Treatment of tumors involving the brain and spine is one of the msot common conditions dealt with by neurosurgeons in their clinical practise. There is a wide spectrum of tumors affecting the cranio-spinal axis and it is very important for the patients and their families to understand this difference prior to commencing the treatment. Quite often, they compare their condition and results with other patients. This significantly affects their own decision making ability and quite often does more harm to their own patient than benefit. The various factors to be taken into consideration include the location of tumor, the pathology of tumor and the neurological condition of the patient prior to undergoing surgery.
Broadly, brain tumors can be divided into Benign and Malignant tumors and intra-axial (gliomas) and extra-axial (meningiomas) tumors. The outcomes achieved are with a curative intent in bengin tumors and extra-axial tumors.
Emphasis is laid on dealing with these patients in multi-disclipinary manner. This involves the radiologist, anaesthetist, neuropathologist, radiation and medical oncologist.
Use of advanced modalities like microscope, endoscopes, navigation, stereotaxy, CUSA and neurosurgical drills (for skull base approaches) significantly alters the outcomes.
Adjuvant therapy has also become very safe. More focused radiation techniques using LINAC reduce the fall out effect of radiation on surrounding brain parenchyma. Chemotherapy for brain tumors is now available in for of tablets and can be taken at home.