A brain tumour surgery is a major medical procedure in which a neurosurgeon removes an abnormal growth (a tumour) in the brain. It is typically performed to remove a benign tumour effectively or to prevent the spread of cancerous growths in the brain.

Brain tumour surgery is usually performed to remove an abnormal growth in the brain which causes symptoms, like seizures, which interfere with the day-to-day life of the patient. If the tumour is malignant (cancerous), removal is often attempted if it is not close to any vital portions of the brain. On the other hand, for a benign (non-cancerous) tumour, surgery is suggested if symptoms are severe or if there is a high risk of brain damage.

Surgery may also be exploratory in nature, i.e. to get a sample of an existing tumour for diagnostic processes.

There are various types of surgery which may be performed to remove the tumour. These include:

• Craniotomy, the most common procedure to remove tumours in the brain
• MRI-Guided Laser Ablation
• Endonasal Endoscopy
• Microsurgery
• Awake Craniotomy, in which the patient is awake for whole or part of the process

Brain tumour surgery is  major surgery and carries several risks, including:

• Bleeding in the brain
• Formation of clots in the brain, which may need subsequent drainage
• Meningitis, a severe infection resulting in an inflammation of the brain
• Reactions to anaesthesia
• Leaking of Cerebrospinal Fluid (CSF)
• Memory loss or problems with memory
• Accumulation of excess fluid in the brain

If the tumour is benign, surgery is often successful and sufficient. After the removal of the tumour, the patient leads a normal life. However, in the case of malignant tumours, the efficacy of the surgery depends on a number of factors, including the location of the tumour and how far cancer has spread. If cancer has not spread beyond the brain, the prognosis is good while in case of secondary malignancies being present, the prognosis is usually poor.

A brain tumour can occur in anyone. However, it usually occurs in patients above the age of 60. Likewise, surgery to remove a tumour is most likely performed in patients in the age range of 60-80 as at higher ages, the risk of severe complications outweighs the potential benefits from the surgery. However, age is not the only factor to decide whether to perform the surgery, as the position of the tumour, the patient’s medical history and current condition also matter.

In case of benign tumours, surgery is often recommended as a last resort when symptoms are severe and a substantial risk of brain damage is present. However, for malignant neoplasms, surgery is often unavoidable as, without prompt intervention, the tumour may quickly spread to other parts of the body.

Various pre-diagnostic tests are performed before brain tumour surgery to make sure that the patient is not at an increased risk of complications during or after surgery. They include:

• A complete blood count, to rule out Anaemia or Leukopenia
• Dental check-up, to rule out infection
• Liver and kidney function tests
• Blood sugar test
• ECG, to rule out heart conditions
• CT Scan or MRI of the Brain, to pinpoint the exact location of the tumour
• Chest X-Ray, to rule out any abnormality in the lungs

In craniotomy, the most common surgical procedure for removing brain tumours, the surgeon makes an incision in the scalp and removes a piece of skull bone using specialised equipment. The dura mater is opened to expose the tumour and the tumour is then removed. The entire operation takes place in the Operation Theatre under general anaesthesia.

Being a complicated surgery, brain tumour surgery can take anywhere from four to six hours to perform. The time duration of the operation depends on the type of surgery performed, the area of the brain operated upon and if any complications occur during surgery.

There will be no pain experienced during brain tumour surgery as the skull will be numbed, and there are little to no pain-receiving nerve endings inside the brain. Some discomfort may manifest after the surgery; however, this can usually be managed with non-narcotic or narcotic pain relievers depending on the intensity of the pain. Pain will gradually decline over time.

You may be required to stay in the hospital for over a week, depending on the type of surgery performed and the overall condition of the patient. However, even after discharge, minor symptoms may persist.

Being a major surgery involving the brain, the road to recovery is often long. However, the prognosis and long-term outcome of the surgery is often favourable and after a few months, the patient is usually in a much better condition than before the surgery.

You may be required to stay in the hospital for over a week, depending on how well you recover from the surgery.

Even after discharge, caution must be taken in performing day-to-day activities. Driving is usually allowed about two to four weeks after surgery while you will be allowed to resume work around two months after surgery if recovery is as planned. The ultimate decision on when to return to a particular activity (vest)s upon the health care practitioner.

Since it a major surgery performed by experienced surgeons, the cost of a brain tumour surgery in India can vary from four to eight lakhs. The price varies from patient to patient, depending on the patient’s condition and the type of surgery performed. For example, an open craniotomy procedure costs much lesser than advanced microsurgery of the brain.

The medical tourism industry in India has been on the rise of late. Due to attractive packages offered, experienced doctors and well-equipped hospitals, more and more foreign nationals are coming to India to undergo complicated medical procedures, including Brain Tumour Surgery.

Choosing a doctor and a hospital for such major surgery is an important decision to make for patients and their family members as it goes a long way in determining the outcome of the operation. When choosing a doctor, look for the previous history of success in the procedure and a good overall reputation. As for hospitals, those with good rehab centres and modern technology and infrastructure should be preferred.