Central Nervous System Cancers - Overview

Central Nervous System cancer is a type of cancer that affects the brain or the spine. Sometimes it can affect both areas at once. It can start when the cells inside the brain or spine start growing and reproducing uncontrollably, forming a mass. The mass is also known as a tumour and can be cancerous or noncancerous.

Types of Neurological Cancers

Central Nervous System cancers can be broadly categorised into

  • Primary brain tumours - These tumours usually originate in the brain or spinal cord
  • Secondary brain tumours - These tumours are also known as metastatic brain tumours. These tumours initiate in other parts of the body and then gradually spread to the brain.
  • Gliomas - As per American Cancer Society, 3 out of 10 brain tumours are gliomas. These can be further categorised into glioblastomas, oligodendrogliomas, and ependymomas.
  • Meningiomas - These account for 1 out of 3 primary brain tumours as per the American Cancer Society. These tumours occur in the meninges, the lining of the outer part of the brain and spinal cord.
  • Medulloblastomas - These are fast-growing, grade IV brain tumours that develop from neuroectodermal cells in the cerebellum. These are more common in children than adults.
  • Schwannomas - These account for 8% of all central nervous system tumours and develop from schwann cells that insulate the cranial and other nerves.
  • Chordomas, Non-Hodgkin lymphomas, pituitary tumours, craniopharyngiomas and gangliogliomas are some of the other variants of neurological cancers.

Signs & Symptoms of Central Nervous System Cancer

The brain’s anatomy is quite complex as it controls the complete body. Different body parts are handled by the complex nervous system functions present in the brain. Therefore, ensuring that the cancer is detected early and treated is essential.

Since different parts of the brain control different functions, the symptoms might vary. For example, someone with a tumour near the optic pathway might encounter an issue with their vision. The most common symptoms of Central Nervous System cancer are:

  • Frequent headaches
  • Difficulty in speaking or thinking
  • Change in personality or behaviour
  • Weakness or numbness in one side of the body
  • Changes in vision or hearing
  • Feeling dizzy or unsteady
  • Confusion, disorientation, or even loss of memory

Causes and Risk Factors of Central Nervous System Cancer

The common causes and risk factors for neurological cancers could include:

  • Inherited genetic changes
  • Acquired genetic changes
  • Exposure to unwanted radiation
  • Family history
  • Weakened immune system

Central Nervous System Cancer Prevention, Diagnosis & Treatment

There is no direct way in which someone can prevent themselves from these cancers. The reasons behind cancer can be unknown exposure to radiation, genetic disorder, or any other. Though one cannot prevent cancer, the risk of it can be reduced by staying away from:

  • Insecticides and pesticides
  • Tobacco and smoking
  • Unwanted exposure to radiation
  • Harmful chemicals

Thorough clinical examinations, diagnostic imaging such asMRIs, CT scans, PET/CT scans, histopathological, immunohistochemistry studies and neurophysiological examinations are the most recommended diagnostic methods for Central Nervous System cancer detection.

The treatment of brain cancer depends on many factors, such as the diagnosis, the current stage of tumour, the extent of spread and the patient’s overall health condition and so on. Some of the popular treatment methods for neurological cancers are proton therapy, surgery, radiation therapy, chemotherapy, autologous stem cell treatment, cancer immunotherapy, and rehabilitation therapy. Amongst all the treatments, proton therapy is deemed the safest and most effective way of treating a versatile range of brain tumours. Proton beam therapy for brain cancer is usually recommended due to its precision and accuracy.

Before proton therapy for brain cancer, the tumour’s exact location, age, and patient’s health need to be analysed. Treatment involves eliminating the cancerous cells. And with the rapid technological advancements, the survival rate has been increasing drastically. Methods like proton treatment for brain tumours have helped improve the patient’s quality of life.

What Are the Things to Remember while Preparing for Proton Therapy Treatment for Neurological Cancer?

Before undergoing proton therapy for neurological cancer, the doctor will take the patient through a simulation exercise and imaging tests to ensure that the proton beam attacks the right place. Apart from this, you can keep a few things in mind while preparing for proton therapy for neurological cancer.

  • Ask as many questions as possible about the treatment process. Understand the process in detail, including the number of required sessions and expectations.
  • Question about the potential side effects of the proton therapy treatment and ways to manage them.
  • Ensure to follow the treatment plan while taking the prescribed medicines and following the scheduled appointments.
  • Maintain your health while focusing on your diet and following a workout plan to keep the body strong while undergoing treatment. The cancer care team at APCC helps with patients' personalised nutritional and exercise programs.
  • Seek help whenever required, including childcare, transportation, or other activities during the treatment. The team at APCC has excellent resources available to help the patients and their families during the treatment.

Which Central Nervous System Cancer Patients Benefit from Proton Therapy?

Proton therapy uses charged particles to impact Central Nervous System tumours specifically. It makes it possible for doctors to attack the tumour while minimising the radiation effect on other sensitive brain organs, tissues, or structures. The precise nature of the treatment helps in reducing any potential damage that can be caused because of the treatment. Moreover, it also helps reduce the risk of any new cancer after the radiation. Thus, proton therapy is highly effective for brain or spinal tumours where other treatment methods like surgery will be difficult or ineffective.

What are the Benefits of Proton Beam Therapy in Treating Brain Cancer?

Proton radiation therapy for brain tumours is highly controlled and precise, making it extremely effective. Moreover, it provides the oncologist with better control of the radiation. The oncologist can also increase the intensity of the beam as per requirement. The significant advantage of proton therapy is its negligible impact on the surrounding healthy tissues.

With less injury to healthy cells, there is a lower risk of any neurological deficit in the future. Moreover, it also significantly reduces the risk of hormonal deficiencies. Unlike conventional treatment methods, proton therapy for brain tumours only emits radiation during the impact. Because of no post or pre-radiation, the patient’s overall health gets significantly better with minimum risk.

Doctors

DR. RAKESH JALALI

MEDICAL DIRECTOR & LEAD - NEURO ONCOLOGY

DR. ARI G. CHACKO

SENIOR CONSULTANT - NEUROSURGERY
DIRECTOR OF NEUROSCIENES

DR. SIDDHARTHA GHOSH

SENIOR CONSULTANT & LEAD - NEUROSURGERY (UNIT 1)

DR. UDAY KRISHNA

SENIOR CONSULTANT - RADIATION ONCOLOGY

DR. SUJITH KUMAR MULLAPALLY

CONSULTANT - MEDICAL ONCOLOGY (BONE & SOFT TISSUES)

Dr. ARVIND SUKUMARAN

SENIOR CONSULTANT - NEUROSURGEON

DR. KRISHNA KUMAR G

CONSULTANT - NEUROSURGEON

DR. ARUNAN MURALI

HEAD OF RADIOLOGY

DR. RAMYA A

CONSULTANT MEDICAL ONCOLOGY

DR. ARULVELAN. A

SENIOR CONSULTANT - ANAESTHESIOLOGY

FAQs Related to Brain Cancer

Neurological cancer is a type of cancer that affects the central nervous system of the human body. It includes cancer that starts forming in the brain and the spine. It is often difficult to detect at an early stage as the symptoms come at a later stage.

Several risk factors can result in neurological cancer, including the following:

  • Age
  • Gender
  • Family history
  • Work or home exposures
  • Electromagnetic fields
  • Race and ethnicity
  • Ionising radiations
  • Exposure to allergens, viruses, or infections.

Proton therapy is a treatment method that uses an intense beam of proton rays, rather than X-rays, to impact the affected region directly. It is an effective treatment option for neurological cancer as the organs are highly critical and require precise and accurate treatment.

Depending on the specificity of the individual case, proton therapy can be used in different ways for neurological cancer treatment. For example, the doctor can prescribe and use it as a standalone treatment, or they can use it along with other traditional therapies like surgery or chemotherapy. The treatment will usually last for at most six weeks, with five sessions every week.

The brain and spine are critical organs for the body’s overall functioning. Thus, while going through the treatment, it is essential to be precise and accurate, as any minimal deflection or deviation can impact the overall quality of life. Proton therapy provides the option to deal with such critical organs better as it is precise and has minimal effect on the surrounding organs. While there is evidence to prove that proton therapy is more effective, the results have been detrimental.

The exact cost of proton beam therapy for a brain tumour depends on different factors. For example, the patient’s age, the severity of cancer, and other health conditions can be determining factors while estimating the cost. One can easily estimate the cost after a discussion with their oncologist.

There are significantly fewer side effects of proton therapy compared to other traditional methods.

Some of the common proton beam therapy brain side effects are:

  • Fatigue or dizziness
  • Skin-related problems around the areas of treatment
  • Hair loss around the treatment areas
  • Soreness in the part of the body getting treated

While most of the side effects go away in a few weeks, the oncologist can suggest further treatment based on the progress.

The overall treatment usually lasts for five to six weeks, considering the severity of the cancer. A patient generally undergoes therapy for five days a week for a given period. The progress is analysed during the treatment, and further action is planned. While the treatment only takes a few minutes every day, the patient might have to spend time before and after therapy to prepare. There is no need for a patient to stay in the hospital overnight for treatment.

During the initial consultations, all details are shared with the patient post-review of their medical history. The patient also undergoes a simulation to understand the process. The simulation also helps identify the patient’s ideal position during therapy. Finding the correct position makes the patient comfortable and helps with the treatment

The oncologist and nurse will guide the person during the complete course of treatment, starting from the consultation. The patient will get proper instructions with details about the process. Moreover, other information regarding do’s and don’ts are also shared with the patients. The support staff can also assist the patient with their personal needs.

Because proton therapy is highly specialised, it is available in limited places. It requires costly and precise equipment, hence is available only at selected centres. Moreover, only a few trained professionals can handle the technology. In India, Apollo hospitals have launched Apollo Proton Cancer Centre (APCC), making India one of the few countries offering the treatment. Many other private and public centres are working towards making proton therapy available across the nation.