A few surgical procedures to treat brain tumours

A diagnosis of a brain tumour is frightening news but today, cutting-edge research and treatment breakthroughs mean many people are enjoying longer and more productive lives, or are even cured.

The most effective therapy for you will be based on the type of tumour you have and its size and location. It also depends on your general health, age and medical history.

• If you have a benign or low-grade tumour, your doctor may simply want to keep the situation under close observation but not actively treat the tumour until it shows signs of growth.
• For all other tumours, your medical team’s immediate goal will be to reduce the size of the tumour as much as possible (sometimes by removing it altogether). Various approaches may be used in this assault, including surgery, radiation therapy, chemotherapy or new investigative procedures.
• While these techniques are sometimes used alone, most often they are deployed in various combinations, depending on the particular situation.

In all likelihood, to begin you'll have the standard treatment:  surgery.

• That may be all you need for some benign and Grade I tumours. In most cases, though, surgery can't completely remove the tumour without doing unacceptable levels of damage to your healthy brain tissue.
• However, surgery can reduce the tumour’s size to alleviate your symptoms and often make other therapies more effective.

• If your tumour can't be removed because it’s too deep or is intertwined with healthy brain tissue, the surgeon may take a sample of it for a biopsy — an examination under a microscope.
• This reveals what type of tumour you have and helps your medical team determine which other treatments will be most effective.
• Neurosurgeons have a number of techniques in their surgical arsenal. If the tumour is close to the surface of your brain, you'll probably have a craniotomy.
• Your surgeon will take out a piece of skull over the part of your brain near the tumour, remove the tumour as completely as possible and replace the bone.
• If your tumour is in an area of your brain that controls motor function or speech, your doctor may perform surgery under local anesthesia to better measure your nerve response during the operation.
• If the tumour can't be reached easily, another option is laser microsurgery, which vapourizes cancer cells with a specific type of laser beam. Your doctor may do this as a single procedure, or as an adjunct to a craniotomy.
• For this surgery, the surgeon may use a guidance system called stereotactic localization (stereotaxy), in which a rigid frame is screwed into the head and an attached scanning device displays a three-dimensional map of the brain, allowing the tumour’s exact location to be pinpointed. A frameless stereotaxy has also been developed.
• After surgery, in most cases you'll have radiation therapy. This is to eradicate microscopic cancer cells left behind in the surrounding brain tissue. Radiation is also used to shrink any part of the tumour that remains, or tumours that are out of reach or inoperable.
• If you have a metastatic malignant tumour, radiation is the mainstay therapy, and is typically directed at the whole brain to root out unseen problems. For some benign tumours, radiation is the only treatment needed.
• Radiation can have serious side effects, including temporary hair loss, nausea and fatigue, as well as destruction of healthy tissue near the tumour (radiation necrosis). However, studies show that for people with certain malignant brain tumours, it can significantly prolong life.

Medical professionals and scientists continue to find new ways to combat cancer. If you are in this situation, be sure to research your options and work with your doctor to find what is best for you.