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BRAIN CANCER
A tumor is a mass or growth of abnormal cells. Brain tumors are classified as primary, which start in the brain, or secondary, which start in another part of the body and spread (metastasize) to the brain. Primary brain tumors can be noncancerous (benign) or cancerous (malignant). Secondary brain tumors (metastatic brain tumors) are malignant and are more common. Either benign or malignant brain tumors may require treatment because, as they grow, they press on normal brain structures in the confined space inside the skull.
Dharamshila Hospital And Research Centre is one of the top cancer hospitals of India for advanced cancer treatment. Dharamshila Hospital offers a comprehensive program to diagnose and treat people with tumors of the brain, spinal cord and nerves that are outside of the brain and spinal cord (peripheral nerves). At DHRC, a multidisciplinary team work together to diagnose and treat people with brain tumors and provide the high-quality, integrated care.
A team of Neurosurgeons, Neuro-oncologists, radiation oncologists, medical oncologists and other medical specialties work together to treat each Brain Cancer patient. They consider each patient's type and extent of Brain Cancers to recommend the most appropriate treatment plan. They also carefully consider and select the treatment option that will allow the patient to maintain improved quality of life with good survival rate.
Neurologist usually diagnoses the brain tumour after reviewing history, doing a thorough neurological examination and reviewing imaging tests.
Imaging tests
Dharamshila Hospital has an international reputation for high-quality imaging and rapid results. Radiologists who specialize in imaging the brain and nervous system ensure that each examination is performed and interpreted to the highest standard of quality.
Imaging tests may include:
- Magnetic resonance imaging (MRI) scan. MRI is a technique that uses a magnetic field and radio waves to create detailed images of the brain. Sometimes a special dye is injected into the bloodstream to make tumors appear different from healthy tissue (MR angiography). Functional MRI scans may be done to identify critical brain areas involved in speech and motor activity.
- Computerized tomography (CT) scan. A CT scan uses a sophisticated X-ray machine linked to a computer to produce detailed, two-dimensional images of the brain. A CT scan can be very helpful in certain types of tumors, especially ones close to or involving bone.
- Other brain scans. Other tests - such as magnetic resonance spectroscopy (MRS), single-photon emission computed tomography (SPECT) or positron emission tomography (PET) scanning - help doctors gauge brain tumor activity and blood flow.
- Angiogram. A special dye is injected into the arteries that feed the brain, making the blood vessels visible on X-ray. This test helps locate blood vessels in and around a brain tumor.
Biopsy
A biopsy involves removing a piece of the tumor for viewing under a microscope. Oncologist needs to know the tumor type and grade to plan proper treatment.
At DHRC, a doctor who specializes in examining brain and nervous system tumors (neuropathologist) examines the tissue. This is critical for an accurate diagnosis. DHRC's neuropathologists are internationally known for their expertise in diagnosing brain tumors.
Tumor grading relates to how tumor cells look under the microscope. Grades 1 and 2 are low grade, Grade 3 is moderate, and Grade 4 is high. Low grade means that the tumor cells resemble normal brain cells. They usually grow slowly and are not likely to spread. In high-grade tumors, the cells look very abnormal and are more likely to grow quickly and spread.
Tumour Board Evaluation
Each and every Brain Cancer patient is evaluated by a special team of Neurologists, Neuro-oncoloigst, surgical oncologists (Head & Neck unit), Medical oncologists, Radiation Oncologists, Onco-pathologists and Imaging Specialists. Depending on the age, general condition, type of pathology and stage of the disease, a custom made treatment plan is charted out for each and every patient as per
International Treatment Guidelines.
Because new treatments continually develop, several options may be available at different points during treatment. The pros and cons of each option are discussed during treatment planning. Advanced technology at DHRC provides the neurosurgeon with real-time data on tumor volume and location during surgery.
A team approach
You may see several DHRC specialists from the brain tumor treatment team, including:
- Neurology. Patient's initial visit will likely be with a neurologist who has expertise and additional training in neuro-oncology. This doctor generally serves as the "quarterback" for your care, coordinating tests and specialist appointments, and developing a plan of care.
- Neurosurgery. neurosurgeons at DHRC are highly experienced, performing hundreds of brain surgeries each year, using the latest technological advances, such as intraoperative MRI, awake brain surgery and lasers.
- Radiation oncology. Radiation oncologists use Intensity Modulated Radiation Therapy (IMRT) to kill cancer cells. This highly complex and promising technique was started at Dharamshila Hospital in 2005. Now, IMRT is being delivered through VMAT techniques in a continuous arc around patient effectively, from infinite delivery angles; reducing the integral dose to one tenth and treatment time to few minutes. IMRT is used for tumours arising from Head and Neck, Brain, Lungs, Lymphomas and Gyneccological Cancers.
- Medical oncology. Medical neuro-oncologists manage chemotherapy or biological therapy, as well as medical disorders arising from the tumor or treatments. The neuro-oncology team of doctors, nurses and social workers use a careful and compassionate approach.
- Neuropathology. Identifying your type of cancer is crucial to providing appropriate treatment. Pathologists at DHRC are world renowned for their diagnostic skills.
- Neuroradiology. Neuroradiologists specialize in the imaging of brain tumors. DHRC performs thousands of diagnostic tests on the head, neck and spine each year. These images are essential in guiding neurosurgery or radiation treatments, or deciding about other treatment options.
- Other services. DHRC offers access to other services, including supportive care, counseling, neurocognitive and neuropsychiatric services, brain rehabilitation and pain management whenever needed.
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