Frequently Asked Questions: Brain Tumor and Brain Tumor Surgery Treatment in India

 

Q1 What is a brain tumor?

A1 Brain tumor is an abnormal growth of cells in the brain that may be either cancerous or non cancerous.

 

Q2 What are the types of brain tumor?

A2  The brain tumors can be classified into the following types:

 

Based on the presence of cancerous cells

 

• Benign brain tumors-Non cancerous tumors

• Malignant brain tumors-Cancerous tumors

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​Generally, malignant brain tumors grow rapidly as compared to the benign tumors. 

They are also aggressive in a way, that they invade surrounding tissues.

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Based on the location of the origin of the tumor

 

Primary tumor- Tumor originated in the brain

Secondary tumor-Tumor originated somewhere else and spread to the brain eventually.

 

Primary tumors can be cancerous(malignant) or non cancerous(benign).

Secondary tumors, also referred to as metastatic tumors are more common and are malignant(cancerous).

They spread to the brain from some other organ of the body that is inflicted with cancer, more commonly from the cancer of the colon, breast, skin,kidney, lungs amongst other body parts.

 

Q3 What are the symptoms of a brain tumor?

 

A3 Symptoms associated with the brain tumor depend upon:

 

1. Type of tumor

2. Size of the tumor

3. Location of the tumor

4. Its extent

5. Rate of growth of brain tumor

6. Age of the patient

7. Patient's medical history

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Patients with brain tumor or brain cancer may be asymptomatic or present with one or more of the following complaints:

• Headache is an unusual symptom of brain tumor to present with. However, it may be the chief complaint if the tumor bleeds leading to its increased volume, there is a swelling around the tumor or if the tumor blocks the normal drainage of the cerebrospinal fluid(CSF) resulting in its accumulation causing a medical condition called Hydrocephalus. Headache due to brain tumor are usually associated with nausea, vomiting, double vision and specifically occurs at night when the patient is lying down building the pressure(Increased intracranial pressure) and wakens the patient up from his/her sleep.
• Seizures
• Neurological deficits such as

  • ​Loss of movement or sensation in an arm or leg

  • Difficulty in Speech 

  • Difficulty in maintaining balance 

  • Hearing problem

  • Sudden and unexplained personality or behavioral changes

  • Persistent Confusion 

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Q4 What needs to be done if found to be suffering from brain tumor?

 

A4 Most brain tumors are found incidentally during a scan done for some other reason. They may either be treated or watched carefully. If there is no growth and no symptoms, they can be left as it is and only need to be watched. However, if they are growing or producing symptoms they need to be treated.

 

Q5 What are the characteristics of the Benign tumor?

A5 Benign tumors have the following features:

• Non cancerous. 

• Grow slowly

• Rarely spreads to other parts of the brain or spinal cord.

• May cause intense pain, permanent brain damage and may even be fatal.

• Can be easily removed without causng any brain damage.

• Unlikely to recur and oftern regarded as Low grade tumors.

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Q6 What are the characteristics of the malignant tumors?

 

A6  Malignant tumors are:

• Cancerous

• Regarded as High grade tumors.

• Grow fast

• Spread easily to other parts of the brain and the spinal cord.

• Can recur even after its complete removal by surgery.

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Q7 How is Brain tumor diagnosed?

 

A7  Diagnosis of Brain Tumor

 

Brain tumor diagnosis is made with the help of the following, which may be carried out step by step or in varied combinations, as deemed suitable by your specialist, to identify the presence of tumor, confirm the diagnosis, type of tumor, its stage, its extent of spread to other parts of the body, prognosis and to decide its best treatment protocol:

 

• Your medical history

• Physical Examination especially neurological examination

• Detailed neurological examination carried out by Neurologist (specializes in medical treatment of neurological conditions) or Neurosurgeon(specializes in surgical treatment of neurological conditions)

• Imaging tests such as 

  • ​MRI(Magnetic Resonance Imaging)

    • ​Uses radiowaves and powerful magnets

    • More detailed as compared to CT scan 

    • Not a good option in case of tumors of the skull as they are not good for taking pictures of bones as good as a CT scan.

    • Some specialized form of MRI may be done in certain patients such as MRA(Magnetic Resonance Angiography), MRS(Magnetic Resonance Spectroscopy), Magnetic Resonance perfusion or perfusion MRI and fMRI(Functional MRI)

  • CT (Computed Tomography) scan

    • ​Uses X rays to produce several 3-D, detailed images of the target area taken from different angles.

    • Provide detailed cross sectional view of the soft tissues of the body by combining the images with the help of a computer.

    • Any abnormality or tumor can be detected, their details, any bleeding, enlargement of ventricles(fluid filled sacs) and a lot more information can be elicited.

    • Less preferred imaging investigation as compared to MRI in case of brain or spinal tumor, however, in some cases such as obese patients or claustrophobic patients who are afraid of enclosed spaces, it may be chosen over MRI. Even preferred for patients in whom MRI cannot be done because of presence of a pacemaker for heart. Provide detailed images of the bony structures unlike MRI, which give it an edge over MRI in tumors of the skull.

    • A contrast medium or dye can be administered either through vein or a pill taken orally, to get better view.

  • PET (Positron Emission Tomography) scan

    • ​Uses radioactive sugar substance, based on the fact that the radioactive substance is taken up more by the tumor cells as compared to normal cells since they use the maximum energy actively, so the tumor cells can be detected easily.

    • It is used to get detailed images of the tissues and organs of the body.

    • It is used to understand the details of the tumor while the patient is already on treatment or if the tumor has occured again.

  • PET-CT scan

    • ​When PET scan is combined with CT scan it is referred to as PET-CT scan by your doctor.

  • ​Cerebral Angiogram

    • ​Used to study the details of the blood vessels in the brain.

    • Uses X rays to procure detailed images.

    • A contrast medium may be administered to the patient.

• ​Biopsy: Sample of tissue is taken to study its details, this procedure is referred to as Biopsy. It is done to confirm the diagnosis. Tissue sample can be taken in two ways as mentioned below:

  • ​Biopsy(Tissue sample taken for study under microscope for abnormality) done at the time of surgery to remove the tumor partially or completely, as feasible. This biopsy is also known as surgical or open biopsy.

  • Stereotactic biopsy-Here, the patient is administered local or general anesthesia, a rigid head frame is fixed followed by a small incision in the scalp. A small hole, called burr hole is drilled into the skull to insert a needle under the guidance of MRI or CT upto the tumor or target area and a tissue sample is withdrawn by the surgeon. It is usually done when the tumor is deep inside the brain or near any critical structure where surgery to remove the tumor is not possible.

• Lumbar Puncture, also referred to as spinal tap, a procedure that may be used to detect tumor cells, blood or tumor markers in the cerebrospinal fluid. CSF sample is drawn out from your lower back with the help of a needle.

• Chest X-ray done to find out any tumor in lungs because most of the times it is the presence of cancer somewhere else in the body, mostly from lungs, that spreads to the brain eventually.

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When you approach your primary doctor with your chief complaints, your signs and symptoms may drive the doctor to suspect presence of brain tumor and accordingly the specialist will take his/her further course of action beginning from taking your complete medical history and thorough clinical examination.

 

If something is found amiss, you might be referred to the specialist doctor, neurologist or neurosurgeon, to carry detailed neurological examination and relevant investigations. 

Detailed neurological examination includes testing neurological functions based on various parameters such as your muscle strength, their coordination, balance, vision, speech and so on. Investigations such as Imaging tests that involve the use of X rays, radioactive substances or powerful magnets to get the images of the brain and spinal cord, if need be, which would be inferred by the concerned specialist and information would be gathered regarding the presence of brain tumor, its type, appearance, location and a lot more. 

Biopsy is done to confirm the diagnosis. CSF examination may be done on Cerebrospinal fluid sample obtained through a procedure known as lumbar puncture and investigations such as chest Xrays point towards possible origin of cancer from lungs.

 

Q8 What are the risk factors that makes a person vulnerable to develop a Brain Tumor?

 

A8 Although in most of the patients with primary brain tumor, the cause is not known. However, certain factors can still be identified, that increase vulnerability of a person to develop primary brain tumor.  

 

These factors, risk factors for brain tumor, as established through research are:

 

• Family history of a brain tumor

• Increased exposure to the Ionizing Radiation

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​Q9 What do you mean by Key hole surgery used for brain tumors?

 

A9 Key hole surgery is a minimally invasive approach taken for brain tumor surgery. 

 

It is used for certain skull based or brain tumors. Here, the brain tumor is accessed through small openings in the skull or natural openings like nostrils. 

 

The factors that determine the exact optimal approach to access brain tumor,such as through nose(Endonasal Endoscopic route), through an incision in the eyebrow(supraorbital), through a cut behind the ear(Retromastoid route), are the location of the tumor and the surrounding brain structures.

 

The aim of this surgery is to reduce the damage to the surrounding critical, normal brain structures and ease the removal of the brain tumor.

 

Advancement in the technology such as high tech endoscopy, specialised surgical instruments, highly advanced imaging techniques has made it possible.

 

However, it is not the best option for all the brain tumors. 

 

Your Neurosurgeon will determine the best surgical approach suitable for you only after evaluating your medical reports and your clinical examination.

 

Q10 What are the indications for key hole brain tumor surgery?

 

A10 Key hole brain tumor surgery is being used for the following conditions:

 

• Meningiomas

• Pineal area tumors

• Pituitary adenomas

• Schwannomas

• Craniopharyngiomas

• Gliomas

• Metastaic brain tumors

• Hemangioblastoma

• Intraventricular tumors

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For certain large brain tumors near the surface, conventional surgery such as Craniotomy is still considered a suitable option.

 

Q11 What is the goal of Key hole brain tumor surgery?

 

A11 The neurosurgeon intends to achieve the following goals by adopting Key hole brain tumor surgical approach:

 

• Minimal handling of or fiddling with the normal and critical brain structures

• Focused towards maximum removal of the brain tumor.

• Preventing complications

• Quick and complete recovery

 

Q12 How long is the hospital stay, post key hole brain tumor surgery?

 

A12 The patient needs to be in the hospital usually for 2 to 3 days post surgery and back to normal activities within the span of around 3 weeks.

 

Q13 What is Craniotomy?

 

A13 Craniotomy, the most common brain tumor surgery, involves surgical removal of a part of the bone of the skull, also called the bone flap, to access the brain inside. Once the surgery is done the bone flap is replaced back. It is done under General anesthesia which means the patient is made unconscious during the surgery. Scalp is shaved over the area to be operated upon. A cut or incision is made in the scalp. A circular piece of bone (bone flap) is removed. Brain is exposed and underlying problem is treated.

 

Eventually, the bony flap is reattached to its original place with the help of metal plates and screws. Scalp incision is closed with the help of staples at the end.

 

Q14 What are the indications for Craniotomy surgery?

 

A14 Craniotomy surgery is indicated for certain brain diseases, injuries or tumor.

 

Your specialist may consider Craniotomy for you under the following conditions:

 

• To remove

• Brain tumor

• Tissue sample for biopsy

• Blood clot, also called Hematoma

• Pus due to an infection(abscess)

• Excessive cerebrospinal fluid

• To treat

• Skull fracture

• Epilepsy

• Bleeding or hemorrhage

• Brain swelling

• Damaged blood vessels or meninges

 

​Other than above indications craniotomy is also carried out to either deliver medicine into the brain or implant a medical device such as Deep brain stimulator. The most common reason for carrying out Craniotomy is to remove Brain tumor.

 

Q15 How much time does Craniotomy surgery take?

 

A15 It takes usually 4 to 6 hrs on an average to carry out Craniotomy surgery.

 

Q16 What to expect after Craniotomy surgery?

 

A16 After Craniotomy surgery is over, the patient once awake, is evaluated in the operation theatre for if he/she is able to follow simple instructions or commands, then shifted to either Intensive care unit or recovery room. The patient is closely monitored, his/her vital signs such as pulse rate, blood pressure, breathing rate etc are checked every hour along with neurological function. 

 

It is encouraged to make the patient move at the earliest, within a day or two with the help of physical and occupational therapist.

 

In absence of any complications, the average duration of hospital stay is going to be 2 to 3 days. 

 

Craniotomy surgery is associated with least pain. 

 

Once home, the patient can usually move around and carry out his/her daily activities with ease. 

 

However, for some patients, more aggressive physical therapy and rehabilitation may be required.

 

Q17 What is Craniectomy?

 

A17 Craniectomy is a term used to refer to a craniotomy surgery with a little variation under the circumstances when the brain is swollen or the skull is infected. Under such scenario, the bone flap is not reattached back right after the surgery, rather it is put off until the swelling and infection subsides. 

 

In another surgical procedure scheduled at a later date, referred to as Cranioplasty, the bone flap is replaced back to its original position with the help of metal plates and screws. Scalp incision is closed with the help of staples at the end.

 

Q18 How does a Neurosurgeon determine if I am a candidate for Brain tumor surgery?

 

A18 Your specialist will take several factors into account before deciding if you need Brain tumor surgery. They are

 

• Your symptoms associated with brain tumor

• The location of tumor

• Type of tumor

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For some patients with benign tumors surgery may not be required at all.  In patients in whom surgery is recommended, it is carried out within a span of 7 to 10 days or at the earliest possible. The goal of the surgery is to remove the tumor as much as possible and achieve maximum functional capacity for the patient. Brain surgery calls for precision and judgement of the specialist for better patient outcome.                 

 

The patient and his/her family is educated about the brain tumor and the surgery to treat it so that they can take an informed decision. Once they approve of it , then only the specialist goes ahead with th surgery.

 

Q19 What is meant by MRI Guided brain tumor surgery in a brain suite?

 

A19 Brain suite is the latest and most advanced technology being employed for carrying out brain tumor surgery. Its an MRI guided brain tumor surgery, also referred to as Intraoperative MRI Neurosurgery suite. 

 

Brain Suite plays a crucial role in making the surgery as perfect as possible by amalgamating image guided surgery, high field MRI within the opreration theatre, data management and visualization at the same time.

 

This specialized set up in the operation theatre leverages all the required surgical and diagnostic tools, well integrated to treat even the most complicated brain tumors and other neurosurgical disorders.

 

The navigation system simulates the GPS (Global Positioning System) for the brain giving immediate updates on the location of the instruments with respect to the tumor. This advantage comes handy especially when the surgery is being done near the critical structures inside the brain. Brain Suite may be used for several conditions that call for brain surgery.

 

They can be summarized as below:

 

• Pituitary tumor

• Brain metastasis

• Glioma and for other primary brain tumors

• Epilepsy surgery

• Biopsy

• Surgery for vascular malformations in the brain

 

 

 

Q20 Who are the best Neurosurgeons in Delhi?

 

A20 Dr Bipin Swarn Walia, Dr K.S Narang, Dr Sudhir Dubey, Dr (Maj Gen) Prakash Singh, Dr Aditya Gupta are some of the finest neurosurgeons in Delhi, Delhi-NCR with ample experience and skills to cater to your neurosurgical medical needs. 

 

They have already treated high volume of patients with excellent clinical outcome. They are counted amongst the top 10 neurosurgeons in Delhi.

 

Q21 What are the most advanced treatment modalities for Brain tumor treatment in India?

 

A21 Medical technology has advanced tremendously to offer high success rate apparent in terms of better, active and longer life. The brain tumor patient can lead a perfectly normal life after treatment or surgery as the condition warrants, as if nothing has ever happened. Furthermore, globally trained, highly skilled and experienced doctors,who are employing that technology perfectly is just like an icing on the cake.

 

Latest treatment provided for Brain tumor treatment in Best Cancer Hospitals of India

• MRI guided brain tumor surgery in a Brainsuite

• Minimally Invasive Brain Tumor Surgery

  • Endoscopic Endonasal approach is adopted in which Brain tumor removal is carried out through nose. It is also referred to as Transsphenoidal Brain Tumor Surgery. It is usually done in case of Pituitary Tumors and Skull Base Tumors. 

 

Brain Tumor Surgery in India|HealthcaretripIndia

 

 

• Advanced brain tumor surgery at the most affordable cost.

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• Minimally invasive and endoscopic brain tumor surgery techniques are being carried out to give maximum benefit to the patient such as quick recovery,short or no hospital stay,minimal scar formation which is aesthetically good and early resumption of activities.

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• Best hospitals in India for brain tumor surgery with dedicated Centre of excellence in neurosciences with state of the art infrastructure and most advanced technology in place such as Brain Suite,3 Tesla MRI, 256 Slice CT scan, PET scan to name a few.

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• Comprehensive care provided by the team of dedicated, globally trained and highly experienced Neurosurgeons.

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• Collaborative efforts are put in by multidisciplinary teams, if the medical condition of the patient calls for the same.

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• Implement internationally accepted most innovative treatment protocol methods.

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• High success rate

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• Great ambience

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• Compassionate staff to look after

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• Hospitals accredited with international organizations such as JCI(Joint commission International) for quality standards.

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• Language no barrier. English speaking people and if required, translators are available for your convenience.

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• Most economical accommodation available at a walking distance from the hospital. Wide range of options starting from guest house, service apartments to five star hotels, best suited to your budget and choice.

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• Good flight connectivity

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• India has a diverse and rich cultural heritage. You can witness its beauty and uniqueness. It offers most conducive environment for recuperation.

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Learn more

 

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Best Neurosurgeons in India| Brain Tumor Surgery|HealthcaretripIndia

 

 

Dr Bipin Swarn Walia

MBBS,MS (General Surgery), M.Ch (Neurosurgery)

Director – Neurosurgery & Head - Unit 1 & Neuro Spine Program

Max Super Speciality Hospital, Saket, Delhi

Best Neurosurgeon in Delhi|Max Hospital|Brain Tumor Surgery Treatment in India

 

 

 

Dr K.S Narang

M.B.B.S, M.S (General Surgery), M.Ch (Neurosurgery)

IGASS Spine Fellow Klinikum rechts der Isar Department of Neurosurgery, Technical University of Munich, Germany

Minimally Invasive Spine Surgery, Wooridul Spine Hospital, Seoul, Korea

Consultant – Neurosurgeon, Institute of Neurosciences

Medanta – The Medicity,Gurugram,Delhi-NCR

Best Neurosurgeon in Gurugram|Medanta Hospital|Brain Tumor Surgery Treatment in India

 

 

 

 

Dr Sudhir Dubey

 

MBBS, M.S, MCh (Neurosurgery)

Fellowship in Endoscopic Skull Base Surgery UPMC, Pittsburgh, USA

Additional Director, Neurosurgery

 

Institute of Neurosciences

Medanta – The Medicity,Gurgaon,Delhi-NCR

Best Neurosurgeon in Gurugram|Brain Tumor Surgery Treatment in India|Medanta Hospital

 

 

 

 

Dr (Maj Gen) Prakash Singh

MBBS, MS (Surgery), Mch (Neurosurgery)

Director & Sr. Consultant Neurosurgery

Max Smart Super Specialty Hospital, Saket, New Delhi

Best Neurosurgeon in Delhi|Brain Tumor Surgery Treatment in India|Max Smart Hospital

 

 

 

Dr Ajay Bajaj

MBBS, MS (General Surgery), M.Ch (Neurosurgery)

Consultant, Neurospine Surgeon

 

Wockhardt Hospital, Mumbai

Best Neurosurgeon in Mumbai|Brain Tumor Surgery Treatment in India|Wockhardt Hospital

 

 

 

Dr Aditya Gupta

MBBS(AIIMS), MS(Surgery), MCh (Neurosurgery)

Fellowship from CJW Medical Center, Richmond, US,

 

Fellowship from Hospital Pitie-Salpetriere, Paris, France

 

Membership: International Gamma Knife Society

 

          Congress of Neurological Surgeons,US

 

Director & Senior consultant Neurosurgery, Radiosurgery & Brain Tumor Surgery

Artemis Hospital, Gurgaon

Best Neurosurgeon in Gurugram|Brain Tumor Surgery Treatment in India|Artemis Hospital

 

 

Dr Sandeep Vaishya

MBBS, MS (Surgery), MCh (Neurosurgery)

Executive Director, Neurosurgery

FMRI, Fortis Memorial Research Institute, Gurugram

Top Neurosurgeon in Gurgaon|Fortis Hospital|Brain Tumor Surgery Treatment in India

 

Dr Varinder Pal Singh

MBBS, MCh (Neurosurgery), DNB (Neurosurgery)

Chairman, Institute of Neurosciences

Medanta – The Medicity,Gurugram,Delhi-NCR

Best Neurosurgeon in Gurugram|Brain Tumor Surgery Treatment in India|Medanta Hospital

 

Dr Amit Srivastava

MBBS,MS (General Surgery), MCh (Neurosurgery)

Director, Neurosurgery

Aakash Healthcare Super Speciality Hospital, Dwarka, Delhi

Best Neurosurgeon in Delhi|Brain Tumor Surgery Treatment in India|Aakash Healthcare