Understanding Glioblastoma - Advanced Brain Tumor Surgery in India

Ever heard of gliomas? These primary brain tumors arise within the brain, but we don't know the cell of origin.There are multiple grades of gliomas -- grade II, III and IV, with grade IV being the most malignant. 

Grade IV tumors are called glioblastoma. They are the most aggressive and are very infiltrative - they spread into other parts of the brain quickly. Glioblastomas don't metastasize outside of the brain.  Glioblastomas can occur in any lobe of the brain and even the brain stem and cerebellum, but more commonly occur in the frontal and temporal lobes. Below, I've answered some common questions I get about glioblastoma.

Are there any known causes or risks factors for glioblastoma?

 Glioblastoma are more common in males, persons older than 50, and people of Caucasian or Asian ethnicity.  There are a few very rare familial syndromes that are associated with brain tumors. One of the only known risk factors that we have for brain tumors is radiation exposure.

What are common symptoms of glioblastoma? 

 The symptoms for any brain tumor are related to the locations from where the brain tumor originates and the rate of tumor growth. Symptoms can vary widely. Some are silent and only found incidentally when a brain scan is done for another reason.  

The most common symptoms include headaches, nausea, vomiting and seizures. Tumors frequently cause subtle personality changes and memory loss or, again, depending on location, muscle weakness and disturbances in speech and language.  

 How is a glioblastoma diagnosed? 

 Most patients with glioblastoma undergo a CT scan, followed by MRI. The actual pathological diagnosis has to be made at the time of surgery (tissue is removed and examined by a neuropathologist). 

What are the treatment options for a glioblastoma? And why, typically, is it hard to treat? 

 The standard treatment for glioblastomas is maximal safe resection (surgery), followed by concurrent radiation and an oral chemotherapy called temolozomide over a 6-week period. Upon completion of radiation, 6-12 cycles of adjuvant temolozomide are given to the patient five days in a row every four weeks. 

Glioblastomas are not surgically curable, but there is good evidence that the more tumor that can be removed, the better the prognosis. The radiation and chemotherapy are designed to target the infiltrative component of the glioblastoma and delay tumor progression. 

What advice would you give someone who has just been diagnosed with a glioblastoma?

One of the most important things that you can do is to seek care or even a second opinion by people that spend all of their time treating this disease. Glioblastoma is a very complicated disease. There are a lot of nuances to both the diagnosis and the treatment, and you want an expert to help you work through the treatment process. 

Also look for a physician who will give you the undivided time and attention you deserve. Your doctor shouldn't be rushing through your visit. I talk to patients about their diagnosis, explain to them all the aspects of the treatment as well as the impact of the tumor on their quality of life. I also spend as much time answering questions as the patient requires. 

Most Advanced  & Latest: Brain Cancer Tumor Treatment in India
For Brain tumor treatments; our hospitals have the multidisciplinary team of Neurologists, Neuro-oncologists, surgical oncologists (Head & Neck unit), Medical oncologists, Radiation Oncologists, Onco-pathologists and neuropsychologists and other Specialists.

There are three main types of treatment approaches for brain tumor:

• Surgery
• Chemotherapy
• Radiotherapy (radiation therapy)

Multi – Disciplinary treatment approaches performed at our world class Hospitals Brain Cancer Tumor Treatment in India

• Brain Suite– latest advancement in image-guided surgery, providing real-time views of the tumor site with intraoperative magnetic resonance imaging (IMRI)
• Trans-Nasal Endoscopic – Advanced surgical treatment options for the management of brain tumors and lesion
• Stereotactic Radiosurgery- Advanced imaging technologies to destroy the tumor and achieve permanent local control.
• Tumor Embolization using Neuro Interventional Radiology.
• Endoscopic Minimally Invasive Neurosurgery.

Latest Treatments – Leukemia Treatment in India at Best Cancer Hospital

Leukemia is cancer of the blood cells. Most blood cells form in the bone marrow. In leukemia, cancerous blood cells form and crowd out the healthy blood cells in the bone marrow. The type of leukemia depends on the type of blood cell that has become cancerous. For example, acute lymphoblastic leukemia is a cancer of the lymphoblasts (white blood cells that fight infection). White blood cells are the most common type of blood cell to become cancer. But red blood cells (cells that carry oxygen from the lungs to the rest of the body) and platelets (cells that clot the blood) may also become cancer.

Leukemia occurs most often in adults older than 55 years, and it is the most common cancer in children younger than 15 years.

Leukemia is either acute or chronic. Acute leukemia is a fast-growing cancer that usually gets worse quickly. Chronic leukemia is a slower-growing cancer that gets worse slowly over time. The treatment and prognosis for leukemia depend on the type of blood cell affected and whether the leukemia is acute or chronic. Chemotherapy is often used to treat leukemia.

Symptoms

The symptoms of leukemia depend on the severity of the cancer. However, the general symptoms are fevers & night sweats, bone pain, unusually frequent infections, bleeding from the rectum or gums, bruising of the skin, swelling in the belly, radiating pain in left shoulder, pain in the left of the belly and weight loss with decreased appetite.

Risk Factors

The risk factors of the leukemia will be increased with the usage of tobacco, smoking, more radiation, exposing to certain chemicals and sometimes also past chemotherapy treatment taken for another cancer.

Types 1. Acute Leukemia

The immature blood cells are rapidly increased to cause the acute leukemia. Such excess cells make the production of the healthy blood cells to be impossible by the bone marrow. Since the malignant cells are rapidly progressing and accumulated, immediate treatment should be given. Otherwise, there will be chances of spreading to the other organs of the body, through splitting over into the bloodstream. It is the most common type of leukemia found in the children.

2. Chronic Leukemia

The blood cells, which are relatively mature, but grown abnormally and become excessive, cause the chronic leukemia. It takes a long time like months and years to grow. The chronic forms are to be monitored before attempting to go for the treatment so that the maximum effectiveness of the therapy can be ensured. It generally occurs in older people, however, technically it is possible to attack anyone of any age. There are no symptoms experienced in the beginning. When it gets severe, infections or swollen lymph nodes are experienced.

Diagnosis

There are multiple diagnostic methods to identify the leukemia.

1. Physical Exam
The swollen lymph nodes, liver and spleen are physically checked by the doctor. 2. Spinal Tap

Cerebrospinal fluid is removed in small amounts by the doctor. This is the fluid that fills the spaces found in and around the spinal cord and brain. A thin and long needle is used to remove this fluid taken from the lower spine. The fluid is then
examined in the lab to find the other signs of the problem.

3. Blood tests

Blood tests are conducted in the lab to check the number of red blood cells, platelets and white blood cells from the sample blood. Since the white blood cells are in high level and eventually, the count of hemoglobin and platelets will be decreased in the red blood cells.

Biopsy: In this process, a small tissue with the cancer is removed from the body for the
check up. This process ensures the infected leukemia. Local anesthesia is given to the organ in order to numb that area.

Bone Marrow Biopsy: A needle, which is thick and hollow, is used to remove the bone marrow and bone in small pieces.

Bone Marrow Aspiration: a very thick and hollow needle is used to remove the same small pieces of bone or bone marrow.

4. Chest X-ray

Chest X-ray helps to view the lymph nodes that are swollen along with the other signs of related disease in the chest.

5. Cytogenetics

In this diagnosis process, a sample of bone marrow, lymph nodes and blood are taken to look at its chromosomes of the cells. The variation and abnormalities in these chromosomes can show the type of the leukemia that patient has.

Leukemia Treatment in India at Best Cancer Hospital

1.  Stem Cell Transplant

The stem cell transplant treats the leukemia, using high dose of radiation or drugs and sometimes both of them. The stem cells are to be taken from the donor, when there is a close math of the bone marrow of the donor and patient. It is necessary to take before, as the high dose kills the leukemia cells as well as the normal blood cells. So, right after the chemotherapy, the stem cells collected from the donor will be put back into the blood. The new blood cells are produced by the stem cells within a few weeks of time.

2. Targeted Therapy

Targeted therapy targets only the cancer causing cells through the usage of the drugs, still not damaging the healthy cells. Cancer growth inhibitors are one kind of this therapy.

3.     Chemotherapy

Chemotherapy is the usage of the drugs to destroy the cancer cells. These drugs can be given by the pills or injection to interfere, the cancer cells’ growth ability. However, they also tend to damage the healthy cells to some extent. And these damaged healthier cells can be recovered over a period of time. It may cause the side effects like vomiting, fatigue, hair loss, nausea, increased risk of infection and loss of appetite.

4.     Biological therapy

Biological therapy makes use of the built-in immune system to enable it to fight against the cancer or sometimes also implemented to control the side effects caused from the other cancer treatments. The body’s defenses are boosted up using the drugs or normal body substances to fight against the illness.

5.     Radiation therapy

High doses of radiation like X-rays are used to destroy the cancer cells in this treatment.

Liver Cancer Treatment India | Liver Cancer Hospitals in India

The liver is the main organ inside the body. It lies just below your ribs and right lung. The liver is generally made up of cells called hepatocytes. It is also made up of other forms of cells. They make bigger when harmful cells produce and increase in the liver than it results in liver cancer.

What are the Types of Liver Cancer?

There are two types of liver cancer: -

Primary Liver Cancer: - Primary liver cancer is one of the less common cancers in Victoria with about 260 people diagnosed each year. It is more common in men and people aged over 65 years. Most primary liver cancers start in liver cells (hepatocellular carcinoma); others start in a bile duct (cholangiocarcinoma). 

In the Western world, most people who develop primary liver cancer also have cirrhosis of the liver. This is scarring of the liver due to causes including heavy alcohol drinking over a long period of time. However, only a small number of people who have cirrhosis of the liver develop primary liver cancer. Infection with hepatitis B, C or D can also increase the risk of cirrhosis and, later, primary liver cancer.

Hepatocellular Cancer: - This is the most widespreadtype of liver cancer in adults. It is also called hepatoma.Hepatocellular cancer (HCC) can have diverse developmentsamples. 

Somestart as a single cancer that developsbigger. Onlydelayed in the disease it extends to other parts of the liver.This is seen most often in people with constant liver damage.

Intrahepatic cholangio carcinoma (bile duct cancer): -These cancers found in the cells that line thetiny tubes that take bile to thegallbladder within the liver. 

Angio sarcoma and hemangio sarcoma cancer: -These are exceptional cancers that start in cells lining the blood vessels of the liver. These cancersriserapidly and are generally toowidespread to be detached surgically by the timethey are originated. 

Hepatoblastoma Cancer: - This is a extremelyexceptional form of cancer that increases in children, generally in those younger than 4 yearsold.

Secondary liver cancer: - Most of the time when cancer is creates in theliver it did not start there but has metastasized from somewhere else in the body, such as the pancreas, colon, abdomen, breast, orlung. Because this cancer has increase from its primary site, it is a secondary livercancer.

Signs & Symptoms of Liver Cancer: -

Liver cancer frequently does not confirm until thelater stages of the disease, but from time to time theyshow up earlier. If you go to your doctorwhen you first observe symptoms, your cancermight be diagnosed earlier, when treatment ishelpful. 

Some of the most ordinary symptoms of liver cancer are:

     Weight loss without any effort
     Loss of hunger
     Feeling very full after a little meal

     Sickness or vomiting
     Abloated liver, felt as a mass below the ribson the right side
     Adistendedirritation, felt as a mass below the ribson the left side
     Pain in the stomach or near the right shoulderblade
     Growth or liquidincrease in the stomach Itching.
     Jaundice.


Some liver cancerscreate hormones that perform onorgans other than the liver. These hormones maycause:

Hypercalcemia, whichcan cause sickness, disorientation, obstruction, pronenessn, or muscle problems

      
      Hypoglycemia, whichcan cause tiredness or lose of consciousness.

      Breast expansion and reduction of the testicles in men

 
      Large number of erythrocytosis which can cause someone to look red and aroused.

      Eminent cholesterol levels

If you are suffering from any of these trouble, it′s important to see your doctor right away so the cause can be found andchecked, if required.

What are risk factors of liver cancer?

A risk determinant is everything thing that influences your chanceof getting a affliction, such as cancer. Differentcancers have dissimilar risk determinants. Some riskfactors, like smoking, can be reciprocated.

There are various risk factors: -

Gender : - Hepatocellular carcinoma isordinary in males than in females. Much of this is apparently because of behavior of conducting.

Chronic viral hepatitis : - The most usual risk determinant for livercancer is long-termcontamination withhepatitis B virus (HBV) or hepatitis C virus(HCV).

Cirrhosis : -Cirrhosis is a infection in which liver cells become busted and are retriened by scar tissue.

Abundant alcohol use : - Alcohol abuse is a preeminant reason of cirrhosis in the United States, which in turn is related with anincreased danger of liver cancer.

Chubbiness : - Being overweightraises the danger of growing liver cancer. This is apparentlybecause it can result in fatty liver infection.


Infection with parasites : -Infection with the parasite that results schistosomiasis can cause liver damage and is related to liver cancer.


Tobacco use : - Smoking raises the risk of getting livercancer. Former smokers have a lesser risk than contemporary smokers, but both groups have a greater danger than those who never smoked.


Birth control pills : - Inexceptional cases, birth ascedancy dose, also known asoral birth control method, can cause amiable cancers called hepatic adenomas.


How is liver cancer diagnosed?

Physical analysis helps in deciding symptoms that may express the existence of liver cancer. Some of the other examinations that are performed identifying liver cancer contain : -

Laparoscopy : - The blood tests also include liver adjuvants and a serum antioxin test.

Angiogram : - The dose of a pigment is complete into an avenue that shows tumor and liver tissues.

Ultrasound : -Immense abudance sound waves from the body are transmitted by this method.

Magnetic Resonance Imaging (MRI) : - A computer, extensiveallurement and radio waves are created in this test that offers clear image of the human body.

CT Scan : - This test also gives explained images of the organs.

How Is Liver Cancer Treated ?
 

Transplant: For some patients a liver transplant may be an option, but only if the cancer has not spread to other organs and a suitable liver can be found. 

Surgery: In cases where the cancer has been found early and the liver is otherwise healthy, or has only early-stage cirrhosis, doctors will remove the portion of the liver where the tumor is located, a process called surgical resection. 

Cryosurgery (also called cryotherapy): This is the use of extreme cold produced by liquid nitrogen (or argon gas) to destroy abnormal tissue. 

Ablation: Some liver tumors can be destroyed by processes called ablation. Radio frequency ablation kills liver tumors by heating them to high temperatures with microwave probes. Another ablation technique destroys tumors by injecting them with ethanol, a form of alcohol. 

Chemotherapy: Although chemotherapy cannot cure liver cancer, a new technique called transarterial chemoembolization may help prolong life for liver cancer patients. In this procedure, chemotherapy drugs are injected into the blood vessels that feed the tumors. This delivers a high dose of chemotherapy to the tumor while decreasing the flow of blood that feeds the tumor. 

Radiation therapy: In some cases, doctors may try to reduce the size or slow the growth of liver cancer with radiation, or high-energy x-rays. Traditional radiation therapy also destroys healthy liver tissue, so doctors are experimenting with new techniques that deliver the radiation with higher precision.