Brain tumor
"Laboratory plasma tests can be used for patients who, due to the tumour’s inaccessible location or the patient’s highly deteriorated general condition, cannot undergo surgery”.
DR. JAIME GÁLLEGO
COORDINATOR. CENTRAL NERVOUS SYSTEM TUMORS AREA
What is a brain tumor?
Brain tumor is a growth of cancer cells in the central nervous tissue, it can be a primary or metastatic tumor.
The primary brain tumor originates in the brain structure cells themselves while the metastatic tumor is a tumor that has spread to the brain from an extracerebral location.
The Clínica Universidad de Navarra has a great deal of experience in caring for and researching the treatment of brain tumors.
We are the only Spanish center to incorporate high field intraoperative magnetic resonance imaging (3T). This allows for maximum precision and control in cranial surgery.
It is a pioneer in techniques and clinical trials, such as immunotherapy for the treatment of glioblastoma or the use of the fluorescent microscope to achieve extraordinary rates of complete removal of malignant glioma.
Research has shown that the survival or cure rate of brain tumors depends, to a large extent, on the total removal of the tumor.
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What are the symptoms of a brain tumor?
- Headache is the most frequent non-specific symptom, but on many occasions it is difficult for its presence to make us suspect a brain tumor.
- The symptoms derived from the increase of the intracranial pressure, like somnolence, can be more indicative of the presence of a glioma.
- There are other more specific signs and symptoms that appear depending on the location of the disease, such as focal signs (loss of strength, difficulty speaking, or visual field deficit), seizures, and hemorrhage.
The most common symptoms are:
- Headache.
- Somnolence.
- Loss of strength.
- Neurological deficits.
Do you have any of these symptoms?
You may have a brain tumor
What are the causes of a brain tumor?
There is no known cause responsible for the appearance of malignant brain tumors.
Less than 5% of gliomas have a known family history. On the other hand, there are various degenerative brain diseases that predispose to gliomas.
Nor has it been demonstrated that frequent use of cell phones is the cause of a higher incidence of these brain tumors.
What is the prognosis of brain tumors?
The prognosis depends primarily on the aggressiveness of the tumor.
In adults, 60% of primary brain tumors are gliomas or astrocytomas.
Low grade gliomas I and II. The factors of good prognosis are being less than 40 years old, tumour diameter less than 6 cm, the tumour not exceeding the midline, the histological type oligoastrocytoma and the absence of neurological deficits.
Survival in these patients with high-grade tumors ranges from 9 to 2 years depending on the prognosis group.
Gliomas III and IV. The factors of good prognosis are age (less than 40-50 years), having a good general condition with autonomy, normal mental state and achieving a complete surgical resection.
Survival in these patients with high-grade tumors ranges from 2 years to 6 months depending on the prognosis group.
How is a brain tumor diagnosed?
The Clinic has the most advanced imaging tests.
The magnetic resonance allows to see the lesions of the cerebral tissue, their location and size. By adding the most sophisticated MRI sequences and PET with methionine, the type of tumor can be specified. It is possible to transfer this information to navigation devices in the operating room that correlate those images with the actual space in which one is working.
Biopsy
The obtaining of tissue and its analysis by a neuropathologist is necessary to establish an accurate diagnosis of the type and grade of the tumor. The biopsy can be performed by open surgery or by image-guided puncture. This second case is the so-called stereotactic technique, which involves less discomfort for the patient.
With a meticulous technique, in the operating room and in the laboratory, it is possible to obtain a sample of sufficient quality and quantity to diagnose and perform the necessary molecular markers.
How is a brain tumor treated?
The Clínica Universidad de Navarra has a fluorescent microscope, a new technique which allows for the total removal of the tumor in more than 80% of the cases.
The objectives of surgery for brain tumors are
- An exact and precise diagnosis of the tumor.
- Decrease the pressure on the healthy brain to improve symptoms.
- Total removal can cure the tumor or facilitate the effect of other treatments.
- Removal without damaging healthy bordering areas.
Neurophysiological monitoring in the operating room
It helps to determine whether or not the surgery can continue through an area without producing a sequel to the patient. It increases the removal and decreases the complications.
Intraoperative image-guided surgery
For all tumors, the image from the previous MRI is used as a map for a navigator to help the surgeon.
Chemotherapy aims at destroying the tumor cell.
In the case of brain tumors, there are two important characteristics that make it more difficult to administer chemotherapy:
- The blood-brain barrier, which protects the central nervous system from the arrival of toxic substances from the blood.
- The special resistance of these tumors to current chemotherapy drugs.
The chemotherapy treatment applied depends on the type of brain tumor. Chemotherapy has been shown to be effective in prolonging survival in high-grade gliomas.
Chemotherapy is the treatment of choice in most patients with primary lymphomas of the central nervous system, after biopsy confirmation of the diagnosis.
In brain tumors that occur in children, chemotherapy treatment is essential, as they are more sensitive to these drugs.
Despite all the treatments, in many cases chemotherapy does not manage to stop the progression of the disease. Therefore, it is important to continue research with basic research and clinical trials.
Precision in the planning and execution of radiation therapy is essential to ensure that the maximum dose is given to the tumor while preserving and not damaging normal tissues.
In the Clinic, this precision is possible, since we have qualified professionals with extensive experience and the most advanced technology in imaging tests for a correct and careful planning.
Radiation therapy can also be curative in some benign tumors, especially if their size and location allows a high enough radiation to the tumor volume.
Studies have shown that its administration in the postoperative period does not increase the survival of these patients, but increases the time in which the tumor is controlled.
La Clínica is the only Spanish center that carries out a study for the treatment of glioblastomas with immunotherapy. The new therapy, which is administered to participating patients in the form of vaccines, is combined with standard first-line treatment. It consists of the surgical removal of the tumor, followed by the administration of radiotherapy and chemotherapy with temozolomide.
The immune system is critical in the development and control of tumors. Immunotherapy aims to repair or increase the response of the patient's immune system.
The limited amount of disease and the combination of chemotherapy and immunotherapy make this a good added option to the treatment of patients with glioblastoma.
Proton therapy for cancer
Proton therapy is the most precise external radiotherapy modality, providing better distribution of radiation dose and therefore less irradiation of healthy tissues.
The Proton Therapy Unit of the Cancer Center Clínica Universidad de Navarra in its Madrid headquarters is the most advanced in Europe and the first in a Cancer Center, with all its healthcare, academic and research support.
Where do we treat it?
IN NAVARRA AND MADRID
Central Nervous System Tumors Area
of the Cancer Center Clínica Universidad de Navarra
In the Central Nervous System Tumors Area we offer maximum safety and efficiency in brain tumor surgery, being the first hospital with a high field magnetic resonance within the operating room.
We have a highly specialized team in the surgery of brain tumors, with more than 15 years of experience.
The individualized treatment of each case by an interdisciplinary team allows us to offer the best alternative to each patient.
Why at the Clinica?
- Integral evaluation of the patient.
- Cutting edge technology.
- Expert professionals who are a national reference.
Our team of professionals
