Neurosurgeons Treat Brain Tumors Utilizing Cutting Edge Techniques

According to the American Association of Neurological Surgeons (AANS), it is estimated that in 2005, there were a total of 18,500 new cases of brain and other nervous system tumors diagnosed 10,620 males and 7,880 females. The estimated number of deaths was 12,760, of which 7,280 were males and 5,480 were females. A brain tumor is an abnormal mass of tissue in which cells grow and multiply uncontrollably, seemingly unchecked by the mechanisms that control normal cells.


Over the last 20 years, new and sophisticated techniques have led to advances in the treatment of brain tumors that were previously considered inoperable. Cutting edge techniques utilized by neurosurgeons include endoscopy, radiosurgery, computer-assisted removal, and brain mapping all of which can help preserve critical neurological functions.


Glioma, the brain tumor Sen. Edward M. Kennedy was diagnosed with, is the most prevalent type of adult brain tumor, affecting an estimated 9,000 people a year. Sen. Kennedy's glioma is located in the left parietal lobe in the upper left part of his brain. The parietal lobes interpret simultaneously, signals received from other areas of the brain such as vision, hearing, motor, sensory, and memory.


Gliomas arise from the supporting cells of the brain, called the glia. These cells are subdivided into astrocytes, ependymal cells and ologodendroglial cells (or oligos). These are graded from the lowest grade 1 to highest grade 4. Glial tumors include the following:


-- Astrocytomas are the most common glioma, accounting for about half of all primary brain and spinal cord tumors. Astrocytomas develop from star-shaped glial cells called astrocytes, part of the supportive tissue of the brain. They may occur in many parts of the brain, but most commonly in the cerebrum.


-- Ependymomas are derived from a neoplastic transformation of the ependymal cells lining the ventricular system, and account for 2 to 3 percent of all intracranial tumors. Most are well-defined, but some are not.


-- Glioblastoma Multiforme (GBM) is the most invasive type of glial tumor. These tumors tend to grow rapidly, spread to other tissue, and have a poor prognosis. They may be composed of several different kinds of cells, such as astrocytes and oligodendrocytes. GBM is more common in people ages 50 to 70, and more prevalent in men than women.


-- Medulloblastomas usually arise in the cerebellum, most frequently in children. They are high-grade tumors, but they are usually responsive to radiation and chemotherapy.


-- Oligodendrogliomas are derived from the cells which make myelin, which is the insulation for the wiring of the brain.


Diagnosis


Sophisticated imaging techniques are utilized to pinpoint brain tumors. Diagnostic tools include computed tomography (CT or CAT scan) and magnetic resonance imaging (MRI). Intraoperative MRI is also used during surgery to guide tissue biopsies and tumor removal. Magnetic resonance spectroscopy (MRS) is used to examine the tumor's chemical profile and determine the nature of the lesions seen on the MRI. Positron emission tomography (PET scan) can help detect recurring brain tumors.


Brain Tumor Treatment


Brain tumors (whether primary or metastatic, benign or malignant) are usually treated with surgery, radiation, and/or chemotherapy alone or in various combinations. Gliomas can present a challenge for complete surgical resection (removal) because they have roots and tentacles. While it is true that radiation and chemotherapy are more often used for malignant, residual or recurrent tumors, decisions as to what treatment to use are made on a case-by-case basis and depend on a number of factors. There are risks and side effects associated with each type of treatment.


Outcome


For a rarely seen grade 1 glioma, there is an estimated 90 percent five-year survival expectancy. For a grade 2 glioma, there is an estimated 60 to 70 percent five-year survival expectancy after surgery and radiation. For a grade 3 glioma, there is an estimated 30 percent five-year survival rate after surgery, radiation, and chemotherapy. For the most devastating brain tumor, glioblastoma multiforme, five-year survival is only about 3 percent.


Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 7,200 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain, and peripheral nerves.


American Association of Neurological Surgeons (AANS)

5550 Meadowbrook Dr.

Rolling Meadows, IL 60008

United States

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