AMPED-UP RADIOTHERAPY FOR BRAIN TUMORS

The nature of Cancer is such that patients and their doctors know that in spite of several treatment options, the road to recovery is long. The goal of the treatment is two-fold – removing the cancerous cells and ensuring that it does not recur. One of the more complex cancers is the one that takes siege of the brain. Dr. Surendran J – Senior Consultant Radiation Oncology (at Dr. Kamakshi Memorial Hospital) discusses Brain Tumors – from symptoms to the best available treatment modalities.

Q:Who is at risk of developing a tumor in the brain?

Dr:Brain tumors can occur in pediatric age, adults and the elderly. Some of the tumors that occur in childhood are curable. In the case of elderly, secondary tumors in the brain are more likely – the primary location being the breast, lung, colorectum, kidneys, prostate and others.

Q:What are the common symptoms of brain cancer?

Dr:Headache, nausea, loss of balance, seizures, sleep problems, weakness in the muscles in limbs and even visual impairment. The symptoms persist for a prolonged period of time. The way the disease presents varies from one person to another. Once other causes for the symptoms are ruled out, the patient needs to be tested for cancer.

Q:How are tumors in the brain detected?

Dr:Before the introduction of computerised imaging treatment of primary brain tumours as well as secondaries in the brain ( metastasis from Breast cancer, Lung cancers and others), was unsatisfactory and dismal. About 40 percent of breast and lung cancers will develop brain metastasis. Appropriate and optimal treatment of Brain metastasis ( BM) is a challenging and demanding task. With the introduction of CT and in particular MRI, tumours could be visualised and defined precisely and therefore treatment can be effectively focused against them. It must be noted that survival of patients with brain metastasis left untreated is very poor.

Q:What treatment options are available to remove the tumor from the brain?

Dr:Treatment modalities include surgical removal , Stereotactic Radiotherapy(SRT) and targeted pharmacological treatment. SRT of brain metastasis involves more parameters and it is the fastest growing method for treating brain metastasis.

Q:What makes SRT the best option for treating brain metastasis?

Dr:The size, number, location and distribution of brain metastasis have marked influence on the survival of the patient. Depending on the patient’s condition and preference SRT enables a treatable situation by optimising the radiation dose to targeted sites at a very high speed, with high efficiency and accuracy in a short duration. This minimises toxicity and spares healthy tissues. After proper treatment of breast/ lung/ colorectal cancer, a significant percentage of patients develop a few metastases in the brain over the next 4 to 5 years. Earlier this was a fatal condition. Now, if we detect a few metastases – around 3 or 4, during a routine follow-up, we can treat them immediately. SRT gives them a second chance at life.

Q:Does Dr. Kamakshi Memorial Hospital offer SRT treatment?

Dr:SRT is an advanced technology facility available and incorporated in the soon-to-be commissioned Linear accelerator at Dr. Kamakshi Memorial Hospital. It can be used to treat a majority of BM without the need for open surgery and withoutthe risks of neurocognitive functional impairment. It extends life expectancy and improves quality of life.

Q:Can Radiotherapy benefit children diagnosed with cancer?

Dr:Yes, radiotherapy does play a part in treating pediatric cancers. While mostly we use chemotherapy for children, certain solid pediatric tumors can be completely cured by including Radiotherapy along with chemotherapy. The challenge is to reduce the morbidity or adverse impact on normal tissues. Craniospinal Irradiation for the treatment of pediatric brain tumours especially Medulablastoma can be perfomed with increased precision using Volume Modulated Arc Therapy (VMAT) which shapes the radiation dose to the tumour while minimising the dose to the organs surrounding the tumour. At Dr. Kamakshi Memorial Hospital we are equipped to treat pediatric cancer patients as well, thanks to the accuracy of the liner accelerator.