Learn how radiotherapy could effectively treat brain tumours, including those near the brain stem, where surgery may not be an option. Discover more today.
Cancer affects nearly one in two people in their lives and a not insignificant proportion of patients have brain tumours to deal with, which can be fatal but is not completely untreatable. However, not all tumours are cancerous.
The term ‘benign tumour’ is one you may have heard and could even have been diagnosed with. However, the word benign does not mean the same thing as harmless. It may not be cancerous, but it can cause problems of all sorts when it reaches a certain size and starts pressing on particular nerves, parts of the brain or the brain stem.
Tumours are, therefore, varied in nature. However, location can be critical in determining what kind of problems they pose and how they can be treated. Often, radiotherapy is the best option and more appropriate and effective than surgery or chemotherapy. On other occasions, different treatments may be effectively used in combination.
This is where our expert Mr George Samandouras comes to the fore, because one of the greatest dangers can come from brain stem tumours and his expertise is in dealing with these and glioblastoma, a specific kind of brain tumour.
Brain stems can be affected both directly and indirectly by tumour growth. The direct kind comes in the form of brain stem gliomas, which start in the brain stem. They can be cancerous, but are often not and while they are more common in children, they can often appear in adults too.
These come in three kinds that arise from different sorts of stem cells, which are astrocytomas, oligodendromas and ependymomas, which come from astrocyte, oligodendrocyte and ependymal cells respectively. All three include some tumours that are cancerous and some not.
The latter distinction is a key issue when it comes to the risk to life, as cancer in this area can spread easily, making treatment vital. A non-cancerous tumour typically causes severe headaches in adults and this, plus several other symptoms, in children.
Critically, because of its location, a brain stem glioma cannot always be excised with invasive surgery although this is sometimes possible. In any case, radiotherapy is a common means of treating it, as is chemotherapy.
Because a brain stem glioma is incurable, it cannot be removed entirely, but treatment can extend life considerably, as well as provide some relief for symptoms.
According to a 2016 review published by Frontiers in Oncology, the average survival time for adults after diagnosis is 30-40 months. This worsens with age, with a median survival time of 34 months for those aged 22-59, but just 14.5 months for over 60s.
The other way the brain stem can be impacted by a tumour is if it starts elsewhere and then grows to the point where it spreads to the brain stem.
A prime example of a tumour that does this is an acoustic neuroma. These tumours start off growing by the vestibulocochlear nerve, with the normal symptoms of these benign tumours being hearing loss in one ear, tinnitus and vertigo.
While those elements can be deeply troubling and may be treated with radiotherapy to relieve them, an acoustic neuroma is very slow growing and often it simply be monitored. It does not actually grow in the brain, but presses on it and can do so more as it grows. However, it can be deadly if this spreads and grows to press on the brain or cerebellum.
This particular kind of tumour is commonly treated by radiotherapy. This is preferable to invasive surgery because that can cause hearing loss and in one case, translabyrinthine surgery, it will definitely cause a loss of hearing as that requires removing a bone from the inner ear.
For acoustic neuroma, single fraction stereotactic radiosurgery can be used in a single session of multiple beams, or Multi-session fractionated stereotactic radiotherapy, which involves multiple daily sessions over a period of weeks, the latter being a better option for preserving hearing.
While these choices can be dictated by the risks to a patient’s hearing, if the tumour is growing and threatening the brain stem the choice is all about what can do the most to prevent it from pressing on the stem, be it excision of shrinkage through radiation therapy.
Because the brain stem is such a sensitive area, it certainly requires some very highly skilled work to reduce tumours in or near it, whether this be by radiotherapy, surgery, chemotherapy or any combination of these.
If you would like more information about brain tumour treatment, please contact Mr Ciaran Hill of Amethyst Radiotherapy.
Centres of Excellence for Stereotactic Radiosurgery treatment of complex Brain Tumours
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