When it comes to going under the knife, it’s natural to feel a sense of fear or anxiety. This fear may become even more pronounced for those preparing to undergo a brain tumour surgery, given the complexity of the brain and the uncertainties that may arise. To ease these concerns, this blog addresses common concerns about brain tumour surgery, providing clear information to support informed decisions and help individuals feel more prepared for the journey ahead.
Understanding the Need for Brain Tumour Surgery
While not all brain tumours require surgery, many do, especially if they are causing symptoms, growing rapidly, or pressing on vital parts of the brain. Surgery is generally considered necessary when a brain tumour:
- Is causing symptoms: Tumours that lead to headaches, vision problems, seizures, or weakness in parts of the body may need to be removed or reduced in size to relieve these issues.
- Is growing in size: Tumours that continue to increase in size may put pressure on nearby brain structures, making surgical removal advisable to prevent further complications.
- Is accessible for removal: If the tumour is located in an area where it can be safely removed without significant risk to surrounding brain tissue, surgery may be recommended.
- Requires a diagnosis: In some cases, a biopsy through surgery is needed to confirm the type of tumour, which helps guide further treatment plans.
- May improve quality of life: Removing or reducing the size of a tumour can help alleviate symptoms and improve daily functioning, even when complete removal is not possible.
Types of Brain Tumour Surgery
Several surgical approaches are used in the treatment of brain tumours, selected based on the tumour’s type, size, and location, as well as the patient’s overall condition. The primary goal is to remove as much of the tumour as safely possible while minimising the impact on healthy brain tissue.
Craniotomy
The most common surgical procedure for brain tumours involves removing a part of the skull to access the tumour. Once the tumour is removed, the bone flap is replaced and secured. Advanced techniques, including intraoperative imaging and monitoring, assist surgeons in precisely removing the tumour while preserving critical brain functions.
Minimally Invasive Surgery
In some cases, smaller openings and advanced tools may allow for minimally invasive approaches. These procedures can reduce recovery time and minimise discomfort while effectively removing or sampling the tumour.
Stereotactic Biopsy
When complete removal is not immediately possible or safe, a stereotactic biopsy may be performed. Using detailed imaging guidance, a small sample of the tumour is removed for analysis to determine the exact type and guide further treatment planning.
Endoscopic Surgery
For certain tumours located near the ventricles or the base of the brain, endoscopic techniques using a thin, flexible tube with a camera may be used to remove or reduce the tumour with minimal disruption to surrounding tissues.
Each surgical method is chosen to balance effective tumour management with preserving neurological function and ensuring the best possible recovery pathway. The surgical team will discuss the most appropriate approach based on the individual case and treatment goals.
What to Expect Before, During, and After Surgery
Understanding what typically happens before, during, and after brain tumour surgery can help prepare for the treatment journey.
Before Surgery
A series of evaluations and tests are conducted to plan the surgery safely. This may include MRI or CT scans to determine the tumour’s exact size and location, along with blood tests and a general health assessment. Discussions with the surgical team help explain the procedure, potential risks, and expected outcomes, ensuring clear communication and preparation.
During Surgery
Brain tumour surgery is performed under general anaesthesia. The chosen surgical method depends on the tumour’s type and location. Intraoperative monitoring and advanced imaging techniques may be used during the procedure to guide the surgeon and help preserve important brain functions while removing the tumour. The duration of the surgery can vary based on complexity.
After Surgery
Following surgery, monitoring takes place in an intensive care or recovery unit to ensure stability and manage any immediate post-operative needs. Hospital stay length varies depending on the procedure and recovery progress. Rehabilitation, including physical therapy or speech therapy if needed, may support recovery and help in regaining strength and function. In some cases, individuals may also benefit from continuing speech therapy at home, especially if mobility is limited or ongoing sessions are required post-discharge. Follow-up appointments are scheduled to monitor healing and assess treatment outcomes through physical examinations and imaging studies.
Every individual’s recovery journey is unique, and the care team provides guidance and support throughout, helping address any concerns and assisting in a gradual return to daily routines.
Potential Risks and Complications of Brain Tumour Surgery
As with any major surgical procedure, brain tumour surgery carries inherent risks and potential complications. While neurosurgical teams take extensive precautions to minimise these, it is important to be aware of them.
- General Surgical Risks: These include standard surgical complications such as infection at the surgical site, bleeding (haemorrhage), blood clots (thrombosis), and adverse reactions to anaesthesia.
- Brain Swelling (Cerebral Oedema): Swelling of the brain tissue around the surgical site is a common occurrence. This is usually managed with medication, but in severe cases, it can increase pressure within the skull.
- Cerebrospinal Fluid (CSF) Leak: CSF is the fluid that surrounds the brain and spinal cord. A leak of this fluid can occur from the surgical site, sometimes requiring further intervention.
- Neurological Deficits: Depending on the tumour’s location and the extent of surgery, there is a risk of new or worsened neurological problems. These can include weakness or paralysis, changes in speech, vision disturbances, difficulties with balance or coordination, and memory or cognitive impairments. Many of these may be temporary, but some can be long-lasting.
- Seizures: Brain surgery can sometimes lead to the development of new seizures or worsen pre-existing ones. Medication is often prescribed to prevent or control these.
- Stroke: In rare instances, surgery can lead to a stroke if blood vessels are damaged or blocked during the procedure.
Individuals undergoing surgery will have a detailed discussion with their surgical team to understand the specific risks relevant to their individual case and tumour.
Choosing the Surgical Team and Hospital
The selection of the surgical team and the hospital is a critical decision that profoundly impacts the outcome of brain tumour treatment. This choice ensures access to highly specialised expertise and a comprehensive support system.
- Importance of Specialised Expertise: It is paramount to seek out neurosurgeons with extensive experience specifically in brain tumour surgery, particularly those who regularly perform procedures for the type of tumour diagnosed. Expertise extends beyond the surgeon to include neuro-oncologists, neuropathologists, and neuro-radiologists.
- Multidisciplinary Approach: The best care is typically delivered by a multidisciplinary team. This involves specialists from various fields – including neurosurgery, neuro-oncology, radiation oncology, and rehabilitation – collaborating closely to develop and implement a personalised treatment plan. This ensures all aspects of care are considered.
- Hospital’s Experience and Technology: Consideration should be given to hospitals that handle a high volume of brain tumour cases, as this often correlates with greater experience and better outcomes. Access to advanced technology, such as intraoperative MRI, neuro-navigation, and state-of-the-art anaesthesia equipment, is also a significant advantage for precise and safe surgery.
- Accreditation and Reputation: Researching the hospital’s accreditations for neurological and cancer care can provide assurance of adherence to rigorous quality and safety standards. A strong reputation, often reflected in professional recommendations and patient feedback, indicates a consistent track record of excellent care.
Key Questions to Ask the Doctor
Engaging in open and thorough communication with the medical team is vital for individuals considering brain tumour surgery. Preparing questions beforehand can help ensure all concerns are addressed and a clear understanding of the proposed treatment is established.
Here are some crucial questions one should consider asking their neurosurgeon before a brain tumour surgery:
- What are the primary goals of this specific surgery for the tumour? Is it for diagnosis, symptom relief, or tumour removal?
- What is the exact type and grade of the brain tumour, and how does this influence the surgical approach?
- What are the specific risks and potential complications associated with the proposed surgery, considering the tumour’s location and individual health?
- What is the expected recovery timeline, both immediately after surgery and in the long term? What kind of rehabilitation might be necessary?
- What alternative treatment options exist if surgery is not chosen or is not fully successful?
- How much experience does the surgical team have with this particular type of brain tumour surgical procedure?
- What is the follow-up care plan after surgery, including appointments, scans, and management of potential long-term side effects?
Conclusion
Brain tumour surgery is a significant step in treatment, aiming to manage the tumour effectively while preserving quality of life. The choice of the best hospital in India plays a crucial role in this journey. Opting for a centre with experienced neurosurgeons, advanced technology, and a multidisciplinary team ensures that care is tailored to the specific needs of each case. This not only supports safer surgery but also provides comprehensive care during recovery and follow-up, helping individuals navigate treatment with confidence and hope for the best possible outcomes.
