Glioma Brain Tumor

Democrat Senator Edward Kennedy has been diagnosed with Glioma, a kind of brain tumor. Tests carried out on the 76 -year old politician, after he suffered a seizure during the weekend, revealed a tumor on his left parietal lobe. A biopsy confirmed the diagnosis as malignant Glioma.

A tumor is a mass of abnormal cells. Brain tumors are typically classified as primary or secondary tumors. Gliomas are primary brain tumors that can be slow-growing (benign) or fast growing (malignant).

The type of brain tumors is usually known after the cells within the nerve tissue from which they originate. There are more than 100 different types of brain tumors and the most common of these tumors originate from the supporting glial cells of the brain; hence they are called - gliomas.

Gliomas do not affect tissues outside the nervous system;  do not usually spread  outside the brain and spinal cord.

There are four main types of glioma –

• Astrocytoma,
• Ependymoma,
• Oligo-dendroglioma, and
• Glioblastoma multiforme or GBM.

GBM is a malignant tumor and can spread to other areas of the brain and is usually seen in adults.

Gliomas located in brain stem area are difficult to treat even if they are benign. The brain stem is a critical area of the brain and is responsible for the very essential respiratory mechanism of the body.

Approximately, 9000 to 17,000 Americans are diagnosed with a primary brain tumor, annually.

Sizing Up

Brain tumor diagnosis is usually kick started by a neurologist and may include checks for vision, hearing, balance, reflexes, coordination and reflexes. He may recommend any of the following tests- 

• Magnetic Resonance Imaging (MRI) Scans  / CT scan - These scans generate pictures of the brain that helps in the diagnosis of the glioma or any other tumor.
• Brain Scans, like the Magnetic Resonance Spectroscopy (MRS), Positron Emission Tomography (PET) and Single-Photon Emission Computed Tomography (SPECT) are also employed to assess brain activity and blood flow.
• Angiogram-A special dye is injected into the brain arteries. This helps to locate blood vessels in and around a brain tumor and can be can be picked up on an X-ray 
• X-rays - An X-ray of the head may pick up alterations that are signs of a brain tumor .However, an X-ray is  employed less often as it is less sensitive when compared to a scan.
• Biopsy - A biopsy confirms the presence of a tumor, its type and stage. For this, a portion of the tumor tissue is removed and evaluated under the microscope. A biopsy may be carried out as part of the surgical process or may be done separately. It is useful in determining the optimal treatment for the patient.

Treating Tumors

Gliomas can be complex and doctors have for long found brain tumors a challenge to treat. However, the recent advancements in medicine have enabled these tumors to be targeted and treated precisely.

The successful management of these tumors depends on the size, type and position of these tumors, besides the age and overall health of the patient.

A variety of techniques are used in the treatment of Gliomas.

a) Surgery is an effective method to cure slow-growing tumors and is the first treatment option for all brain tumor patients. Surgeries aim to remove as much of the harmful tissue as is possible, while minimizing the risk to healthy tissues.

Not all tumors can be removed completely; some cannot be removed at all. In the case of the later, a biopsy is carried out to assess the treatment modalities best suited for the patient.

Partial removal of the tumor tissues helps to alleviate the symptoms and to reduce the size of the tumor in order to make it more receptive for other treatments, such as, radio-or chemo-therapy.

Some of the surgical innovations that has helped in the treatment of gliomas are-

• Computer-assisted neurosurgery- allows the brain to be accurately mapped, thereby enabling intense treatment
• Intra-operative MRI –provides details regarding the tumor volume and its location
• Awake –brain surgery-   carried out when the tumor has invaded the areas of the brain, which control movement and speech. Here the patient is awake, and the response of the patient to queries helps the doctor to carry out the surgery with precision and to minimize injury.
• Laser surgery - also employed in the removal of tumors.

Futuristic treatment techniques, such as gene therapy, are also being researched.

b) Radiotherapy or gamma knife is used to treat brain tumors, such as gliomas. It can bring about a complete cure in some, while it can control the disease and help to prolong the life span of some others.

c) Chemotherapy

Chemotherapy benefits very few patients with glioma but is employed mostly for pain relief. Some of the drugs employed are-

• Corticosteroids –for reducing tumor size and intracranial pressure 
• Anti-convulsant drugs for seizures
• Heparin and warfarin for deep vein thrombosis or pulmonary emboli

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Improving lifestyles

Improved treatments are regularly emerging and this has a direct impact on the prognosis of the patient and his quality of life.

Average period of survival for a brain tumor patient-

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• Less than a year for aggressive tumors
• Approximately five years for slow growing tumors.

Regular scans need to be taken long after the treatments have stopped. This is to monitor the effect of the treatment on the tumor and also to look out for the recurrence of the tumor, if any.

Brain tumors impact thoughts and behaviors of the affected individual. These patients often feel that they are unable to return to normal life without help from others. As the possibilities of a longer life become real, from intensive treatment, they often suffer from grave side effects. These individuals may have issues, mostly with cognition. Experts from different specialties need to come together and offer the best brain rehabilitation programme possible.

A sympathetic approach to these individuals from family, friends and colleagues, along with timely treatment offered with rehabilitative measures, will help brain tumor patients to come to terms with their health condition and may motivate them to live and enjoy life.

Source-Medindia
Dr. REEJA THARU/K