Brain tumors are on the increase -- there is no doubt about it. In the past, they were found more often in elderly people in their 70s, but nowadays, more younger and middle-aged adults are being diagnosed with brain tumors.
In children, it is the second most common cancer after leukemia, and in some countries, it has overtaken leukemia!
Although no definite cause has been found, risk factors have been identified.
First, brain tumors are more likely to develop in males; second, if there is a family history of tumors; and last, exposure to radiation, chemicals such as formaldehyde, vinyl chloride and acrylonitrile, and perhaps mobile phone usage increases the risk.
It will take a few more years before we know for sure, but at least, the treatment methods today are more advanced and better than ever before.
What are the symptoms?
Brain tumors result from an abnormal growth of cells in the brain. Something triggers the cells to grow excessively and create a tumor. When this reaches a certain size, it will cause clinical symptoms.
Brain tumors are either primary or secondary, meaning they start in the brain (primary) or in another part of the body (secondary) and then spread to the brain. They can be benign (slow-growing, such as over 10 years or more), or malignant (fast-growing and invasive, such as over one to two years).
Although symptoms depend on the location and size of the brain tumor, the most common are worsening headaches which are more severe in the morning, sometimes accompanied by nausea and vomiting, and changes in vision such as blurred or double vision.
There may be confusion, changes in personality, weakness of the arms or legs, slurred speech, hearing loss or even epilepsy. If any of these occur and are recent in onset, it is best to see a doctor for investigations.
The next question is, how is the diagnosis being made?
The doctor will first perform a neurological examination, which evaluates the cranial nerves, vision, hearing, balance, reflexes and motor coordination.
Radiological tests of the brain will then be performed, such as CT scan, MRI scan, angiogram, magnetic resonance spectroscopy and single-photon emission computerized tomography (PET). (Figure 1. Picture of MRI brain scan showing a tumor).
What is the treatment?
Since brain tumors are complex, treatment requires a team of specialists -- usually led by a neurosurgeon, and will include a neurologist, radiologist, neuro-anesthetist, oncologist and radiotherapist.
The primary and most important first step in the treatment of a brain tumor is neurosurgery.
"The goal of surgery is to remove as much of the tumor as possible while leaving neighboring healthy brain tissues intact," said Dr. Keith Goh, Consultant Neurosurgeon and Medical Director of Neurosurgery Centre at the Eastshore Hospital in Singapore.
There are many new technologies available to the surgeon, which make brain surgery safer, more accurate and with less complications than ever before, he said.
For example, they can now use computerized image-guidance operating systems (IGS), similar to a GPS system, which enables surgeons to pinpoint the exact location of the tumor, and make a small, key-hole surgical incision.
"Sometimes we can use a neuro-endoscope to look into the brain and remove the tumor under direct visualization."
Following surgery, the tumor tissue will be analyzed and the tumor type will be determined. Radiation therapy or chemotherapy may be needed, especially if the tumor is malignant.
Additional treatments and medication will focus on alleviating the symptoms of the brain tumor, such as a shunt to drain excess cerebrospinal fluid, and drugs to reduce seizure activity and brain swelling.
What is the recovery process?
Sometimes the surgery may require removal of certain parts of the brain, and there may be movement, speech or feeding difficulties after surgery.
Various forms of therapy will help you recover or modify your activity to cope with your condition. For example, physiotherapists can help you recover a range of motion and power, and a speech therapist can help you speak and eat better.
The important things to know are that a brain tumor should be diagnosed early and treated early, so that the outcome will be good. Today, medical knowledge, surgery skills and operating room technology have made brain tumors a treatable and often curable condition.
Articles in this column, which will appear every two weeks, are provided by a panel of health professionals from www.flyfreeforhealth.com, a leading multimedia medical tourism platform dedicated to providing travel and lifestyle incentives for those adopting a healthy lifestyle.
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