NOPPASIN TAKERNGDEJ, M.D.
Neurosurgery
The brain is a vital organ that signals and controls various aspects of our lives. It is no surprise that when something happens to the brain, such as being diagnosed with a brain tumor, we often worry about what the future holds. Patients diagnosed with brain tumors frequently convey these negative feelings to me. As a neurosurgeon, the treatment for a brain tumor must begin with alleviating that anxiety—clearing up doubts about where it came from and whether it can be treated.
If you or a relative discovers a brain tumor, remember to breathe slowly, stay calm, and remain mindful. This is the most crucial starting point for treatment, and I will explain why shortly.
I always tell my patients that there are two main types of brain tumors:
If you have no prior history of cancer, statistics show that about 70 percent of brain tumors are benign. After diagnosis, doctors will attempt to identify the specific type; currently, they can be sub-categorized into 130 types. For initial identification, I categorize them into two broad groups:
The difference in tumor type significantly affects the treatment plan and prognosis. Confirming the type requires a biopsy. Therefore, a doctor's opinion before the biopsy results is based on probabilities derived from medical history and X-ray imaging.
With growing knowledge in Epigenetics (mechanisms affecting genes without altering the DNA sequence), we have found that various factors can lead to brain tumors. A major cause is a modern lifestyle filled with stress, which can trigger the secretion of stress hormones.
Stress can lead to cellular abnormalities and decrease the body's ability to eliminate abnormal cells, eventually impacting tumor growth. Therefore, reducing stress is the first step in preparing to fight brain tumors effectively.
Because blood vessels in the brain can be compressed or pulled by a tumor, patients often experience nausea and abdominal discomfort along with "headaches," which frequently occur in the morning. These are general symptoms found in both benign and malignant tumors. Headaches can range from moderate to severe and may be intermittent, with characteristics varying based on the tumor's location and size. Common symptoms include:
If you experience headaches with these characteristics, you should consult a doctor immediately for a diagnosis.
Currently, tumor grading is based on the World Health Organization (WHO) classification. WHO grades range from 1 to 4: Grade 1 refers to tumors that are slow-growing and least aggressive, while Grade 4 refers to rapidly growing or invasive malignant cells.
Initially, the doctor will take a medical history, perform a physical exam, and screen for tumors using a Computerized Tomography (CT) scan or Magnetic Resonance Imaging (MRI) to examine the tumor size and surrounding details.
Brain tumors are treatable, but the outcome depends on the type, size, and location. Treatment is generally divided into three methods:
Close monitoring to track the size and behavior of the tumor. Doctors often find these tumors incidentally via CT or MRI in patients who show no symptoms. These tumors have often been present for a long time and do not affect the patient's daily life.
Surgery is necessary if the tumor causes abnormal symptoms or is a benign tumor that has grown larger during observation. Today, Minimally Invasive Surgery is used for certain types of tumors, often in conjunction with surgical navigation systems (Navigator) for precision and safety.
This includes various other treatment modalities. The choice of treatment depends on the type, size, location, age, and overall health of the patient. These methods are often used as alternatives or in combination with surgery.
After learning about treatment methods, many wonder about the prognosis. Can it be fully cured? Studies show that many types of brain tumors can be cured, with a low chance of recurrence. I want everyone to feel at ease and be prepared for every step of treatment.
Before your appointment, patients should prepare information such as:
Since the exact cause of many brain tumors is not fully understood, prevention focuses on overall health maintenance and avoiding cancer risk factors, such as:
Headaches are common in brain tumor patients, but they are often more severe and progress rapidly. Medication often fails to provide relief, and nausea may be present. Symptoms are typically worse in the morning because the tumor can swell during sleep.
Complications can be serious and may lead to disability. Common complications include memory loss, issues with vision, hearing, speech, or smell. Some patients may experience seizures, limb weakness, lower-body paralysis, bladder/bowel issues, or an increased risk of pneumonia.
Malignant brain tumors can recur. In most cases, they reappear near the original site, though they can occasionally be found elsewhere. Therefore, patients should attend all follow-up appointments for regular monitoring.
Brain tumors are treatable, though outcomes vary based on type, location, and size. Key points to understand after diagnosis include:
Don't forget to keep your heart strong. With mindfulness, we can understand things better and find happiness.
Neurosurgery