If you’ve been diagnosed with a brain tumour, or referred to a specialist by your GP for further testing, then no doubt you will have of lot of questions and new experiences and emotions to deal with. One of the things which often causes anxiety for new patients is going for a scan, but unfortunately multiple scans will usually be necessary. 

Here is some more information about the type of scans you will have, and some tips on how to feel calm and prepared during your scan. 

CT Scans

CT scans, or CAT scans as they are often called, refer to Computerised Tomography scans. The CT scanner will take multiple images of the inside of your head, and then computer technology will be used to stack them together into one 3D image. This allows clinicians to confirm if you have a brain tumour, and if so, where it is positioned and how big it is.

MRI scans

MRI stands for Magnetic Resonance Imaging, and this type of scanner uses magnetic fields rather than x-rays. However, the 3D image is created in a similar way, by taking several 2D images of the inside of your head, which are then used to build a single 3D image.

PET scans

PET scan stands for positron emission tomography scan. They work by injecting a slightly radioactive substance into the body, and a specialised camera is then used to highlight may areas of abnormality. They can provide a more accurate diagnosis of a tumour than MRI scans, but are more often used for monitoring purposes.

Before your scan

If you have told that you have an appointment for a scan, find out in advance which type of scan it will be, and ask your doctor to talk through the process with you. If you would find it helpful, record the conversation so you can play it back later and make sure that you have understood all the points. 

The scanning process

Both MRI and CT scans involve placing your head and neck inside the scanner. An MRI scanner is usually a tube shape, while a CT scanner is ring shaped. CT scans are usually fairly quick, taking between one to 10 minutes, depending on the model of scanner.

MRI scans usually take longer, and the time taken varies depending on how large the area being scanned is, and how much detail is required. It could be anything from 15 to 90 minutes. 

Before your scan, a clinician will conduct a health questionnaire to make sure that the procedure is safe for you. You’ll be asked to remove any metal items that you are wearing, such as jewellery, including piercings and watches. You will also need to remove dentures, hearing aids, glasses, and wigs. 

One of the main reasons that people fear scans is because they find the prospect claustrophobic. This is perfectly understandable and very common. It may help to have someone with you, such as a friend or relative. 

Let your GP or hospital staff know in advance if you think that you will have difficulty in coping because of your anxiety. They may prepare a mild sedative to help you feel calmer, although you should have someone to drive you home afterwards if this is the case. You will also be given an emergency button to press if you want to stop the scan at any point. 

In some cases, staff may be able to position mirrors which help you to see outside of the scanner, which can reduce feelings of claustrophobia. It may be useful to explore some mindfulness techniques, which focus on controlled breathing as a way of managing anxiety. 

Scans are not painful procedures, but they can be disconcerting experiences. An MRI scanner will make intermittent loud tapping noises, for example, which is created by the electric current being turned on and off. You’ll usually be given the option of listening to music through headphones, or given earplugs, which can help to keep you calm.

Remember that it’s important not to talk or move during the scan, as this will result in blurred and inaccurate images. Unless you have had a sedative, you should not experience any after effects from the scan. 

It usually takes one to two weeks for the results of your scan to be available. This can be an emotionally demanding time, and it may help to join some support groups which put you in touch will others in a similar situation. 

If you would like some more information about gamma knife surgery in the UK, please get in touch with us today. 

The All-Party Parliamentary Group on Cancer (APPGC) has discussed the diagnosis and treatment of brain tumours at a recent meeting. The Brain Tumour Charity reports that one of their Involvement Champions attended the meeting at Westminster to talk about her personal experience.

Phillipa Anders recently lost her husband Rob, after he was diagnosed with a grade 4 brain tumour in 2020. She talked about the lack of personal support Rob received at the point of diagnosis, and advocated the use of Holistic Needs Assessments to make sure patients are given sufficient advice from their healthcare team.

Philippa also raised the wider point that brain tumours are often diagnosed at the point of emergency admission to hospital, unlike many other types of cancer which are now detected by doctors much earlier. As brain tumours are responsible for the most cancer deaths in people under 40, and children, earlier diagnosis could save many lives.

Symptoms of a brain tumour include headaches, which are often combined with a frequent feeling of sickness, and problems with vision, such as the appearance of flashing lights, blurred vision, tunnel vision, or blind spots. Around eight out of 10 people will experience seizures, and some people may feel drowsy or lose consciousness.

Philippa told the meeting: ‘It is essential that brain tumours are diagnosed at the earliest possible opportunity to allow referrals and support to be put in place, but brain tumours aren’t ‘staged’ in the same way as other cancers and this needs to be factored into the NHS targets and ambition.”

She added: “The 10-Year Cancer Plan should include greater awareness and understanding of signs and symptoms, in healthcare settings, work settings, and the broader community.”

The APPGC also discussed the need for better communication between patients and healthcare professionals, better IT and digital systems, and improved staff retention rates within the NHS.

If you would like some information about gamma knife surgery in the UK. please get in touch today.

Cerebral arteriovenous malformations (AVMs) arise when an abnormal tangle of blood vessels occurs in the brain as a result of an abnormal connection between an artery and vein. These can have serious consequences such as haemorrhaging, stroke, brain damage and seizures. Gamma Knife radiosurgery represents a massive improvement in the treatment options for AVMs, as a targeted and precise, non-invasive approach.

What are the treatment options available for AVMs?

The three treatment options are endovascular embolization (“gluing”), neurosurgical resection (surgery) and stereotactic radiosurgery (Gamma Knife). In some cases, just one treatment modality is required but a mix of these treatments can sometimes also be used depending on the characteristics of the AVM and the patients’ own preferences.

Generally, for smaller AVMs that are under 3cm in size, Gamma Knife treatment is commonly used. Embolization can be used to de-vascularise or shrink the AVM prior to surgical or radio-surgical treatments.

How are AVMs diagnosed?

AVMs can occur anywhere in the body but most commonly present in the brain). Many patients have no symptoms of an AVM until a bleeding event occurs. AVMs are usually diagnosed by MRI or CT head. Angiography can be performed to give the best and most detailed picture of the vascular anatomy. They can often be discovered incidentally, that is to say when a scan is done for another reason. Alternatively, AVMs can present with symptoms such as seizures, headaches or a neurological problem like weakness in one part of the body or speech disturbance. AVMs can therefore have a significant impact on patient’s lives and the specifics of each case should be discussed with a skilled and experienced team.

Why do we treat arteriovenous malformations (AVMs)?

Untreated, AVMs carry a risk of haemorrhaging which can cause brain damage or death. A 2020 study on the clinical outcomes following cerebral AVM haemorrhage published by the National Library of Medicine found that an AVM rupture has around 20% likelihood to result in mortality, 45% likelihood to result in a minor or major deficit, and 35% likelihood of complete recovery. This means that even when an AVM presents without symptoms and a bleeding event has not occurred, it can be important to treat them.

There are also several factors that can increase the risk of AVMs haemorrhaging, including its size. Although it seems counterintuitive, smaller lesions tend to carry a higher risk of haemorrhage due to the higher arterial pressure that builds in smaller vessels.

What are the benefits of Gamma Knife?

Gamma Knife stands out as a treatment option from surgery and embolization in a number of ways. It mitigates the many risks associated with patients going under general anaesthetic, and of open surgery such as infection, bleeding, or wound problems.

Gamma Knife also has the capability to treat very deep and sensitively located AVMs which cannot be otherwise treated. This is because it uses up to 192 precisely focussed beams of radiation to target selected brain lesions, without harming the surrounding healthy brain tissue. From this, over time the walls of the AVM thicken and scar, eventually closing most of the vessels supplying the AVM, thus preventing rupture. Although the procedure involves several steps on the day of treatment including imaging and planning, the treatment itself in many cases can take less than an hour.

Article by Ms. Mary Murphy Clinical Director of Neurosurgery at The National Hospital for Neurology and Neurosurgery. Quality and safety lead for the specialist hospital board at University College Hospital London.

The waiting times for patients with brain cancer are not currently meeting NHS targets, the latest figures show. The national targets stipulate that 93% of patients who are referred for treatment with a suspected brain tumour should be seen within two weeks. However, the latest NHS data shows that the figure is 92.17%.

The overall target for cancer patients was even worse, with 89.07% of patients being seen within two weeks of referral. The Guardian reports that this has led to a 39% rise in people self-funding treatments, compared to pre-pandemic years.

The Brain Tumour Charity interim CEO Graham Norton commented: “It’s really concerning to see that, despite the incredible work of so many NHS staff, the target for those referred with suspected brain cancer to be seen within two weeks has been missed for five out of the last six months, as the pressures on the NHS continue.”

He added: “It is so important that people with worrying symptoms who are referred with a suspected brain tumour are seen within the two-week timeframe, so that they can either have a brain tumour ruled out or begin treatment and get the support they need as quickly as possible.”

“We know that any delays in this process can be distressing, at what will be an already worrying time. That’s why we’re calling for the Government’s new 10-year Cancer Plan to ensure sufficient planning and investment to grow the NHS cancer workforce and help increase capacity of these services to meet the growing demand.”

When a suspected brain tumour patient visits a specialist, they will undergo a neurological examination, which tests the vision, hearing, alertness, coordination, and reflexes. They may then be referred for a diagnostic scan which can produce a 3D image of the brain.

 

If you would like some information about gamma knife surgery in the UK, please get in touch today.

In the field of neurology and brain health, there are a number of tumours, lesions and growths that can cause pain and affect normal brain activity, most of which are observed and managed differently based on a range of different factors.

These are known as benign and malignant brain conditions and are often treated very differently from each other, with some conditions not receiving any treatment at all, whilst others require a very rapid response.

What is the difference between different conditions, why are some conditions not treated and how has gamma knife treatment fundamentally changed certain conditions, such as acoustic neuroma treatment?

Benign Vs Malignant Conditions

Most lesions, tumours and growths are graded based on their potential to spread, their present danger and how quickly they grow, with these elements affecting which treatment paths are available to a patient and in some cases whether treatment is possible at all.

Lesions and tumours that are benign are those that grow pretty slowly, do not spread away from the initial growth area and usually do not come back if they are entirely removed. This does not mean they are not serious, and in many cases, they can cause painful symptoms.

On the other hand, malignant tumours are cancerous tumours that grow quickly, can spread to different parts of the body and can be very difficult to treat, especially if not caught quickly

Why Were Some Tumours Not Treated?

Before the advent of more advanced targeted radiotherapy, some benign tumours and lesions were left untreated because of the risks inherent in brain surgery.

Due to the potential for complications, neurosurgery had enough of a risk that it was only used when the risk of the disease outweighed the risk of surgery, and where there is a certainty that the whole tumour can be removed and thus there is no risk of the tumour growing back.

This meant that for benign tumours where there was a low enough risk that observation was an option, or for tumours so fast-spreading and malignant that surgical intervention may not help, other treatments are attempted instead.

However, the rise of radiotherapy has helped to fundamentally change how some conditions are treated.

The Rise Of Radiotherapy

In 1951, Swedish neurosurgeon Lars Leksell pioneered stereotactic radiosurgery, more commonly known as Gamma Knife treatment, which allowed for accurate and precise doses of radiation to be used to target and destroy lesions whilst destroying as little healthy tissue as possible.

This treatment, which did not require any surgery, helped to transform the treatments of benign tumours such as acoustic neuromas and pituitary adenomas, not only because it could help to effectively control the growth of abnormal cells but in some cases could reduce the need for surgery at all.

This can also be used to reduce potential complications involved with certain types of neurological conditions and allows surgeons the option of removing most of the tumour safely whilst destroying the rest with careful use of stereotactic radiosurgery, a treatment that has a far shorter recovery time.