KUALA LUMPUR- “You have a brain tumour” is the last thing you want to hear from your physician during a routine health screening.
Viewed by many as a death sentence, this is not always the case thanks to the significant advancements in medical science through the years.
This World Brain Tumour Day, FMT Lifestyle spoke with neurosurgeon Dr Regunath “Regu” Kandasamy about this most feared, and often misunderstood condition.
“To put it simply, a brain tumour is an abnormal growth of tissue within the cranial cavity or skull, and it can be divided into two types: benign or malignant.”
Regu explained that the biggest challenge a doctor faces when treating tumours in one’s brain is the skull’s limited space. Having an abnormal mass in this confined space can cause significant life-threatening effects to the patient.
Symptoms
The most common symptoms associated with this condition are headaches, nausea, vomiting, blurring of vision, seizures, imbalance, weakness of limbs, abnormality of speech and cognitive function.
“However, the symptoms also depend on which part of the brain the tumour is located, as different parts control different bodily functions,” he said.
While headaches are a condition most people experience from time to time, Regu said the headaches that deserve medical attention are those with associated nausea, vomiting or blurred vision. He said when this happened, it was a clear indication of raised intracranial pressure caused by the tumour.
Due to the limited space in the skull and the complexities of the brain’s functions, a tumour must be treated with extra caution as compared to tumours in other parts of the body, whether benign or not.
“Even a benign mass can lead to a raise in the intracranial pressure and affect the brain’s function. Hence it would still require treatment.”
Types and treatments
In listing some of the common benign tumour types, Regu said this included meningioma, vestibular schwannoma and pituitary adenoma.
The malignant tumours, on the other hand, include glioblastoma which is primary brain cancer, and metastatic brain cancer, which is more commonly.
“This is because cancer treatments nowadays are improving, so when patients survive longer there’s a higher chance of the cancer spreading to the other body parts, which is what ‘metastatic’ means.”
He said typically when there is suspicion of a brain tumour, a brain scan or MRI is ordered first. This is followed by a treatment plan tailored for that patient as there’s no one-size-fits-all plan.
There are different types of treatments to address brain tumours, he said. These include:
- surgery to remove the tumour or to redirect the cerebrospinal fluid flow blocked by the tumour;
- radiosurgery where focused beams of radiation are used to treat the cancerous tissues;
- adjuvant therapy, which is radiotherapy or chemotherapy.
Misconceptions and myths
One of the most common myths about brain tumours are that they are most certainly terminal.
“Actually, a significant portion of brain tumours – about two thirds of them – are benign and can be removed completely if detected early,” he said.
Then there’s the myth that a patient will never function as “normal” again after undergoing brain surgery.
Regu explained that this was not true as there is a strong potential for recovery depending on the tumour’s type, how early it was detected and if it has not had the chance to cause much damage to the brain.
He also shared how some patients refused treatment after receiving a diagnosis, only to return requesting for another brain scan after claiming a traditional medical practitioner had treated them instead.
“While I’m not opposed to their beliefs, it is better to provide treatment in a complementary manner. This is because it’s important to establish trust with patients and respect their diverse beliefs, especially in our multicultural society.”
Above all else, Regu stressed the importance of seeking treatment early. “In our field, we always say time is neurons, because when parts of the brain are damaged, there are no spare parts or replacements.”