How much does brain tumor treatment cost?

What is a Brain Tumor?

How much does a brain tumor surgery cost in Iran?

The cost of a brain tumor surgery depends on the complexity of the surgery. The cost of a brain Tumor surgery in Iran starts from $2000.

A brain tumor is a collection, or mass, of abnormal cells in your brain. Your skull, which encloses your brain, is very rigid. Any growth inside such a restricted space can cause problems. Brain tumors can be cancerous (malignant) or noncancerous (benign). When benign or malignant tumors grow, they can cause the pressure inside your skull to increase. This can cause brain damage, and it can be life-threatening.

Brain tumors are categorized as primary or secondary. A primary brain tumor originates in your brain. Many primary brain tumors are benign. A secondary brain tumor, also known as a metastatic brain tumor, occurs when cancer cells spread to your brain from another organ, such as your lung or breast.

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Before Brain Tumor Treatment

Symptoms

What are the symptoms of a brain tumor?

Symptoms of brain tumors depend on the location and size of the tumor. Some tumors cause direct damage by invading brain tissue and some tumors cause pressure on the surrounding brain. You’ll have noticeable symptoms when a growing tumor is putting pressure on your brain tissue.

Headaches are a common symptom of a brain tumor. You may experience headaches that:

. Are worse in the morning when waking up

. Occur while you’re sleeping

. Are made worse by coughing, sneezing, or exercise

You may also experience:

. Vomiting

. Blurred vision or double vision

. Confusion

. Seizures (especially in adults)

. Weakness of a limb or part of the face

. A change in mental functioning

Other common symptoms include:

. Clumsiness

. Memory loss

. Confusion

. Difficulty writing or reading

. Changes in the ability to hear, taste, or smell

. Decreased alertness, which may include drowsiness and loss of consciousness

. Difficulty swallowing

. Dizziness or vertigo

. Eye problems, such as drooping eyelids and unequal pupils

. Uncontrollable movements

. Hand tremors

. Loss of balance

. Loss of bladder or bowel control

. Numbness or tingling on one side of the body

. Trouble speaking or understanding what others are saying

. Changes in mood, personality, emotions, and behavior

. Difficulty walking

. Muscle weakness in the face, arm, or leg

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Symptoms of pituitary tumors

The following symptoms can occur with pituitary tumors:

. Nipple discharge, or galactorrhea

. Lack of menstruation in women

. Development of breast tissue in men, or gynecomastia

. Enlargement of the hands and feet

. Sensitivity to heat or cold

. Increased amounts of body hair, or hirsutism

. Low blood pressure

. Obesity

. Changes in vision, such as blurry vision or tunnel vision

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What are the risk factors for a brain tumor?

Risk factors for brain tumors include:

. Family history

Only about 5 to 10 percent of all cancers are genetically inherited, or hereditary. It’s rare for a brain tumor to be genetically inherited. Talk to your doctor if several people in your family have been diagnosed with a brain tumor. Your doctor can recommend a genetic counselor for you.

. Age

Risk for most types of brain tumors increases with age.

. Race

Brain tumors in general are more common among Caucasians. However, African-American people are more likely to get meningiomas.

. Chemical exposure

Being exposed to certain chemicals, such as those you might find in a work environment, can increase your risk for brain cancer.

. Exposure to radiation

People who have been exposed to ionizing radiation have an increased risk of brain tumors. You can be exposed to ionizing radiation through high-radiation cancer therapies. You can also be exposed to radiation from nuclear fallout. The nuclear power plant incidents in Fukushima and Chernobyl are examples of how people can be exposed to ionizing radiation.

Diagnosis

If it’s suspected that you have a brain tumor, your doctor may recommend a number of tests and procedures, including:

. A neurological exam. A neurological exam may include, among other things, checking your vision, hearing, balance, coordination, strength and reflexes. Difficulty in one or more areas may provide clues about the part of your brain that could be affected by a brain tumor.

. Imaging tests. Magnetic resonance imaging (MRI) is commonly used to help diagnose brain tumors. In some cases a dye may be injected through a vein in your arm during your MRI study.

A number of specialized MRI scan components — including functional MRI, perfusion MRI and magnetic resonance spectroscopy — may help your doctor evaluate the tumor and plan treatment.

Sometimes other imaging tests are recommended, including computerized tomography (CT). Positron emission tomography (PET) may be used for brain imaging, but is generally not as useful for creating images of brain cancer as it is for other types of cancer.

. Tests to find cancer in other parts of your body. If it’s suspected that your brain tumor may be a result of cancer that has spread from another area of your body, your doctor may recommend tests and procedures to determine where the cancer originated. One example might be a CT or PET scan to look for signs of lung cancer.

. Collecting and testing a sample of abnormal tissue (biopsy). A biopsy can be performed as part of an operation to remove the brain tumor, or a biopsy can be performed using a needle.

A stereotactic needle biopsy may be done for brain tumors in hard to reach areas or very sensitive areas within your brain that might be damaged by a more extensive operation. Your neurosurgeon drills a small hole into your skull. A thin needle is then inserted through the hole. Tissue is removed using the needle, which is frequently guided by CT or MRI scanning.

The biopsy sample is then viewed under a microscope to determine if it is cancerous or benign. Sophisticated laboratory tests can give your doctor clues about your prognosis and your treatment options.

Side effects

It’s common for people to feel worse immediately after their surgery than they did before. This can be upsetting if you are not prepared for it. Removing a brain tumor is a big operation so it might be a while before you feel the benefits from having the tumor removed.

Brain surgery can cause swelling in the brain. Your doctors and nurses monitor this closely and will give you treatment to reduce the swelling. But it might still cause symptoms such as:

. Weakness

. Dizzy spells

. Poor balance or lack of coordination

. Personality or behavior changes

. Confusion

. Problems with your speech

. Fits (seizures)

Your symptoms might be worse at first. And you may notice symptoms that you didn’t have before.

This can be a difficult time for you and your family. They might worry that your operation has not worked. But symptoms usually lessen or disappear as you recover.

Your doctor and clinical nurse specialist can give you some idea of what to expect about recovery. Some people recover completely from their surgery. Others may have some long term problems. It isn’t always possible to tell beforehand how things will work out.

Long term problems after brain surgery

Some people recover well after brain surgery, but this can take some time. Other people have some problems, or long term difficulties.

The problems you may have depends on the area of the brain where the tumor was (or still is if you only had part of the tumor removed). Problems might include:

. Difficulty walking

. Weakness on an arm or leg

. Difficulty concentrating or remembering things

. Behavior changes

. Problems with speech

During Brain Tumor Treatment

Types of Brain Tumors

A brain tumor, known as an intracranial tumor, is an abnormal mass of tissue in which cells grow and multiply uncontrollably, seemingly unchecked by the mechanisms that control normal cells.

More than 150 different brain tumors have been documented, but the two main groups of brain tumors are termed primary and metastatic.

. Primary brain tumors, include tumors that originate from the tissues of the brain or the brain’s immediate surroundings. Primary tumors are categorized as glial (composed of glial cells) or non-glial (developed on or in the structures of the brain, including nerves, blood vessels and glands) and benign or malignant.

. Metastatic brain tumors, include tumors that arise elsewhere in the body (such as the breast or lungs) and migrate to the brain, usually through the bloodstream. Metastatic tumors are considered cancer and are malignant.

Metastatic tumors to the brain affect nearly one in four patients with cancer, or an estimated 150,000 people a year. Up to 40 percent of people with lung cancer will develop metastatic brain tumors. In the past, the outcome for patients diagnosed with these tumors was very poor, with typical survival rates of just several weeks. More sophisticated diagnostic tools, in addition to innovative surgical and radiation approaches, have helped survival rates expand up to years; and also allowed for an improved quality of life for patients following diagnosis.

Types of Benign Brain Tumors

. Chordomas are benign, slow-growing tumors that are most prevalent in people ages 50 to 60. Their most common locations are the base of the skull and the lower portion of the spine. Although these tumors are benign, they may invade the adjacent bone and put pressure on nearby neural tissue. These are rare tumors, contributing to only 0.2 percent of all primary brain tumors.

. Craniopharyngiomas typically are benign, but are difficult tumors to remove because of their location near critical structures deep in the brain. They usually arise from a portion of the pituitary gland (the structure that regulates many hormones in the body), so nearly all patients will require some hormone replacement therapy.

. Gangliocytomas, gangliomas and anaplastic gangliogliomas are rare tumors that include neoplastic nerve cells that are relatively well-differentiated, occurring primarily in young adults.

. Glomus jugulare tumors most frequently are benign and typically are located just under the skull base, at the top of the jugular vein. They are the most common form of glomus tumor. However, glomus tumors, in general, contribute to only 0.6 percent of neoplasms of the head and neck.

. Meningiomas are the most common benign intracranial tumors, comprising 10 to 15 percent of all brain neoplasms, although a very small percentage are malignant. These tumors originate from the meninges, the membrane-like structures that surround the brain and spinal cord.

. Pineocytomas are generally benign lesions that arise from the pineal cells, occurring predominantly in adults. They are most often well-defined, noninvasive, homogeneous and slow-growing.

. Pituitary adenomas are the most common intracranial tumors after gliomas, meningiomas and schwannomas. The large majority of pituitary adenomas are benign and fairly slow-growing. Even malignant pituitary tumors rarely spread to other parts of the body. Adenomas are by far the most common disease affecting the pituitary. They commonly affect people in their 30s or 40s, although they are diagnosed in children, as well. Most of these tumors can be treated successfully.

. Schwannomas are common benign brain tumors in adults. They arise along nerves, comprised of cells that normally provide the “electrical insulation” for the nerve cells. Schwannomas often displace the remainder of the normal nerve instead of invading it.

Acoustic neuromas are the most common schwannoma, arising from the eighth cranial nerve, or vestibularcochlear nerve, which travels from the brain to the ear. Although these tumors are benign, they can cause serious complications and even death if they grow and exert pressure on nerves and eventually on the brain. Other locations include the spine and, more rarely, along nerves that go to the limbs.

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Types of Malignant Brain Tumors

Gliomas are the most prevalent type of adult brain tumor, accounting for 78 percent of malignant brain tumors. They arise from the supporting cells of the brain, called the glia. These cells are subdivided into astrocytes, ependymal cells and oligodendroglial cells (or oligos). Glial tumors include the following:

. Astrocytomas are the most common glioma, accounting for about half of all primary brain and spinal cord tumors. Astrocytomas develop from star-shaped glial cells called astrocytes, part of the supportive tissue of the brain. They may occur in many parts of the brain, but most commonly in the cerebrum. People of all ages can develop astrocytomas, but they are more prevalent in adults — particularly middle-aged men. Astrocytomas in the base of the brain are more prevalent in children or younger people and account for the majority of children’s brain tumors. In children, most of these tumors are considered low-grade, while in adults, most are high-grade.

. Ependymomas are derived from a neoplastic transformation of the ependymal cells lining the ventricular system and account for two to three percent of all brain tumors. Most are well-defined, but some are not.

. Glioblastoma multiforme (GBM) is the most invasive type of glial tumor. These tumors tend to grow rapidly, spread to other tissue and have a poor prognosis. They may be composed of several different kinds of cells, such as astrocytes and oligodendrocytes. GBM is more common in people ages 50 to 70 and are more prevalent in men than women.

. Medulloblastomas usually arise in the cerebellum, most frequently in children. They are high-grade tumors, but they are usually responsive to radiation and chemotherapy.

. Oligodendrogliomas are derived from the cells that make myelin, which is the insulation for the wiring of the brain.

Other Types of Brain Tumors

. Hemangioblastomas are slow-growing tumors, commonly located in the cerebellum. They originate from blood vessels, can be large in size and often are accompanied by a cyst. These tumors are most common in people ages 40 to 60 and are more prevalent in men than women.

. Rhabdoid tumors are rare, highly aggressive tumors that tend to spread throughout the central nervous system. They often appear in multiple sites in the body, especially in the kidneys. They are more prevalent in young children, but also can occur in adults.

Pediatric Brain Tumors

Brain tumors in children typically come from different tissues than those affecting adults. Treatments that are fairly well-tolerated by the adult brain (such as radiation therapy) may prevent normal development of a child’s brain, especially in children younger than age five.

Some types of brain tumors are more common in children than in adults. The most common types of pediatric tumors are medulloblastomas, low-grade astrocytomas (pilocytic), ependymomas, craniopharyngiomas and brainstem gliomas.

The World Health Organization (WHO) has developed a grading system to indicate a tumor’s malignancy or benignity based on its histological features under a microscope.

. Most malignant

. Rapid growth, aggressive

. Widely infiltrative

. Rapid recurrence

. Necrosis prone

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Treatment

Treatment for a brain tumor depends on the type, size and location of the tumor, as well as your overall health and your preferences.

. Surgery

If the brain tumor is located in a place that makes it accessible for an operation, your surgeon will work to remove as much of the brain tumor as possible.

In some cases, tumors are small and easy to separate from surrounding brain tissue, which makes complete surgical removal possible. In other cases, tumors can’t be separated from surrounding tissue or they’re located near sensitive areas in your brain, making surgery risky. In these situations your doctor removes as much of the tumor as is safe.

Even removing a portion of the brain tumor may help reduce your signs and symptoms.

Surgery to remove a brain tumor carries risks, such as infection and bleeding. Other risks may depend on the part of your brain where your tumor is located. For instance, surgery on a tumor near nerves that connect to your eyes may carry a risk of vision loss.

. Radiation therapy

Radiation therapy uses high-energy beams, such as X-rays or protons, to kill tumor cells. Radiation therapy can come from a machine outside your body (external beam radiation), or, in very rare cases, radiation can be placed inside your body close to your brain tumor (brachytherapy).

External beam radiation can focus just on the area of your brain where the tumor is located, or it can be applied to your entire brain (whole-brain radiation). Whole-brain radiation is most often used to treat cancer that spreads to the brain from some other part of the body and forms multiple tumors in the brain.

A newer form of radiation therapy using proton beams is being studied for use in people with brain tumors. For tumors that are very close to sensitive areas of the brain, proton therapy may reduce the risk of side effects associated with radiation. But proton therapy hasn’t proved to be more effective than standard radiation therapy with X-rays.

Side effects of radiation therapy depend on the type and dose of radiation you receive. Common side effects during or immediately following radiation include fatigue, headaches, memory loss and scalp irritation.

. Radiosurgery

Stereotactic radiosurgery is not a form of surgery in the traditional sense. Instead, radiosurgery uses multiple beams of radiation to give a highly focused form of radiation treatment to kill the tumor cells in a very small area. Each beam of radiation isn’t particularly powerful, but the point where all the beams meet — at the brain tumor — receives a very large dose of radiation to kill the tumor cells.

There are different types of technology used in radiosurgery to deliver radiation to treat brain tumors, such as a Gamma Knife or linear accelerator.

Radiosurgery is typically done in one treatment, and in most cases you can go home the same day.

. Chemotherapy

Chemotherapy uses drugs to kill tumor cells. Chemotherapy drugs can be taken orally in pill form or injected into a vein (intravenously). The chemotherapy drug used most often to treat brain tumors is temozolomide (Temodar), which is taken as a pill. Many other chemotherapy drugs are available and may be used depending on the type of cancer.

Chemotherapy side effects depend on the type and dose of drugs you receive. Chemotherapy can cause nausea, vomiting and hair loss.

Tests of your brain tumor cells can determine whether chemotherapy will be helpful for you. The type of brain tumor you have also is helpful in determining whether to recommend chemotherapy.

. Targeted drug therapy

Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die.

Targeted therapy drugs are available for certain types of brain tumors, and many more are being studied in clinical trials. Many different forms of targeted therapy are being developed.

. Visualase

Laser Thermal Ablation is a newer technique that some centers are using to treat smaller tumors particularly in areas that may be more difficult to reach using previous open surgery procedures. This involves placing a tiny catheter within the lesion, possibly completing a biopsy, then using laser to thermally ablate the lesion. This technique is only more recently used in brain tumor treatments, therefore the long term efficacy has not been established.

Alternative medicine

Little research has been done on complementary and alternative brain tumor treatments. No alternative treatments have been proved to cure brain tumors. However, complementary treatments may help you cope with the stress of a brain tumor diagnosis.

Some complementary treatments that may help you cope include:

. Acupuncture

. Art therapy

. Exercise

. Meditation

. Music therapy

. Relaxation exercises

Talk with your doctor about your options.

After Brain Tumor Treatment

Recovering from brain tumor surgery

It can take some time to recover from your brain tumor operation. Everyone takes a different amount of time to recover.

You might stay in hospital for around 3 to 10 days after surgery. How long you stay in hospital depends on your operation and how long you take to recover. As soon as it is safe, you will be allowed to go home where you continue to recover.

Going back to work

Some people make a full recovery from their brain tumor. Others will have some long term side effects. It isn’t possible to tell beforehand how things will work out.

Whether you get completely back to normal and how soon depends on:

. The type of tumor you have

. How big the tumor is and where it is

. The treatment you had

. Your particular job

Some people have difficulty concentrating or remembering details after having treatment for a brain tumor. You might not be able to go back to the same level you were before your diagnosis if you had a job where your mental skills and abilities were very important. This can be very difficult to accept and adjust to.

You might not be able to go back to your job straight away if you operate heavy machinery. You should talk to your occupational health department if you have one. If not, talk to your manager.

If necessary, some employers can arrange for you to take on another role until you are better. Ask about this possibility if it is not offered. You might be able to go back to work part time. Then you can go back to your regular hours once you have got your strength back.

It might be helpful to contact a benefits advisor at your local hospital if you can’t go back to the job you did before.

Rehabilitation after treatment

Because brain tumors can develop in parts of the brain that control motor skills, speech, vision and thinking, rehabilitation may be a necessary part of recovery. Depending on your needs, your doctor may refer you to:

. Physical therapy to help you regain lost motor skills or muscle strength.

. Occupational therapy to help you get back to your normal daily activities, including work, after a brain tumor or other illness.

. Speech therapy with specialists in speech difficulties (speech pathologists) to help if you have difficulty speaking.

. Tutoring for school-age children to help kids cope with changes in their memory and thinking after a brain tumor.

Sources:

https://www.cancer.net/cancer-types/brain-tumor/types-treatment

https://www.radiologyinfo.org/en/info/thera-brain

https://www.nhs.uk/conditions/malignant-brain-tumour/

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  9. hello, my fiance is 32 year old with a brain tumor.although he has been operated on but they want to do chemotherapy on him. do you think its OK to have chemotherapy on someone whom just had a surgery??

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    1. Hello. you have to consider that whether a tumor is operable depends on its size, location, the symptoms its causing and the experience of the Surgeon.We perform many second opinions for patients with in operable tumors. Because of the experience of our neurosurgeons and the technology available at our hospitals we are able to operate on many tumors that have been considered as inoperable somewhere else.

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