By Dr. Anandh Balasubramaniam
Brain tumors are the commonest solid tumors in children and in adults form a major chunk including brain metastases.
The awareness of brain tumors is increasing day by day due to earlier diagnosis possible due to advanced imaging technology available like MRI in almost all cities and even towns. Technological advances have not only made the diagnosis easier and earlier than before, but also has made treatment for brain tumors safe and effective. Earlier days brain tumor was doomed to be end of patient’s life and there was fear of brain surgery even among doctors. But now modern imaging with MRI, ability to see functioning nerve centers before the operation, visualizing the nerve bundles pre operatively have all helped to make safe operative treatment planning and execution without harming patients functioning status.
Even difficult to locate deep seated tumors can be operated safely nowadays with Navigation technology and intra operative imaging technology like navigable ultrasound and intra op MRI. Modern anesthetic techniques help us do awake anesthesia where we can operate with the patient aware and moving the part of the body, we want to preserve the function of. Intra op Neurophysiology monitoring gives valuable information of intactness of the nerve bundle or tracts as we operate and help us preserve them well to maintain function. It also cautions us when we reach those areas making it safe surgery and enhances tumor resection to completeness as much as possible safely.
The resection of the tumor itself is well achieved with newer technologies like CUSA which helps remove tumor tissue selectively, Fluorescence guided resections ( ALA and yellow) also help in the same goal. Apart from invasive surgeries being made safe, technology has helped in Minimally Invasive approaches for tumor removal or treatments too. Endoscopic advances have made some of these brain tumors especially in the base of skull like pituitary tumors to be removed completely through the nose safely.
Without invasive surgery, some tumors even benign ones can nowadays be treated with radiation using technique of Radiosurgery where radiation is delivered precisely to the tumor area only in a short span of time there by saving normal surrounding tissue and effectively controlling tumor growth with one sitting of treatment. Laser ablation technology has enabled small recurrent tumors to be treated with minimal invasive approaches avoiding full open surgery too.
Not only in primary surgery and treatment of brain tumors, but also in understanding the nature of tumors has increased for the better with advances in molecular genetics and diagnostic pathology. This enables us to classify and prognosticate tumors better for the well being and quantify patient expectations better post treatment. Personalization of brain tumor treatment according to genetic variations is also coming close and is beneficial already in some metastatic brain tumors.
Rehabilitative measures especially Neurorehabilitation advances with use of preventive and restorative techniques has made recovery from brain tumor surgery or impact quicker and effective for the patients. Robotic assistance in patient physiotherapy is a big boon for quicker return to normalcy.
Thus, all the newer advances in diagnosis, treatment and recovery techniques for brain tumors have made this dreaded disease bearable and make treatment of these safely and effectively and reality with team based specialist approaches.
(The author is the HOD, Neurosurgery, Amrita Hospital, Faridabad. The article is for informational purposes only. Please consult medical experts and health professionals before starting any therapy, medication and/or remedy. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)
