Neuro-Oncology

Neuro-oncology is a specialized field focused on the diagnosis, treatment, and management of brain and spinal cord tumors, including both primary CNS cancers (gliomas, meningiomas) and metastatic tumors (from lung, breast, or melanoma cancers). With advancements in precision medicine and neurosurgical techniques, patient outcomes are continually improving.

Types of Brain & Spinal Cord Tumors

1. Primary Brain Tumors

• Glioblastoma (GBM) – Most aggressive primary brain tumor
• Meningioma – Typically benign, but can require surgery
• Medulloblastoma – Common in children
• Pituitary Adenoma – Affects hormone regulation

2. Spinal Cord Tumors

• Ependymoma – Arises from spinal cord lining
• Schwannoma – Nerve sheath tumor

3. Metastatic Brain Tumors

• Spread from cancers like lung, breast, or melanoma

Risk Factors & Symptoms

Key Risk Factors:

• Genetic conditions (Neurofibromatosis, Li-Fraumeni syndrome)
• Radiation exposure
• Immune system disorders

Warning Signs:

• Persistent headaches (worse in the morning)
• Seizures (new-onset in adults)
• Neurological deficits (weakness, vision changes, speech problems)

Diagnosis & Staging

• MRI with Contrast – Gold standard for brain tumor detection
• CT Scan – For emergency evaluation
• Biopsy/Stereotactic Surgery – Determines tumor grade & molecular profile
• Lumbar Puncture – For leptomeningeal disease detection

Treatment Options

1. Surgery

• Awake Craniotomy – For tumors near critical brain areas
• Minimally Invasive Techniques – Endoscopic, laser ablation

2. Radiation Therapy

• Stereotactic Radiosurgery (Gamma Knife, CyberKnife) – Precise, non-invasive
• Proton Therapy – For pediatric & sensitive areas

3. Systemic Therapies

• Chemotherapy (Temozolomide for glioblastoma)
• Targeted Therapy (EGFR inhibitors, VEGF blockers like Bevacizumab)
• Immunotherapy (Clinical trials for GBM)

Breakthrough Advances

• Liquid Biopsies – Detecting tumor DNA in cerebrospinal fluid
• Tumor-Treating Fields (TTFields) – Electric field therapy for GBM
• CAR-T Cell Therapy – Emerging for aggressive brain cancers

Post-Treatment Care

• Cognitive Rehabilitation – For memory & executive function
• Physical Therapy – For motor skill recovery
• Support Groups – Emotional & psychological support

Why Early Intervention Matters

• 5-year survival for glioblastoma: ~5% (improving with new therapies)
• Meningioma survival: Often >90% with complete resection