Oncologist

Oncologist is a doctor who deals with treating and managing cancer. While some oncologists specialize in a specific type of cancer, others deal with diagnosing and treating various kinds of cancer. An oncologist has to identify possible symptoms of cancer and conduct tests that might help diagnose effectively. Often a combination of treatments are suggested to combat cancer. Diagnostic methods that are often used are biopsy, endoscopy, MRI or CT scan and blood tests. Tumor markers help identify specific types of cancer.

Radiation Therapy

Radiation therapy is usually part of cancer treatment administered under the guidance of an oncologist. It is used along with other treatments such as chemotherapy and surgery to control malignant cells. Radiation controls cell growth and plays a vital role in destroying cells or keep them from multiplying. The oncologist will decide on the kind of radiation and dosage of radiation. Some amount of healthy cells are likely to be targeted in the radiation therapy. There are two forms of radiation therapy.

External beam radiation: High powered x-rays are directed into or near the tumor from outside the body.

Internal beam radiation: Here the radiation is done from inside or near the tumor.

The side-effects of radiation therapy are hair loss, nausea, vomiting, skin problems, increased susceptibility to infection and low blood counts. Radiation therapy cannot be used on a pregnant woman.

Brain Cancer

Malignant tumors in the brain are the consequence of abnormal growth of cells in the brain. Brain cancers can be primary, arising from primary brain cells, or from other brain components. Metastatic brain cancer starts elsewhere in the body and spreads to the brain. About 25% of tumors elsewhere in the body metastasize to the brain. The most common cancers that metastize to the brain are lung cancer, breast cancer, colon cancer and melanoma. The majority of brain metastases are located in the cerebral hemispheres and then in the cerebellum. Very few occur in the brain stem.

Causes/ risk factors for brain cancer

• Any radiation to the head
  
• Hereditary
  
• HIV infection
  
• Smoking
  
• Toxins found in the environment such as chemicals in oil refinery, rubber industry chemicals etc)
  

Symptoms of Brain Cancer

• Severe headache in the morning.
  
• Nausea and vomiting, especially early in the mornings.
  
• Some changes/problems while talking, listening or seeing.
  
• Problems while walking.
  
• Memory problems or lack of alertness.
  
• Twitching of muscles or seizures.
  
• Numbness in the arms or legs.
  
• General weakness
  
• Clumsiness
  
• Gradual changes in intellectual and emotional capacity.
  

These symptoms may be very gradual and therefore overlooked by the patient. Occasionally however, these symptoms may appear more rapidly.

Who is at risk for brain cancer ?

Persons with the following conditions are at more risk for developing cancer of the brain.

• Frequent exposure to radiation
  
• Age
  
• Exposure to pesticides, herbicides and fertilizer
  
• Workers occupied in petroleum, plastic, rubber and textile industries.
  
• Exposure to electromagnetic fields
  
• Genetic disorders
  

Diagnosis of Brain Cancer

MRI has higher sensitivity for detecting the presence and characteristics of a tumor. In case, the CT or MRI indicates the presence of a brain tumor, the patient will be referred to a neurosurgeon or to a neuro oncologist. The next step in diagnosis is to confirm cancer in the brain. A biopsy is taken to identify the type of tumor and the grade of the tumor. This is done by a surgical procedure called craniotomy. The skull is opened with the intention of removing the whole tumor if possible. A biopsy is taken from the tumor. In some cases, if the exact location of the tumor is detected, by using a CT or MRI scan, a biopsy is taken without opening the skull. This technique is stereotaxis, where a needle is used to collect the biopsy. A pathologist examines the biopsy under a microscope and diagnoses the disease.

Brain cancer treatment

Treatment for brain cancer is based on the patient's age, and general health status, size, location and type and grade of the tumor. In most cases of brain cancer, surgery, radiation and chemotherapy are the preferred treatment. As treatment protocols of brain cancer are highly complex, most treatment plans will involve several consultations and sittings with the neurosurgeon, oncologist, radiation oncologist and healthcare provider.

Most people with brain cancer undergo surgery to assign and grade the tumor and then remove the tumor or take a sample to identify the type and grade. In some cases, a benign tumor can be cured by surgical intervention and removal of tumor.

Stereotactic radio surgery, a knife less technique that can destroy a brain tumor without opening the skull can be adopted. With a CT or MRI, the exact location is pinpointed and with high energy radiation beams the tumor from different angles is destroyed. Knife less procedure has fewer complications and the recovery time is shorter. The disadvantage is the lack of tissue available to send to a pathologist for diagnosis of brain swelling.

Radiation can be administered externally or internally. External radiation travels through skin and the skull, healthy brain tissue and other tissues to get to the tumor. Internal radiation uses a tiny radioactive capsule placed inside the tumor itself. The radiation emitted from the capsule destroys the tumor.

Chemotherapy drugs may be administered by mouth or through an IV line. Chemotherapy is usually administered in cycles, each cycle consisting of a short period of intensive treatment followed by a period of rest and recovery. The side effects of chemotherapy include nausea, vomiting, mouth sores, loss of appetite, loss of hair among others. New therapies with the use of nanotechnology for cancer are being developed and are promising. Regular follow up is essential after treatment of brain cancer. Such checkups would include physical and neurologic exams, and occasional CT and/or MRI.