Brain tumours can be split into two categories, primary and secondary brain tumours. Primary brain tumours are when the cancer begins in the brain; an example of primary brain tumours would be low grade glioma. There are many different types of low grade glioma; nevertheless, they are all cancerous lumps in the brain and spinal cord. Many cases of low grade glioma begin as benign and some may turn into malignant cells. This form of cancer often grows slowly over a long period of time.
Although people with low grade glioma are rarely cured, there are a number of different treatments that can prolong an enjoyable life and relieve symptoms. Sometimes the best treatment for this type of tumour is surveillance. If the tumour is present and not causing any harm to the person, doctors may advise to do nothing. For example, performing surgery on someone is very risky and could do more harm than good. Every action has a consequence and sometimes it is better to do nothing than to take action. Instead, the doctor could suggest that the person come in for regular check-ups so that the doctor can monitor the tumour.
They monitor the tumour by using CT scans or MRI scans, this allows the doctors to see what is going on inside the brain without actually going in. However, if there is a change in the tumour or it is causing the person problems, the doctor will have to reassess the situation. At this time, it may be necessary to perform surgery in an attempt to take it out. The reason people perform surgery is to remove as much of the tumour as possible without damaging the brain. Doctors either remove the tumour in parts or if possible completely in order to relieve symptoms and improve their quality of life.
The reason why people choose surgery as their treatment is because it is the process of removing the tumour. If this method works it is because the doctor successfully removed all the cancerous cells that were in the brain. Although the idea of surgery seems like a good idea, it is a very complex procedure. Low grade glioma unfortunately grows into the brain, making it very hard to distinguish which is cancerous and which is healthy. Doctors must be extremely careful that what they are taking out is not a piece of the healthy brain. Sometimes the doctor will perform an awake craniotomy to help reduce the risk of damage.
During this process, they perform brain mapping which allows the doctors to locate the important regions (ie. speech) so they can avoid them during surgery. The tumour also sometimes takes residence in the part of the brain responsible for breathing, speech and body movement. When this is the case, the doctor will strongly advise against this form of treatment. However, there are some exceptions that could make the doctor reconsider surgery. For example if there is an increase in pressure in the brain, a bleed in the tumour or seizures occur that are not responding to medication the doctor may be forced to go in. Surgery is not for everyone; there are many risks and it is not the only other treatment.
When treating low grade glioma, doctors do not usually advise the patient to choose chemotherapy as the first treatment option. Doctors usually suggest this method of treatment when surgery and radiation is not an option. The doctor could also suggest this treatment before or after the patients has had surgery. Chemotherapy is when the patient is administered medication to stop or slow the growth of the cells. If the doctor suggests chemotherapy before surgery it would be to reduce the size or stop it from growing so it would be easier to remove.
If the patient is to do chemotherapy after surgery it is because they were not able to take the entire tumour out. The way chemotherapy works is that it interferes with the ability of the cancerous cells to reproduce. Chemotherapy medication damages the cells when they are either splitting into two or copying the genes. This process does not affect most of the patient’s regular cells because they are not growing at an abnormal pace. Instead, normal cells take breaks when they are reproducing making it less likely to 1 / 3 be affected.
The exceptions to this are hair roots, the lining of the gastrointestinal tract and bone marrow. Chemotherapy is not a long term solution; it may be a suggestion to relieve symptoms for a few months until the doctor has found a better treatment. Some people prefer to treat low grade glioma by using radiotherapy. This method of treatment uses a high dose of radiation that is aimed at the cancerous cells to damage, shrink and/or destroy them. Radiotherapy is done by breaking the DNA in the cancerous cells. It is done over and over so that the cancerous cells do not have any time to repair themselves.
Unfortunately, even though the radiation has different effects on cancerous and normal brain cells, normal cells still get damaged in the process. The ultimate goal of radiotherapy is to continue so that the cancerous cells cannot repair but still allow the normal cells to. Unlike chemotherapy which is dumped into the blood stream and affects the whole body, radiotherapy is localized to specific areas. However, not all people are able to use radiotherapy as their treatment because they do not qualify.
Those who are eligible to use it can use it as a primary treatment or can use it in combination with something else (ie.surgery). There are two common types of radiotherapy, intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT). It is very rare that a doctor would use stereotactic radiosurgery (SRS) on a patient with low grade glioma. IMRT is when the doctor uses complex computer software and pictures from a CT scan to focus a beam directly onto the tumour.
This method reduces side effects of the treatment and reduces the amount of normal brain cells being exposed. IGRT is when the doctors use either CT scans or x-rays to assist in the correct set up.
This method allows more accuracy and reduces movement during treatment. Determining whether or not radiotherapy is an option all depends on different factors of the low grade glioma in the brain. Sometimes people want to try alternative ways to treat low grade glioma. This could be for a number of different reasons, they could believe that the three common ways do not work or think that another method could help them more. For example there are a number of different clinical trials that people could apply for that study new treatments or study new combinations of existing treatments.
One clinical trial that patients could try has to do with reducing the inflammation, which is a side effect of low grade glioma. Studies shows that resin from the Boswellia serrata tree reduce inflammation. Some lab studies also suggest that this resin could also make the cancerous cells to “undergo programmed cell death” (Stevens). People who wish to take part in this trial will need to ingest the resin from the tree four times daily with standard treatment for six months. The doctors will see if it reduces the inflammation and tumour growth by asking the patient to eat low-fat healthy diets.
This is because they want to see if the resin from the Boswellia serrate tree can help reduce an enzyme that is responsible for converting arachidonic acid into eicosanoids, which is linked to inflammation and tumour growth. By eating a diet high in red meat which has lots of arachidonic acid, the doctors can see whether or not the resin reduces the conversion. It is not known how successful these trials have been, however it takes time to gather up results and examine them. However, one study showed that it helped limit the inflammation and had an anti- tumour effect.
This is just one of the many different alternative treatments available to people who choose to not only use the three traditional treatment methods. Patients with any illness have an option to either treat it or leave it. This is the same for people who have low grade glioma, however sometimes there are a number of different options on how they could choose to fight it. In this case it is important to be aware of the different methods of treatment so that the best decision is made in that particular case.
Low grade glioma is rarely cured, but with the right treatment, people could live years longer than they would with none. Treatments like surgery could relieve symptoms and improve the quality of their lives until either they are or die.
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