Neurosurgery is the medical specialty that treats, through a surgical procedure, changes in the central and peripheral nervous system, that is, brain, spine and nerves. The specialist in this area is the neurosurgeon, who works in the surgical treatment of nervous structures, while the neurologist works in the diagnosis and conventional, non-surgical treatments.
Both neurosurgery and neurology are specialties that require knowledge of neurological routines from the brain to the spinal cord, nerves and muscles, but only the neurosurgeon can diagnose the need and feasibility of surgery, as well as perform the procedure. In the case of cancer patients, neurosurgery comes in mainly when there is a need for surgical treatment to remove brain tumors.
According to the World Health Organization (WHO), cancer of the Central Nervous System (CNS) is among the 20 most common types in the world, with a rate of 3.5 cases per 100,000 inhabitants, causing 2.8 deaths per year. every 100 thousand inhabitants. In Brazil, the José Alencar Gomes da Silva National Cancer Institute (Inca) estimates that in 2021, 11,090 new cases of brain cancer will be diagnosed, 5,870 in men and 5,220 in women.
These numbers tend to be much higher if benign tumors of the central nervous system, which comprise the brain and spinal cord, are also considered. Almost 90% of CNS tumors are in the brain. It is estimated that they represent 3.1% of all cancer cases.
Brain tumors can be malignant or benign. The benign ones are less dangerous, have a slow growth and are less likely to affect brain function. Malignant tumors, on the other hand, have a high multiplication rate and are more frequent in the elderly and in men, while benign tumors, such as meningiomas, which arise in the membranes surrounding the brain and spinal cord, are more common in women.
Treatment for these tumors may include surgery, radiation therapy, and chemotherapy. The choice of which approach to use depends on factors such as tumor size, location, symptoms, and the patient’s clinical condition. When the problem is discovered early, treatments can lead to a cure.
When the case is surgical, the procedure is conducted by the neurosurgeon, with the support of the entire interdisciplinary team that assists the patient. In this sense, seeking many second opinions for patients with tumors considered inoperable is highly recommended by physicians. With surgery, it is possible to check whether it is a case of a tumor, a recurrence or dead tissue. Its removal allows a more specific analysis to be carried out and to verify if the patient needs or can perform other therapeutic approaches.
There are also cases of cancers from solid tumors that spread from other regions of the body to the brain. In these cases, surgery should only be considered when dealing with a single tumor. If there are multiple tumors, the use of radiation or radiosurgery are the most indicated approaches, as are targeted therapy and immunotherapy.
Risk factors and prevention
Exposure to radiotherapy and radiation, such as excessive X-rays and CT scans, can increase the risk of intracranial tumor, that is, in the brain. Researchers have also identified genes that can facilitate the emergence of tumors in the body, but in general, their formation is multifactorial, that is, in addition to a genetic predisposition, there are other causes for their emergence.
According to Inca, the causes of cancer of the brain and Central Nervous System are still unknown and the disease rarely presents symptoms, therefore, the ideal is to carry out periodic exams for early diagnosis, especially in those who have a family history.
What symptoms should I watch out for?
The most frequent symptom in patients who develop brain tumors is a persistent headache, one that the person has never had and that continues to bother them for a long time.
Progressive pain, which increases in intensity and frequency over time, associated with episodes of vomiting, convulsions, visual or motor changes, speech and tingling are warning signs.
These phenomena are more common in adults aged between 40 and 50 years and children. When these symptoms appear, it is a sign that it is time to seek an opinion from a neurologist, who will indicate the need to consult a neurosurgeon.
Intracranial Tumors – Neurocirurgia.com