Neuro-Oncology

Neuro-oncology is a discipline of medicine that's associated with brain and spinal cord cancers. Nervous system cancers are serious conditions that frequently advance to a life-threatening phase. 

These neurological cancers can be fatal and include brain stem tumors, astrocytomas, glioblastoma multiforme, glioma, pons glioma, and ependymoma, and brain stem tumors.

Among the malignant brain cancers, high-grade astrocytoma and gliomas in the brainstem are examples of the most serious diseases. Patients often may not survive more than a few months without treatment. In some circumstances, chemotherapy and radiotherapy can increase the lifespan by several years. 

Cancers of the nervous system can develop as primary tumors, secondary tumors, or metastatic tumors that develop as a result of cancer spreading from another section of the body. Men develop primary cancers at a higher rate than women, with the exception of meningiomas. Secondary tumors may attack the nervous system directly or metastasize from a different site of origin. (1)

Definition and Overview

Neuro-oncology focuses on the diagnosis and treatment of brain and nervous system cancers. It combines the fields of neurology and oncology. In simple terms, neuro-oncologists specialize in recognizing and managing tumors that develop in the brain, spinal cord, and peripheral nerves. Both benign (non-cancerous) and malignant (cancerous) tumors are managed by neuro-oncologists.

Imaging studies are used in neuro-oncology diagnosis to identify the position, size, and extent of the tumor. Magnetic resonance imaging (MRI) and computed tomography (CT) are the most used methods in neuro-oncology. Positron emission tomography (PET), myelography, and angiography are further diagnostics that could be employed. Cerebrospinal fluid analysis and lumbar puncture are sometimes needed. 

Numerous genetic disorders include neurofibromatosis, tuberous sclerosis, and Turner syndrome can result in the development of brain tumors. Brain cancer risk factors include advanced age, radiation exposure, immune system impairment brought on by HIV/AIDS or the use of immunosuppressive drugs, and radiation exposure. (2)

Procedures

In neuro-oncology, there are three main treatment approaches to central nervous system cancers. These include chemotherapy, radiotherapy, and surgery.

• Chemotherapy

One of the most common types of treatment for brain and nervous system cancers in neuro-oncology is chemotherapy. Chemotherapy involves administering chemicals to cancer cells to either kill them or stop their growth and spread. Its use depends on a number of variables, including the kind of tumor, where it is located, and the overall therapy strategy chosen for the particular patient.

• Radiotherapy

When treating brain and nervous system cancers, radiotherapy—also known as radiation therapy—involves the use of high-energy radiation beams to either kill or stop the growth of cancer cells. Radiotherapy helps control the growth of some brain tumors. It generally can be utilized in conjunction with surgery or chemotherapy to treat brain tumors.

• Surgery

Some tumors may only require surgical removal and constant monitoring. For a low-grade brain tumor, it is frequently the sole form of treatment needed. The prognosis for a person with a brain tumor can often be improved by removing the tumor, which can also assist other brain tumor treatments to work better and offer tissue for genetic research and diagnosis. (3,4)

Candidates

Oncologists manage cancer treatment throughout the disease. They help diagnose cancer, identify treatment options, discuss the benefits and side effects of each option, oversee treatment, and manage post-treatment care. Neuro-oncologists treat patients with 

• leukemias, lymphomas, and certain other cancers that tend to be aggressive,
• a tumor pressing on an organ or other vital part of the body,
• tumors that originate in the brain itself, such as gliomas (e.g., glioblastoma), meningiomas, pituitary tumors, medulloblastomas,
• brain tumors and cancer that affect the nervous system.

The requirement for neuro-oncology treatments depends on the type, size, and location of the tumor, the patient's overall health, and the therapeutic goals. (5,6)

Risks and Side Effects

The side effects and risks of neuro-oncological treatments for cancer can be extensive. These typically happen when treatment harms healthy cells and surgery, in which organs are taken out to treat cancer. The side effects and risks can vary from person to person, depending on the medication and type of treatment. These can be listed as follows.

• Neutropenia
• Lymphedema
• Hair Loss
• Nausea and Vomiting
• Problems with Thinking and Remembering Things
• Cancer Pain
• Blood Clots (Deep Vein Thrombosis)
• Tiredness 
• Trouble eating 
• Pain
• Swelling
• Anxiety
• Depression

Post-Procedure and Follow-up

Comprehensive cancer care includes the aftercare procedure for cancer treatments as a key component. To maintain their well-being and manage any potential long-term effects, patients need continued monitoring, support, and follow-up care after completing treatments. Patients often see their neuro-oncologist on a frequent basis to monitor side effects, assess therapy response, and discuss any concerns. Patients undergo a recovery period after surgery during which they are attentively monitored in the hospital. Persistent side effects or symptoms from treatments are addressed and managed through supportive care measures.

Recovery

During the aftercare process, patients may experience physical and emotional difficulties after cancer treatment. They may also receive emotional support, counseling, and resources to help them cope. The healthcare team develops a personalized aftercare plan for each patient that meets their specific needs, ensures continuous monitoring, manages potential side effects, promotes healthy living, and provides the necessary support during the recovery process. 

Results

Each cancer patient's response to treatment is different. Since the treatment is over in cancer, all other processes are not considered finished. Once the treatment that is received has ended, the patient regularly assesses their response to treatment, checks to identify any relapses, and provides ongoing care and support for optimized outcomes. In this process, patients should pay attention to taking the medications given by the doctor, daily activities, stress management, and healthy nutrition. (7)