreover, not all brain tumors have headache as an early sign.
  • Seizures may be another early symptom. The neurologist will evaluate whether seizures are because of brain tumour or other cause.
  • Nausea/vomiting
  • Blurred vision
  • Imbalance of body (Gait abnormalities)

Other symptoms of brain tumors develop based on the part of brain involved. Tumors in:

  • Parts of Cerebrum (outer part of brain) – weakness, numbness of one side of the body.
  • Areas close to the cerebrum – Difficulty to speak
  • Front part of cerebrum – May hamper thought process, or affect personality development as well as language.
  • Basal ganglia – can cause abnormal movements of body.
  • Cerebellum – Difficulty with regular activities like walking.
  • Areas near to the pituitary or optic nerves cause problems with vision
  • Areas near to cranial nerves – loss of hearing, difficulty swallowing

What is the difference between benign and malignant tumor?

Benign brain tumor is not a cancer. It grows slowly & does not spread. Whereas, malignant brain tumor is a fast growing and it can spread to other parts of brain & spine.

What are the risk factors of brain tumor?

One of the major risk factors of brain tumor is Radiation Exposure. Those who undergo radiation therapy very often develop the risk of the formation of the brain tumor more than others. Brain tumor does not run in families usually; however there are rare instances of genetically inherited brain tumors.

People having disorders in the immune system may develop brain tumor (lymphomas).

Controversial risk factor: Excessive use of cell phones may cause brain tumor as the radio frequency wave emitted by the mobile phone is extremely harmful. The matter is debatable and nothing has been proved yet.

How is it diagnosed?

Diagnosis of brain tumors includes detailed history & detailed neurological examination of the patient. If the history & examination are suggestive of tumors, patient is referred to an experienced neurosurgeon who then evaluates the medical condition of the patient using a combination of the following diagnostic methods

Neurological Examthat includes a thorough checking of the various body parts- eyes, ears, touch, balance, reflex, coordination, thought process etc.
MRI (Magnetic Imaging Resonance): MRI Head helps to detect brain tumors & tumor in the spinal cord. Various types of MRIs (advanced technology) are available these days to study the tumors
MRA (Magnetic Resonance Angiography): MRA helps to see the blood supply of the brain tumors. It is useful to study tumors before brain tumor surgery.
MRS (Magnetic Resonance Spectroscopy): It helps to see the features of brain tumor which can’t be seen with the help of a normal MRI scan.
Functional Magnetic Resonance Imaging: It is an advanced MRI which helps to study the different areas of the brain which control different important functions of the body. These areas can be spared during the surgery with the help of this MRI.
Magnetic Resonance Perfusion Study: A special dye is administered into the blood vessels near to the tumor & MR scans are taken. It helps to plan the brain tumor surgery.

CT scan of brain is not as much used as MRI in case of brain tumors. It is done in cases where MRI cannot be done.

CT Angiography: A dye is injected into the blood vessels, followed by CT scan imaging. It helps to see the blood supply of the tumor & helps in making decisions about surgery.
Positron Emission Tomography (PET): PET is not a routinely done imaging in brain tumors. A dye is injected in the blood vessels
Biopsy: Once a tumor is detected, a small sample of it is taken to be examined under the microscope to test if it is cancerous. Needle biopsy or open biopsy can be done.
Lumber Puncture: This procedure is done to examine presence of cancer cells in CSF (fluid present in spinal cord & ventricles in brain)

Who treats Brain Tumors?

Typically, brain tumors are treated by experienced neurosurgeon (who perform surgeries of brain). In some cases, the treatment may also be done by radiation oncologist (who treat cancers with the help of radiation therapy), medical oncologist (who treats cancers with the help of medical oncologists) or by endocrinologist (who treat diseases related to hormones; hormone secreting tumors may be treated by endocrinologist).

The treatment modality depends on the type and location of tumors. Some types of brain tumors are treated by surgical removal. Some types are treated with the help of either radiation therapy or chemotherapy or targeted therapy or a combination of either of these or all.

What questions should I ask my doctor before treatment?

  • Is it cancer?
  • What is the type of my tumour?
  • Where in the brain it is located? Has it spread to other areas of the brain/body?
  • What all tests do I need to get done?
  • What is your experience in treating this type of cancer?
  • What is the best treatment option for me?
  • Will I need radiation therapy or chemotherapy?
  • What will be the risks/complications of the treatment?
  • How long will the treatment take?
  • What will be the cost of treatment?
  • What are the chances of tumor coming back in my body?

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