Most Advanced Gamma Knife RadioSurgery in india

Gamma knife is now the most accepted and widely used radio surgery treatment in the world for brain tumours. About half a million people have been treated with Gamma knife surgery, and it's the only Radiation Therapy System cleared by the FDA for irradiating brain metastases. Gamma knife surgery, despite the name, there is no blade or knife - it's called Gamma knife because radio surgery (one-session treatment) has such a dramatic and precise effect in the target zone that the changes are considered 'surgical.' So there's no incision or blood, and minimal risk of complications. The device aims gamma radiation through a target point in the patient's brain. The patient wears a specialized helmet that is surgically fixed to the skull, so that the brain tumor remains stationary at the target point of the gamma rays. An ablative dose of radiation is thereby sent through the tumor in one treatment session, while surrounding brain tissues are relatively spared.

 Radiosurgery uses high doses of radiation to kill cancer cells and shrink tumors, delivered precisely to avoid damaging healthy brain tissue. Gamma Knife radiosurgery is able to accurately focus many beams of high-intensity gamma radiation to converge on one or more tumors. Each individual beam is of relatively low intensity, so the radiation has little effect on intervening brain tissue and is concentrated only at the tumor itself.

 GammaKnife radiosurgery has proven effective for patients with benign or malignant brain tumors up to 4 centimeters in size, vascular malformations such as an arteriovenous malformation (AVM), pain or other functional problems.

The risks of gamma knife radiosurgery treatment are very low, and complications are related to the condition being treated. Gamma-Ray Stereotactic Treatment System. The Gamma Knife instrument put many gamma-ray beams from different angles and directions irradiate to body, making them all together to form the focus point. Since each dose of radiation beam is very small, it basically does not cause damage to human tissues which it through. As long as the ray focuses on the lesion, it can be as precise as a scalpel to destroy the lesion, with no trauma, no hemorrhage, no infection, no pain, and also reach rapid, safe, reliable magical effect.

Why is gamma knife surgery performed? 

Your doctor may recommend gamma knife surgery to treat some diseases and conditions of the brain. Your doctor may recommend gamma knife surgery to treat:

• Acoustic neuroma, a tumor of the nerve between the brain and the ear
• Arteriovenous malformations (AVMs) and other blood vessel disorders in the brain
• Brain tumors including some types of malignant and benign tumors
• Some types of cancer of the eye
• Epilepsy caused by a brain tumor. A brain tumor that causes epilepsy may be treated with gamma knife surgery if medications do not control seizures.
• Parkinson’s disease, a brain disorder that leads to uncontrollable shaking, muscle stiffness, and severe problems with coordination and balance
• Trigeminal neuralgia, a nerve disorder causing debilitating face pain

 Advantages Of Gamma Knife Radiosurgery

• Gamma Knife is a neurosurgical tool designed exclusively for the treatment of brain disorders.

• No incisions, No general anesthesia.

• The lesion being treated receives a high dose of radiation with minimum risk to nearby tissue and structures..

• The absence of an incision eliminates the risk of haemorrhage and infection.

• A secure head frame ensures safety and accuracy within half a millimeter

• Hospitalization is short, typically an overnight stay or an outpatient surgical procedure. Patients can immediately resume their previous activities.

• Patients go home usually on the same day (time lost from employment is minimal)
  
  
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Advanced MR imaging helps in interpretation of Brain Tumours

Advanced MR imaging techniques such as perfusion and functional imaging have been a great help in improving the diagnosis and staging of brain tumours. Unlike conventional MR techniques, advanced MR techniques can be used to obtain information not only on the morphological, but also on the functional characteristics of tumours.

One of the most common types of brain tumour is glioblastoma, which is highly malignant and has a high cell reproduction rate due to the fact that it is nourished by a large network of blood vessels. there are two types of glioblastoma: primary glioblastomas, which tend to form and make their presence known quickly by growing aggressively, and secondary glioblastomas, which are also aggressive but show slower growth and only represent 10% of all diagnoses.

Due to a lack of effective of therapies, the prognosis in cases of glioblastoma remains poor, and so there is an urgent need to find new therapeutic approaches.

One of the reasons why the treatment of glioblastoma is such a challenge is that it consists of various cell types, which may react differently to various forms of treatment. As a result, the treatment, in most cases, combines several methods.

“Overall there is no effective treatment for high-grade glioblastoma. The current therapeutic approaches are surgical resection of the tumour bulk if possible, depending on the location of the tumour, followed by radiation and chemotherapy. One of the main difficulties is that it can be difficult to exactly measure the tumour‘s extent, since malignant tumour cells often infiltrate the brain parenchyma beyond the tumour’s contrast-enhanced portion, which makes it difficult to completely surgically resect the initial tumour .

Radiation and chemotherapy are used to slow the growth of tumours that cannot be removed surgically. Chemotherapy may also be used in young children to delay the need for radiation.

Despite achievements in the field of advanced imaging techniques it still remains difficult to predict and monitor brain tumour response in individual patients, especially when it comes to the use of anti-angiogenic therapies, during which uncommon patterns of tumour response and progression can be seen.

Pseudoprogression for example usually occurs early while treating a brain tumour with radiation and Temodar, which makes the tumour appear to progress due to its increased size and contrast enhancement. This is a common reaction to the treatment, but the lesion will decrease in size and concentration on its own if the initial treatment is continued without any change.

Pseudo-response on the other hand occurs during anti-angiogenic therapy, for example the use of Avastin, which causes significant reduction in contrast enhancement due to changes in vascularity, but should not be mistaken for a real reduction in the extent of the lesion.

“Both can be best detected with advanced MR imaging especially diffusion-weighted imaging, which looks at the random motion of water molecules and perfusion imaging, which studies the cerebral blood volume and cerebral blood flow in the brain, including the tumour. Though MR spectroscopy is less helpful.”

Confusion and incorrect interpretation can, in part, be avoided by having good clinical information about the original tumour type; tumour extent, as seen through MR imaging after contrast administration; current course of chemotherapy treatment; radiation dose; and the time between radiation treatment and imaging findings. It is also helpful to use perfusion and diffusion imaging as part of the MR imaging protocol. The use of PET imaging might also be valuable, as well as a combination of information gained from both modalities.

Despite the fact that the long-term prognosis remains poor, there have been recent studies which have shown an increase in the overall survival rate for glioblastoma patients treated with Avastin .

Especially in recurrent glioblastoma, the treatment options have mainly been limited to high-dose chemotherapy. The administration of Avastin alone or in combination with CPT-11 has shown a significant improvement in response rates, progression-free survival times and overall survival.

A more recent study has shown that Avastin alone was nearly as effective as it was in combination with chemotherapy, but with much milder side effects. When dealing with patients suffering from terminal glioblastoma a stand-alone Avastin therapy may lead to an improvement in quality of life, without the common toxic side effects of chemotherapy.

When asked about whether we need advanced imaging techniques in daily practice, Yes, I strongly advocate the use of advanced MR imaging in the work-up and follow-up of a patient with brain tumour. It is helpful for the radiologist or neuroradiologist to give the correct interpretation and it is helpful for the clinician in the treatment of the patient.

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MRI Guided Brain Tumor Surgery in India : Advantages of Next Generation Technology Over Conventional Neurosurgery to Remove Brain Tumor

MRI Guided Brain Tumor Surgery in India

A brain tumor is a group (mass) of abnormal cells that start in the brain. Primary brain tumors can arise from the brain cells, the membranes around the brain, nerves, or glands.

Tumors can directly destroy brain cells. They can also damage cells by producing inflammation, placing pressure on other parts of the brain, and increasing pressure within the skull. The cause of primary brain tumors is unknown. There are many possible risk factors that could play a role. MRI Guided Brain Tumor Surgery is an advanced imaging treatment technique developed to enable neurosurgeons with intra-operative MRI to aid in the removal of complex and difficult-to-access brain tumors during surgery.  The technique involves use of a powerful computer system that precisely helps neurosurgeon locate a lesion, plan each step of the procedure on computer screen and find out the ideal access to the tumor before performing the operation. The technique is particularly helpful in treating a tumor that has difficult accessibility such as it is located deep inside the brain. During the procedure, the instrument movement is tracked very precisely by the computer providing surgeon with total control inside the brain with the help of real-time imaging. The technique also helps the surgeon to check if the tumor has been removed. The Brain Suite has two main parts. There is a high-intensity MRI scanner integrated with an image-guided surgical system. The MRI scanner has a wide-bore opening allowing a patient to lie on his or her side. Previously, tumors that could only be accessed from the side of the skull were not easy to scan. This special MRI system lets doctors repeat scans during the operation to get more accurate information on the location, shape and size of the tumor. This minimizes problems associated with brain tumors shifting during excision. Advantages of Next Generation Technology over Conventional Neurosurgery to Remove Brain Tumor Conventional Neurosurgery to remove Brain Tumor MRI Guided Brain Tumor Surgery in a Brain Suite, Next Generation Technology Conventional neurosurgical procedure like conventional craniotomy relies on surgeon's visualization of the tumour. The surgeon has to spend time and significant effort to find the tumor. The surgeon is guided during the surgery by live Advanced New Generation computer assisted MRI and thus knows exactly where tumor ends and normal brain begins. In some types of tumours, surgeons may not completely visualize the tumour and there is a risk that surgeon can resect normal brain tissue along with the tumor, which can result in neurologic deficit, paralysis, loss of speech, blindness etc. Enhanced ability of Neurosurgeon to excise the complete tumor. Less risk of post operative complications. Functional image guidance with MRI allows for accurate, non-invasive preoperative assessment and planning for brain tumor surgery. Normal brain tissue can be damaged unnecessarily. This can result in neurologic deficit and prolonged stay in the hospital MRI guided Brain Tumor Surgery allows a more complete tumor removal with much less risk to surrounding brain tissue. A surgeon performs a subtotal removal of the tumor . The consequence is only partial tumor resection that will result in a faster recurrence of the tumor and neurological symptoms. "Inoperable" tumors (inoperable by conventional surgical techniques) can be resected with MRI Guided Brain Tumor Surgery. Frequently, these are deep seated-relatively benign tumors in children and young adults or elderly patients. Many of these tumors can be cured with this most advanced technolog

Combinations of Several Types of Treatments to effectively fight against Brain Cancer

Brain cancer is an abnormal growth of cells in the brain, which result in a collection of cells called a brain tumor. If the abnormal cells were originally brain cells that started to grow uncontrollably, it is a primary brain tumor. If the abnormal cells originated in another part of the body, such as the lung or breast, and were carried to the brain by the blood or other body fluid, then it is considered a metastatic brain tumor. 

Primary brain tumors

There are many types of primary brain tumors, including meningiomas, pituitary adenomas, schwannomas and gliomas, which are divided into astrocytomas, ependymomas, medulloblastomas and oligodendrogliomas. Each primary brain tumor is categorized based on the type of normal brain cell from which they originated and has its own unique characteristics and growth patterns. Gliomas account for 40 percent of all primary brain tumors and it is common for them to spread from the brain to other parts of the body.The most aggressive type of glioma is called glioblastoma multiforme.

Metastatic brain tumors

 The cells that form metastatic brain tumors travel to the brain from other parts of the body through the bloodstream, along nerves or within the fluid surrounding the spinal cord and brain. These cells most commonly originate in tumors within the lung, breast, skin or colon, and are deposited in the brain where they grow into a tumor.

Both primary and metastatic brain tumors can be very dangerous because they can compress sensitive brain tissue and nerves within the head, causing patients to experience symptoms such as vision loss, hearing loss, difficulties with balance, pain or seizures. As these tumors grow larger, they can be life-threatening because they disrupt critical parts of the brain that are responsible for breathing and other basic life functions.

How is Brain Cancer Treated?

The treatment of brain tumors often requires combinations of several types of treatments to effectively fight the disease.

Surgery: 

For solitary tumors that are not near the brain’s most critical structures, such as those involved in vision or regulation of breathing, the most common treatment option is surgery, in which the tumor is cut out through surgery.⁵ Surgery is used for primary brain tumors, such as a GBM, as well as solitary brain metastases and benign tumors. Surgery is often followed by whole brain radiation therapy or partial brain radiation techniques to eliminate any microscopic bits of the tumor. In some cases, malignant brain tumors can be treated in combination with chemotherapy for greater effect.

Radiation therapy: 

If the patient suffers from multiple tumors, as is often the case with metastatic brain cancer, treatment is often whole brain radiation therapy. Whole brain radiation treatment typically requires 20 to 40 sessions over four to six weeks and is used to treat the entire brain, including both the tumor(s) and normal tissue. The normal brain tissue is not as susceptible to small doses of radiation as the tumor cells, so the extended courses of whole brain radiation therapy result in minimal destruction of normal brain cells for the patient.

For patients with a limited number of tumors in their brain, radiosurgery is another option.

Chemotherapy: 

Chemotherapy medication is delivered orally or through an IV. It affects both normal tissue and the cancer cells, so patients may experience side effects, such as severe nausea and vomiting, infections, fatigue and weight loss. Chemotherapy is typically given to a patient in combination with other types of brain cancer treatment. For example, it may be given after whole brain radiation therapy to target both the metastatic tumors in the brain and the tissues outside the brain that originally produced the cancer cells.

Radiosurgery: 

During the last 25 to 30 years, radiosurgery has emerged as an alternative to surgery. Unlike conventional radiation therapy, during which small doses of radiation are delivered over weeks and months, radiosurgery can treat a tumor in one to five sessions by delivering a high dose of radiation with extreme accuracy. During radiosurgery, hundreds of narrow radiation beams are delivered from different angles, all intersecting at the tumor. This treatment allows the tumor to be attacked by a high dose of radiation without damaging surrounding sensitive brain tissue. To be effective and safe, radiosurgery must be accurate. To achieve this accuracy, some radiosurgery devices, such as the Gamma Knife®, require a rigid stereotactic frame be affixed to a patient’s head so the system can pinpoint the exact location of a tumor.

These frames are screwed into a patient’s skull after local anesthesia is given. Many patients find these frames to be uncomfortable and painful. In addition, if multiple treatment sessions are required, the patient may have to be hospitalized with the frame in place for several days until the treatment is complete.

Other radiosurgery devices, such as the CyberKnife Robotic Radiosurgery System, improve on other radiosurgery techniques by eliminating the need for stereotactic frames. As a result, the CyberKnife System enables doctors to achieve a high level of accuracy in a non-invasive manner and allows patients to be treated on an outpatient basis

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Brain Tumor Basic Facts - Brain Tumor Treatment

TumorGrades and Types

When most normal cells grow old or get damaged, they die, and new cells take their place. Sometimes, this process goes wrong. New cells form when the body doesn't need them, and old or damaged cells don't die as they should. The buildup of extra cells often forms a mass of tissue called a growth or tumor.

Primary brain tumors can be benign or malignant:

Benign brain tumors do not contain cancer cells:

- Usually, benign tumors can be removed, and they seldom grow back.

- Benign brain tumors usually have an obvious border or edge. Cells from benign tumors rarely invade tissues around them. They don't spread to other parts of the body. However, benign tumors can press on sensitive areas of the brain and cause serious health problems.

- Unlike benign tumors in most other parts of the body, benign brain tumors are sometimes life threatening.

- Benign brain tumors may become malignant.

Malignant brain tumors (also called brain cancer) contain cancer cells:

- Malignant brain tumors are generally more serious and often are a threat to life.

- They are likely to grow rapidly and crowd or invade the nearby healthy brain tissue.

- Cancer cells may break away from malignant brain tumors and spread to other parts of the brain or to the spinal cord.

- They rarely spread to other parts of the body.

Tumor Grade

Doctors group brain tumors by grade. The grade of a tumor refers to the way the cells look under a microscope:

- Grade I: The tissue is benign. The cells look nearly like normal brain cells, and they grow slowly.

- Grade II: The tissue is malignant. The cells look less like normal cells than do the cells in a Grade I tumor.

- Grade III: The malignant tissue has cells that look very different from normal cells. The abnormal cells are actively growing (anaplastic).

- Grade IV: The malignant tissue has cells that look most abnormal and tend to grow quickly.

Cells from low-grade tumors (grades I and II) look more normal and generally grow more slowly than cells from high-grade tumors (grades III and IV).

Over time, a low-grade tumor may become a highgrade tumor. However, the change to a high-grade tumor happens more often among adults than children.

Types of Primary BrainTumors

There are many types of primary brain tumors. Primary brain tumors are named according to the type of cells or the part of the brain in which they begin. For example, most primary brain tumors begin in glial cells. This type of tumor is called aglioma.

Among adults, the most common types are:

Astrocytoma: The tumor arises from star-shaped glial cells called astrocytes. It can be any grade. In adults, an astrocytoma most often arises in the cerebrum.

- Grade I or II astrocytoma: It may be called a low-grade glioma.

- Grade III astrocytoma: It's sometimes called a high-grade or an anaplastic astrocytoma.

- Grade IV astrocytoma: It may be called a glioblastoma or malignant astrocytic glioma.

Meningioma: The tumor arises in the meninges. It can be grade I, II, or III. It's usually benign (grade I) and grows slowly.

Oligodendroglioma: The tumor arises from cells that make the fatty substance that covers and protects nerves. It usually occurs in the cerebrum. It's most common in middle-aged adults. It can be grade II or III.

Among children, the most common types are:

Medulloblastoma: The tumor usually arises in the cerebellum. It's sometimes called a primitive neuroectodermal tumor. It is grade IV.

Grade I or II astrocytoma: In children, this lowgrade tumor occurs anywhere in the brain. The most common astrocytoma among children is juvenile pilocytic astrocytoma. It's grade I.

Ependymoma: The tumor arises from cells that line the ventricles or the central canal of the spinal cord. It's most commonly found in children and young adults. It can be grade I, II, or III.

Brain stem glioma: The tumor occurs in the lowest part of the brain. It can be a low-grade or high-grade tumor. The most common type is diffuse intrinsic pontine glioma.

Latest and Advanced Treatment options for Brain Tumor in India

Brain Tumor is no more a scary health condition as modern technology and advanced surgical modalities now offer near perfect clinical outcomes and the patients can soon return to normal life after surgery. 

• Brain Suite - Intra-operative MR Navigation Microsurgery
• Trans-Nasal Endoscopic Removal of brain Tumor through the nose
• Stereotactic Radiosurgery - Gamma Knife & Novalis TX
• Tumor Embolization using Neuro Interventional Radiology
• CyberKnife Radiosurgery

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Cancer Treatment in India, Best Cancer Hospitals , Radiation Therapy in India , Medical Oncology, Surgical Oncology in India

Cancer Treatment India has really set new benchmarks as far as treatment of this disease is concerned. If one is on the lookout for quality health care at cost effective solutions then no doubts to the fact that India has to top the list for sure. The country tops the world in terms of medical patients coming for treatment as they are quiet crazy for getting treatment in the country. In this regard associating with oncologyandcancer hospital would be the way forward as the worries seem to be a think of the past.

Medical Tourism India is gaining momentum day by day in the country. It has evolved from such a stage when one was hardly aware of the precise definition of the term as now it is the toast of the nation. It implicates a procedure where the patients leave their domestic frontiers in order to seek medical treatment on the international shores. It is in fact one of the fastest growing sectors in the country and is responsible for a massive contribution to the economy. The government along with the private sector has realized the importance of this sector and have given all out support to the sector. A testimony to this fact is that even one shows a letter from the medical centre; they can get an extension of visa to the tune of 6 months.

Medworld India  deals with the subject related to the various diseases of cancer. The doctor who deals with the professional treatment of this disease is known as oncologist. The diagnosis of cancer along with the various surgeries as well as therapies fall under the scope of this disease. Not only the treatment of this disease is important but the screening efforts are all the more important as sometimes the patients may develop terminal tangencies. It is observed that in certain cases the relatives of the patients need to be screened also as it is a form of hereditary disease.

India as a country has a huge amount of natural as well as historical resources at their disposal. When one compares it to the developed countries of the world, the treatment in the country tends to be cheaper by at least ¼. If one talks about any sort of medical treatment at cost effective solutions without comprising on the quality aspect a wee bit the obvious answer has to be India for sure.

After having chosen the desired destination as India, some amount of homework has to be done by the patients. Sometimes it is observed that surgery might not only be the desired option, as certain non surgical methods can do the trick. In this regard it is advised to avail the services of a medical tourism company as they have renowned panellists who can guide you on what could be the best course of action. The choice of it is a critical aspect as one has to choose the one which has testimonies of the patients from all over the world.

 

Affordable Best Cancer Treatment in India

Cancer is a word used to describe many different diseases, so there is no single treatment that is used universally.

We know Cancer challenges patients and their families in many ways. We strive to help ease the burden of this difficult experience. We believe that there is hope for every life to fight this dreadful disease if we offer best-in-class infrastructure and services, and support every patient on his or her journey.

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