• A brain tumor is a collection, or mass, of abnormal cells in the brain.

What are the types of tumours?
There are two main types of tumor:

• Benign Tumor
• Malignant or Cancerous Tumor
  • Primary
  • Secondary

What is the grade of tumour?

• Grade I: Benign tissue. The cells grow slowly and look like normal cells.
• Grade II: Malignant tissue. The cells look less like normal cells than the Grade I tumor.
• Grade III: Malignant tissue. It has cells that are different from normal cells which are anaplastic
• Grade IV: The malignant tissue has cells that are the most abnormal and grow very quickly.

What is the treatment of tumour?
Surgical removal is done by craniotomy. Minimally invasive techniques are becoming the dominant trend in neurosurgical oncology. The main objective of the surgery is to remove as many tumor cells as possible, with complete removal. Any person undergoing brain surgery may suffer from epileptic seizures. These can take the form of either absence seizures. Medication can lessen and sometimes prevent these attacks.

What are the other possible ways of treating brain tumour?
Radiation therapy:
The goal of radiation therapy is to kill tumor cells while leaving normal brain tissue unharmed.

• Conventional radiation therapy. The treatment location is determined based on anatomic landmarks and x-rays. In certain situations, such as whole brain radiation therapy for brain metastases, this technique is appropriate. For more precise targeting, different techniques are needed.
• 3-dimensional conformal radiation therapy (3D-CRT).On a computer, a three dimensional model of healthy tissue and the tumor surrounding the tumor is created This aims the radiation beams directly at the tumor, sparing the healthy tissue from high doses of radiation therapy.
• Intensity modulated radiation therapy (IMRT). IMRT is a type of 3D-CRT that can more directly target a tumor. It delivers high dose of radiation to the tumor and not much to the surrounding tissues.The radiation beams are broken up into smaller beams and the intensity of each of these can be changed.
• Proton therapy.It is a type of external beam radiation therapy that uses protons.it is typically used for tumors when less radiation is required.this include tumors that have grown into nearby bone.
• Stereotactic radiosurgery. It is the use of a single dose of radiation given directly to the tumor. The equipment’s used are:
  • High energy radiation is created by a modified linear accelerator by the use of electricity to form a stream of fast-moving subatomic particles.
  • Another form of radiation therapy is a gamma knife that concentrates highly focused beams of gamma radiation on the tumor
  • A robotic device called cyber knife is used in radiation therapy to guide radiation to the tumor target, particularly in the brain, head and neck regions.
• Fractionated stereotactic radiation therapy. Radiation therapy is divided in fractions given over several weeks though delivered with stereotactic. It is a technique used for tumors which are located close to sensitive structures such as optic nerves or brain stem.
• Internal radiation therapy (implant radiation therapy or brachytherapy): Radioactive material usually contained invery small implants called seeds helps in the radiation. The seeds are placed inside the brain and give off radiation for months. Once the radiation is gone, they don’t need to be removed.

Chemotherapy
Patients undergoing chemotherapy are administered drugs designed to kill tumor cells. Although chemotherapy may improve overall survival in patients with the most malignant primary brain tumors. Chemotherapy is often used in young children instead of radiation.Chemotherapy only be done depending on the patients’health, type of tumor and the extent of the cancer.

Targeted Therapy
It is a therapy that targets the tumors specific genes or proteins or tissue environment that contributes to a tumors growth or survival.The targeted therapy which blocks the growth and spread of tumor cells.

Alternating electric field therapy (tumour treating fields)
It uses a non- invasive portable device which interferes with parts of a cell that are needed for growth and spread of tumor cells.Electrodes are placed which produce an electric field on the outside of a person’s head. The device is called optune.

What are the recent advances in the field of brain tumours?

• Enhanced imaging tests. Research is going on for newer techniques that can scan images. IT is used by doctors for tracking the treatment and watch possible tumor growth or recurrence.
• Cyber knife Robotic Radiosurgery. It is a treatment for cancerous and non-cancerous tumors and any conditions where radiotherapy is required.

It is used to treat conditions in the brain like benign and malignant primary tumors, brain metastases, trigeminal neuralgia, acoustic neuromas and arteriovenous malformations (AVMs). Cyber Knife stereotactic radiosurgery (SRS) is used for treating complicated neurosurgical cases while sparing brain tissues which are involved in functions such as hearing and vision.

When patients prefer a clinically proven, on-invasive procedure or when the invasive techniques are too risky, the Cyber knife system is performed by radiation oncologists and neurosurgeons.

• Biomarkers. Brain tumors are diagnosed and patient’s prognosis are estimated by examining biomarkers.
• Immunotherapy. It is designed to boost the body’s natural defenses to fight cancer. It is also known as biological response modifier(BRM) therapy. Materials used are either made by the body or in a laboratory to improve target or restore the immune system function. The use of dendritic cells or the use of vaccines which are aimed against a specific molecule on the surface of the tumor cells.
• Oncolytic virus therapy. It is a therapy where virus infects and destroys the tumor cells sparing the healthy brain cells.currently, it is being researched as a treatment for brain tumours.
• Targeted therapy. Targeted therapy targets faulty genes or proteins which contribute to a tumor’s growth and development. Researches are done on the use of therapies that target brain tumors.
• Blood-brain barrier disruption. It disrupts the brains natural protective barrier which allows chemotherapy to easily enter the brain from the bloodstream.
• New drugs and combinations of drugs. Newer drugs or combination of some drugs that targets different pathways by which a tumor grows are explored.
• Gene therapy. It seeks to replace or repair abnormal genes causing tumor growth.
• Palliative care. To find better ways of reducing symptoms and side effects of current brain tumor treatments, clinical trials are done to improve patients comfort and quality of life.