Brain tumors are a common cause of death from neurological disease second only to strokes.

Q. What are brain tumors?

Ans : Brain tumors are intracranial solid neoplasm defined as a growth inside the brain created by uncontrolled and abnormal multiplication of cells.

Q : Are all the brain tumors cancerous?

Ans : No, all the brain tumors are not cancerous. They can be cancerous (malignant) or non-cancerous (benign)

Q : What is difference between cancerous and non-cancerous tumors?

Ans : Cancerous tumors grow fast with a rapid progression of symptoms within days to months. Non-cancerous tumors grow at a much slower speed and produce symptoms which gradually increase over months to years.

Q : Clinical signs/symptoms of brain tumors i.e. how do brain tumors present?

Ans : Brain is contained in the bony skull - that is a closed cavity. Any increase in volume caused by growth of tumor cells will cause an increase in pressure within the skull and result in symptoms. In addition, the location of tumor determines what function of brain is affected. The patient with brain tumor will present with the following symptoms -

• Headache-most common
• Nausea/vomiting
• Loss or alteration of consciousness
• Seizures or fits
• Behavioral changes, personality changes, confusion, irritability
• Visual disturbances like decreased vision, black-outs, double vision
• Sensation loss over the face
• Facial asymmetry
• Difficulty in hearing
• Difficulty in swallowing food
• Weakness or numbness of the limbs
• Speech difficulty

Q : What should be done if one is having these symptoms?

Ans : Seek expert opinion from Neurosurgeon/Neurologist

Q : What are the initial tests to be done?

Ans : Complete clinical examination done by expert doctor who regularly sees 
s uch patients

• Clinical examination includes –complete neurological examination, eye examination, ENT examination, general physical examination.
• CT scan or MRI scans – usually with dye (contrast)
• CT scan is the initial investigation of choice - easily available, cheap but with some radiation exposure
• MRI is the investigation of choice - has better delineation of the normal and abnormal brain tissue and is without radiation exposure.
• Sometimes both are mandatory to complement each other
• Other investigations may be required depending on characteristics of the tumor.

Q : What are different treatment options?

Ans : Observation in small, non-cancerous, slow growing tumors, with mild symptoms controlled with minimum medicines, especially in old people – usually done in very small number of patients

• Medical treatment to control symptoms before definitive treatment
• Micro-neurosurgery using a microscope to safely and delicately remove the tumor without damaging the normal brain tissue
• Endoscopic surgery – a minimally invasive technique using an endoscope to remove certain tumors through a small opening in the skull
• Stereotactic biopsy – using computer assisted techniques to safely take a small biopsy from deep seated brain tumors
  Radiation therapy - whole brain radiation
• Chemotherapy
• Radiosurgery – using highly focused beams of radiation to control small brain tumors without opening the skull or giving any incision

Q : What is the outcome of brain tumors?

Ans : In non cancerous tumors a complete cure is possible with the use of sophisticated diagnostic tests, advanced surgical techniques using modern technology, in the hands of experienced surgeons - especially if the tumors are diagnosed early. In cancerous tumors complete cure is possible in some patients whereas in others we can prolong the life and improve the quality of life.