Approach
Oncology Management The adoption of technology has improved the quality of survival as well as longevity
Neuro-oncology
Dr NK Venkataramana, Founder Chairman & Director Neurosciences, Brains Hospitals, Bangalore
has
evolved
in
a
such as 3D Imaging, MR Tractography,
big way for the last three decades.
image-guided
In the 1980s, the delay in diagnosis,
assisted neuro-navigation, ultra-sonic
lack of proper imaging had resulted
surgical
aspirations,
in patients with large brain tumours
bi-polar
and
causing complete visual loss, hearing
helped to precisely remove the tumours
loss,
paralysis
or
surgery,
computer-
radiofrequency
tumour
fluorescence
unconsciousness.
completely and safely regardless of the
Those days cerebral angiography was
location. This has improved the quality
the mainstay in diagnosis. In the 1990s
of survival as well as longevity and in
advent of CT scans and MRI at the dawn
many benign tumour cures.
of the new century has resolved many issues. Brain tumours were diagnosed early and even small tumours were detected easily.
Parallelly, advances in neuropathology, genetics
molecular
diagnosis
and
immune histochemistry have paved the way for tailormade therapies for select
In the 1980s the treatment options
individuals with specific tumours. The
were also very limited. Neurosurgery
delivery of radiotherapy has advanced
was known as macro neurosurgery
tremendously
with lots of limitations, leading to only
radiotherapy, stereotactic radiosurgery
partial removal of tumours. There were
with image guidance has contributed to
associated
the prolonged survival of the malignant
complications
like
brain
swelling, a significant insult to the surrounding neural tissue leading to unacceptable morbidity and mortality. The advent of micro neurosurgery made surgery precise and gross total removal of the tumours as well as preserving the surrounding nerves helped to improve the outcomes and quality of life of these patients. Adoption of technology subsequently,
called
Stereotactic
tumours. Gene
therapy,
immunotherapy
and
targetted therapies are going to be the future for the highly selected targetoriented treatment of brain tumours. Despite all the advancements, some of the malignant brain tumours such as Glioblastoma Multi-pharma poses severe challenges to neurosurgeons even today.
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