Brain Tumour - Latest Development in Treatment Strategy

written by Dr Chee Chee Pin on 15 May 2013
Brain tumours can be benign or malignant, primary or secondary metastasis from cancers outside the head.
Common benign brain tumours are meningiomas arising from the meninges or dura, acoustic neuroma from 8th hearing nerve, pituitary tumours.
Primary Maglinant tumours include gliomas, lymphomas, germ cell tumours and sarcomas.
Brain tumours can present in the following ways :
a. Raised intracranial pressure with headache, vomiting and blurring of vision with ultimate coma.
b. Localizing signs depending on the part of the brain affected i.e. weakness, numbness, blindness, hearing loss,
    loss of smell or poor memory and poor balance.
c. Fits or epilepsy.
Or Headache alone.
The investigations of brain tumours include :
a. Brain imaging like MRI, CT Scan
b. MR spectroscopy, functional MRI and DTI
c. Angiogram, EEG
The prime purpose of the treatment is to cure or improve quality of life and DO NOT HARM.
a. Surgery to excise the tumour completely or partially, sometimes only biopsy. Latest techniques to minimize the
     morbidity and improve outcome includes image guidance stereotaxy, endoscopy, ultrasound guidance and intra-
     operative neuro-physiological monitoring.
b. Radiosurgery for certain small benign tumour without biopsy and as an adjunct after incomplete removal because
    of safety reasons. Cyber knife, Gamma knife and X-knife and Proton beam therapy.
c. Radiotherapy, chemotherapy, hormonal therapy, immunotherapy.