DR VARINDERA PAUL SINGH, CHAIRMAN, NEUROSURGERY, MEDANTA- THE MEDICITY, GURUGRAM
Brain tumours are abnormal masses that develop in the brain and may be either non-cancerous (benign) or cancerous (malignant). In India, an estimated 40,000 cases of brain tumours are recorded every year.
Researchers have found that in the North East region, the incidence of brain tumours were over twice more prevalent among males than in females, and were most common in the 20-60 years age group.
It is often assumed that headaches are the defining sign of a brain tumour. This is because any addition to the closed skull cavity — whether an abnormal growth, bleeding or swelling — usually results in an increase in pressure in the skull, resulting in headache.
However, if the tumour is slow-growing, then the increase in pressure in the skull is very gradual, and the patient can adapt and compensate for it, thus not developing headaches till the tumour becomes big.
There are other symptoms that do present themselves in cases of brain tumour, and recognising these subtle indicators is crucial for timely diagnosis and potentially life-saving treatment.
Early Warning Signs Beyond Headaches
Changes in vision can be one of the first — and often the most apparent — symptoms, with patients suffering blurred or double vision, or even a gradual loss of side vision. These changes can occur when a tumour presses against the optic nerve or visual areas of the brain. Frequent changes of spectacles with incomplete correction of vision is another red flag.
Changes in personality or mood may also be symptomatic of a deeper underlying problem: dramatic mood changes, forgetfulness, or a poor attention span may suggest that the tumour is positioned in the brain’s frontal lobe, which manages emotions, judgment, and decision-making. Issues with balance and coordination, such as feeling unstable, tripping, or being unusually clumsy, may indicate a tumour near the cerebellum, which is the part of the brain responsible for balance. Progressive worsening of any such symptom can be a pointer towards a probable brain tumour.
Another warning signal is developing seizures as an adult: brain tumours often interrupt electrical communication in the brain, resulting in everything from generalized convulsions to short, focal seizures. Difficult to control seizures, multiple types of seizures in the same patient and onset of seizures for the first time with repetitive seizures (status epilepticus) may be suggestive of a brain tumour.
Numbness, weakness (often unilateral), or tingling can occur if the tumour is pressing on motor or sensory pathways. Difficulty in speech, such as slurred speech or difficulty finding words, could indicate tumours in areas of the brain related to communication. There can also be other vague symptoms as the tumour grows, such as fatigue, low-grade nausea, and changes in hearing.
The Role of Diagnosis
If any of these symptoms continue over time, it is essential to consult a doctor without delay. Early medical evaluation can help identify the underlying cause and ensure timely treatment, which may significantly improve outcomes. A neurological examination may include an evaluation of motor coordination, reflexes, and sight. The assessment may also include brain imaging via CT scan and/or MRI. If an abnormal mass is found, a surgery will likely follow to identify the type of tumour, and to determine the treatment options ahead.
Brain Tumour Surgery
In cases of brain tumour, surgery is usually the first step towards treatment, and aims to completely remove the mass while preserving healthy brain tissue and normal brain functions.
Common procedures include craniotomy — where an area of the skull is removed — as well as the use of advanced imaging to improve accuracy. A variety of modern technologies — Neuro navigation, tumour immunofluorescence, intra operative neuro monitoring, intra operative MRI imaging, computer assisted surgery, and Neuro endoscopy — help safely remove the mass via surgery.
Some tumours — usually located in the delicate areas of the brain — are not treatable surgically. In such cases, there are other treatment options that are available to the patient, such as radiation, chemotherapy, and targeted drugs. Certain small brain tumours can be treated by a technique called stereotactic radiosurgery, using CyberKnife, which is non-invasive (without opening the skull).
Listen to your body
Being told that you or a loved one has a brain tumour can feel overwhelming, but one must never lose hope: most tumours can be monitored and/or treated safely, especially those diagnosed early.
Don’t wait for a headache to tell you that there is a problem. Listen to your body, get help early, and share this message, because early intervention changes everything.