Cerebral tumor surgery - Further information
The primary purpose of brain tumour surgery is to treat a cancer condition by removing a cancerous tumour. This is achieved via a number of different surgical techniques, including:
- stereotaxy, which uses computers to create a precise, three-dimensional image of the location of the tumour. The technique aids complex brain tumour surgery and can be used in real time to guide the progress of the neurosurgeon’s operating tools, and thus greatly reduce the duration of a surgical procedure.
- embolization is a procedure used to reduce the blood supply to a tumour by blocking the flow of blood in selected arteries. This happens before surgery gets under way and is assisted by arteriography – an X-ray of the circulatory system – that informs the process. The intended surgical procedure then follows quickly to avoid any re-growth or re-routing of blood vessels.
- endoscopy inserts a neuroendoscope (a narrow, illuminated surgical tube) close to the surgical site in order to provide visual access. Used in conjunction with detailed scanned images of the location of the tumour, this surgery can often be performed through a relatively small incision. The use of a less-invasive procedure also reduces the risk of side effects and speeds up recovery times.
- laser surgery is a technique that aims a laser beam at the source of the cancer and uses heat to destroy it. Laser beams cannot penetrate bone, and thus the laser is used rather like a scalpel once the procedure has begun. Computers are often used to guide the laser beam so that its immense power can be used to vaporise cancerous cells at close range.
- photodynamic laser surgery combines the use of a laser light beam with drugs that make tissues photosensitive (sensitive to light). A photosensitizing drug is first injected into a blood vessel close to the site of the tumour. Once blood flow has carried the medication to the location of the tumour, the laser beam is then used to activate the drug and thus use heat to attack and destroy the cancerous cells.
- ultrasonic aspiration is a method that employs ultrasonic sound waves to break up the tumour so that it can be removed in small pieces by aspiration (suction). This technique uses less heat than many other procedures and results in much less destruction of normal healthy tissue.
When is brain tumour surgery used?
Brain tumour surgery may have several possible aims including
- obtaining tissue to confirm diagnosis of the type of tumour present
- the removal of all or part of the tumour
- the direct insertion of chemotherapy drugs into the brain
- the direct insertion of material into the brain for radiation treatment (brachytherapy)
- the reduction of symptoms of associated conditions (e.g. the build-up of cerebrospinal fluid)
- relieving any intracranial pressure caused by a cancer
What are the risks of brain tumour surgery?
Brain tumour surgery is a major procedure, which carries a number of possible risks and side effects, including:
- infections, such as lung or bladder infections
- wound infections
- blood clots
- brain swelling
- permanent neurological damage
- bleeding in and around the surgical site
- allergic reaction to anaesthesia
Are there alternatives to brain tumour surgery?
Whether surgery is considered a recommended treatment option for your brain tumour will depend on:
- the type of tumour present
- its stage of development
- how easy it would be for a neurosurgeon to reach
- an assessment of the risks it poses to your health
Where surgery is not an option for high-grade tumours, the following treatment options may be available:
- radiation therapy, which employs X-rays and other radiation strategies to destroy cancerous tumour cells or to inhibit their growth
- chemotherapy, which uses powerful drugs to eradicate rapidly dividing cells
- targeted therapy, which aims to destroy specific cell elements in order to prevent further cell growth
- tumour treating fields (TTF) is carried out by using a wearable device, which creates electrical fields designed to disrupt the cell division (growth) of cancerous cells and thus prevent their spread
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