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.
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 Cancer doctor In noida 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 a good survival rate.
Brain Cancer doctor In noida
Types of Brain Cancer
1.Primary :Tumors that originate within brain tissue are known as primary brain tumors. Primary brain tumors are classified by the type of tissue in which they arise. The most common brain tumors are gliomas, which begin in the glial (supportive) tissue. There are several types of gliomas, including the following:
2.Secondary :Secondary brain tumors are tumors caused from cancer that originates in another part of the body. These tumors are not the same as primary brain tumors.
The spread of cancer within the body is called metastasis. Cancer that spreads to the brain is the same disease and has the same name as the original (primary) cancer. For example, if lung cancer spreads to the brain, the disease is called metastatic lung cancer because the cells in the secondary tumor resemble abnormal lung cells, not abnormal brain cells.
Treatment for secondary brain tumors depends on where the cancer started and the extent of the spread as well as other factors, including the patient’s age general health, and response to previous treatment.
Astrocytomas arise from small, star-shaped cells called astrocytes. They may grow anywhere in the brain or spinal cord. In adults, astrocytomas most often arise in the cerebrum. In children, they occur in the brain stem, the cerebrum, and the cerebellum. A grade III astrocytoma is sometimes called anaplastic astrocytoma. A grade IV astrocytoma is usually called glioblastoma multiforme.
Oligodendrogliomas arise in the cells that produce myelin, the fatty covering that protects nerves. These tumors usually arise in the cerebrum. They grow slowly and usually do not spread into surrounding brain tissue.
Ependymomas usually develop in the lining of the ventricles. They may also occur in the spinal cord. Although these tumors can develop at any age, they are most common in childhood and adolescence.
Meningiomas grow from the meninges. They are usually benign. Because these tumors grow very slowly, the brain may be able to adjust to their presence; meningiomas may grow quite large before they cause symptoms. They occur most often in women between 30 and 50 years of age.
Schwannomas are benign tumors that arise from Schwann cells, which produce the myelin that protects peripheral nerves. Acoustic neuromas are a type of schwannoma. They occur mainly in adults. These tumors affect women twice as often as men.
Craniopharyngiomas develop in the region of the pituitary gland near the hypothalamus. They are usually benign; however, they are sometimes considered malignant because they can press on or damage the hypothalamus and affect vital functions. These tumors occur most often in children and adolescents.
Germ cell tumors arise from primitive (developing) sex cells, or germ cells. The most frequent type of germ cell tumor in the brain is a germinoma.
Pineal region tumors occur in or around the pineal gland, a tiny organ near the center of the brain. The tumor can be slow growing (pineocytoma) or fast growing (pineoblastoma). The pineal region is very difficult to reach, and these tumors often cannot be removed.
Stages of Brain Cancer
Below is description of the various tumor grades, based on the World Health Organization (WHO) grading system.
Grade I is a separate group of tumors called juvenile pilocytic astrocytoma (JPA). The term juvenile does not refer to the age of the patient, but the type of cell. This is a noncancerous, slow-growing tumor that can often be cured with surgery. It is different from a low-grade astrocytoma or Grade II glioma, which is likely to come back after treatment.
A grade II tumor does not have dead cells in the tumor, called necrosis, but shows an abnormally large number of cells, called hypercellular. A grade III tumor is hypercellular and has cells that are actively dividing, called mitosis. It is often called anaplastic astrocytoma.
A grade IV tumor is usually a glioblastoma, also called glioblastoma multiforme or GBM. Cells in the tumor are actively dividing, and it has blood vessel growth and areas of dead cells in addition to the factors common to grade II and III tumors.
In adults, the age of the patient and his or her level of functioning, called functional status (see below) when diagnosed is one of the best ways to predict a patient’s prognosis. In general, a younger adult has a better prognosis.
Resection is surgery to remove a tumor, and residual refers to how much of the tumor remains in the body after surgery. Four classifications are used:
- Gross total: The entire tumor was removed. However, microscopic cells may remain.
- Subtotal: Large portions of the tumor were removed.
- Partial: Only part of the tumor was removed.
- Biopsy only: Only a small portion, used for a biopsy, was removed.
A patient’s prognosis is better when all of the tumor can be surgically removed.
A tumor can form in any part of the brain. Some tumor locations cause more damage than others, and some tumors are harder to treat because of their location.
The doctor will test how well a patient is able to function and carry out everyday activities by using a functional assessment scale, such as the Karnofsky Performance Scale (KPS), outlined below. A higher score indicates a better functional status. Typically, someone who is better able to walk and care for themselves has a better prognosis.
- 100 Normal, no complaints, no evidence of disease
- 90 Able to carry on normal activity; minor symptoms of disease
- 80 Normal activities with effort; some symptoms of disease
- 70 Cares for self; unable to carry on normal activity or active work
- 60 Requires occasional assistance but is able to care for needs
- 50 Requires considerable assistance and frequent medical care
- 40 Disabled: requires special care and assistance
- 30 Severely disabled; hospitalization is indicated, but death not imminent
- 20 Very sick, hospitalization necessary; active treatment necessary
- 10 Moribund, fatal processes progressing rapidly
- 0 Dead
A tumor that starts in the brain or spinal cord, if cancerous, rarely spreads to other parts of the body in adults, but may grow within the CNS. For that reason, with few exceptions, tests looking at the other organs of the body are typically not needed. A tumor that does spread to other parts of the brain or spinal cord is linked with a poorer prognosis.
Certain molecular markers found in the tumor tissue can provide information on whether treatment will work well. For instance, for oligodendroglioma, the loss of part of chromosome 1 on the part of the chromosome, and the loss of part of chromosome 19 on the q part of the chromosome, called a 1p and 19q co-deletion is linked to more successful treatment, particularly with chemotherapy, and can be used to help plan treatment, especially for anaplastic oligodendroglioma.
Mutations in the isocitrate dehydrogenase (IDH) gene, which is found in about 70% to 80% of low-grade gliomas in adults has been linked with a better prognosis. Higher-grade tumors can also have IDH gene mutations, which suggest that these tumors started as lower-grade tumors that became a higher grade. This mutation is also linked with a better prognosis in higher-grade tumors.
Prevention of Brain Cancer
Tumor Board Evaluation
Each and every Brain Cancer patient is evaluated by a special team of Neurologists, Neuro oncologist, 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
A team approach
- 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, 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. 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 tumors 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 caring and compassionate approach.
- Neuro-pathology– Identifying your type of cancer is crucial to providing appropriate treatment.
- Neuroradiology-Neuroradiologists specialize in the imaging of brain tumors. Doctors perform 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 – We offer access to other services, including supportive care, counseling, Neuro-cognitive and Neuro-psychiatric services,brain rehabilitation and pain management whenever needed.