Neurosurgery

As a former neurosurgical/neurological nurse I have worked with a very large number of neurological patients, many of which were cancer patients.  The most common reasons other than tumours were traumatic brain injury, sub-arachnoid haemorrhage and sub-dural haematoma.

The majority of our patients underwent treatment with minimal complications and side effects and went on to make excellent recovery.
 
Whilst some did indeed die and some did develop varying levels of chronic debility as a result of the tumour and the effects from subsequent treatment, so many of our patients demonstrated remarkable feats of recovery, many times in the face of our trained set of expectations.  Time and time again we witnessed the amazing ability of some of our patients to overcome the medical difficulties that they faced.


Tumours
There are many different type of brain tumours that can arise.  They have different effects, treatments and survivability “values”.  When diagnosed, the most common question asked is, “Will it kill me?” and if so, “How long do I have left?”  Three main factors that are considered are 1. The malignancy of the type of tumour (i.e. how fast does it spread)  2. The speed of growth of the tumour and, 3. The location.    

The post-operative affects from tumours can include the direct effect of the tumours themselves (large tumours can damage the surrounding area and can compress blood vessels to surrounding brain cells) and where surgery is involved, there is the necessary damage incurred in accessing and removing the tumour.  For example, healthy areas might need to be surgically cut through in order to access the tumour.

Other effects can come from medication used such as severe weight gain and psychological disturbances from steroidal treatments, immune suppression and burns from radiotherapy treatment. 

Secondary problems can arise with postoperative complications such as drug allergy and associated drug reactions, wound infection, DVT and hospital acquired infection (such as MRSA).

Brain surgery is itself enormously stressful, both physiologically and psychologically.  Additional to all this are problems such as inability to get decent sleep in hospital, the reactions of friends and relatives, employment problems, relationship issues, the attitudes of ward staff and the difficulties that can arise from sharing a room with other people who are potentially seriously ill, confused or just plain annoying.  Other patients also come complete with their own relatives who can also present petty annoyances.

Depression is a very common reaction in the weeks and months following treatment for brain tumour.  This really isn’t surprising.  This can arise for both physiological reason as well as the psychological reasons that arise from such situations.

Adjustment to ordinary life following brain tumour can be quite problematic.  Dealing with the physiological problems can be hard enough – dealing with relatives, relations and relationships can be harder. 
If this is you, call me: 07838 387580  email: diggingahole@hotmail.com  


Types of Tumours

Gliomas
These tumours develop from the supporting cells of the brain known as the glial cells. About 50% of all primary brain tumours are gliomas.  Primary tumours are ones that arise in the brain, rather than secondary tumours that have spread from another part of the body.

Astrocytoma
This is the most common type of glioma and develops from star-shaped cells called astrocytes. Grade 4 gliomas (glioblastoma multiforme) and grade 3 gliomas (anaplastic astrocytomas) are the most common brain tumours found in adults.

Oligodendroglioma 
These tumours develop from the cells that produce the myelin sheath that covers nerve cells.  These usually grow slower than astrocytomas.

Mixed glioma 
Gliomas can be made up of a mixture of different types of glial cells, and the most common are oligo-astrocytomas.

Other tumour types 

Ependymoma  
These are rare and develop from the cells which line the spaces of the brain and spinal cord.  These tumours can spread to other parts of the brain.

Medulloblastoma
These are not common in adults but are the most common malignant tumour in children.  They usually develop in the cerebellum but may spread to other parts of the brain.

Pineal tumours
Tumours in this pineal gland region of the brain are very uncommon and they can be made up of different types of cells. The most common tumours are germinomas; others include teratomas, pineocytomas and pineoblastomas.

Meningioma
These tumours arise from the meninges, the layer covering of the brain and are rarely malignant.  They can occur in any part of the meninges over the brain and usually grow very slowly. Most meningiomas are benign and do not spread from their original site. Because of their surface location, they are usually the easiest to remove and cause least damage.

Acoustic neuroma (vestibular schwannoma, neurilemmoma)
These are benign tumours that develop in the acoustic or auditory nerve, which controls hearing and balance. The nerve is covered by schwann cells.  Acoustic neuromas are usually found only in adults and removal can result in partial facial paralysis and deafness in the ear affected.

Haemangioblastoma
This is a rare type of tumour that develops from cells that line the blood vessels. Haemangioblastomas are benign and grow slowly.

Pituitary tumours
Pituitary tumours are benign and are called pituitary adenomas. Symptoms often occur due to disturbances in vision or hormone levels.


Links

BUPA Factsheets

Brain Tumour Action
Extensive information on brain tumour
Brain Tumour UK
Brain Tumour Foundation
Wikipedia: Brain Tumour