Brain Tumour Treatment in India: Surgery, Radiosurgery & Glioblastoma Care

The topic, Brain tumour treatment in India for international patients is becoming popular. Simultaneously the need to know about the details is rising. This blog will take you straight into the essential details of the topic and will make sure you pick up the best knowledge from it. 

There are a number of important segments that should be covered under the head including the types of brain tumors, decision making process, high and low grade gliomas, Meningioma, Pituitary tumours and various neurosurgery and radiosurgery options available for international patients in India. It is even necessary to know about the details regarding brain cancer surgery cost in India. Let us now dive in.

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Brain Tumour Types and Treatment Decision-Making

Brain tumors are abnormal growths of cells in the brain, segmented as either benign or non-cancerous or malignant meaning cancerous. Treatment decisions rely on the tumor's size, type, grade, location, and the patient's age and health. There are a number of alternatives like radiation therapy, surgery, watchful waiting, chemotherapy and targeted therapy. The key types of brain tumours include primary and metastatic tumours based on the location of their origin. Let us get into the details of the types of brain tumours:

Primary Tumours

Primary tumours begin in the brain tissue. General types include Meningiomas and Gliomas like oligodendrogliomas, astrocytomas,, and glioblastomas that can be highly dangerous and even aggressive in nature. 

Metastatic Tumors

Metastatic tumours are cancerous cells that reach the brain from other body parts like the breast, lungs or colon. Other kinds of brain tumours are medulloblastomas, pituitary tumors, and CNS lymphomas.

Treatment Options

Brain tumours require immediate medical help and diagnosis. There are a number of treatment options and therapies that can be effective against brain tumors and their aggressive spreads throughout the body. It is essential to know about the treatment options available for brain tumours in India. Brain Tumor treatment in India for international patients includes all these treatment options. Let us know more:

Watchful Waiting : Doctors normally advise watchful waiting normally when the growth of the tumour is not significant or seems benign. Regular MRI scans help in understanding the depth and gravity of the tumours.

Surgery: Surgery spreads the most basic treatment option available for brain tumors. Surgery focuses on getting rid of the tumor in the safest manner possible. Surgeries successfully avoid further spread of the tumour. 

Radiation Therapy & Radiosurgery: Radiation Therapy & Radiosurgery uses proton therapy and gamma rays or high-energy X-rays to kill the growing cancer cells. 

Targeted Therapies & Immunotherapy: Medications including angiogenesis inhibitors and kinase inhibitors prepared to aim at the important proteins and genetic mutations increasing the scope of tumours can be used as a wonderful treatment option. 

Chemotherapy: Chemotherapy is also an important option that can be used to treat brain tumors or brain cancers. 

Determinants of Treatment Decisions

Your treatment decision will depend upon the number of factors including tumor features and location your doctor will verify and check for all these details before suggesting a particular treatment option. Ladies no about the determinants of your cancer treatment decision : 

Location: Tumors located near or in important functional areas like the parts having sensational controls should be treated with priority with proper and professional medical care.

Tumor Features : Tumor features are also important in determining your treatment related decisions. Low grade tumours require immediate treatment than high grade or aggressive brain tumors. 

Personal Aims & Preferences: Patient's personal and medical history along with preferences are also important in determining the treatment decisions related to brain tumor management. Factors like family support, priorities and side effect management should be considered well before taking a treatment decision. 

Patient's Health & Age: Patient's health and age also play an important role in determining the treatment type. There are patients who are not in a position of handling the side effects related to intense therapies and surgeries. Doctors need to study all these factors in detail to reach a treatment decision. 

Low-grade vs high-grade glioma

Gliomas are tumors arising from the brain's glial cells. They are segmented by the World Health Organization or WHO into four grades on the basis of the abnormality of the cells when seen under a microscope and how fast they develop. Brain tumour treatment in India for international patients includes treatment for low grade and high grade gliomas. Let us understand in detail about Low Grade Gliomas ( Grades 1 and 2 ) : 

Low-Grade Gliomas ( Grade 1 and 2)

Low grade gliomas are slow growing tumours that are similar to normal cells. The symptoms include newly developed seizures. The growth is slow and hence do not require high end treatments like radiation and chemotherapy. These tumours can develop into high grade tumours over time. The survival rate is higher in these cases. 

High-Grade Gliomas ( Grades 3 and 4)

High grade gliomas are fast growing tumours often along with symptoms like cognitive dysfunction, sudden headaches and neurological problems. These tumours need a high level of medical intervention including chemotherapy, radiation and medications. The prognosis of high grade gliomas is challenging and difficult in nature. The long term survival rate is lesser than low grade gliomas. Let us have a look at the difference in a tabular manner:
 

CHARACTERISTIC	LOW GRADE GLIOMA	HIGH GRADE GLIOMA
DEVELOPMENT	It has the ability to get transformed in high grade glioma.	It can develop from an already existing low grade glioma.
PROGNOSIS	The survival rates are higher in the case of low grade glioma.	The prognosis is difficult and can occur again and again.
SYMPTOMS	It can have newly developed symptoms.	Sudden weakness, headache and cognitive changes are some common symptoms of high grade gliomas.
TREATMENT	Generally surgery rules out low grade gliomas. However other advance treatments can be essential in some cases.	Multi level treatment including radiotherapy, chemotherapy and radiation are essential to treat high grade gliomas.
CELL APPEARANCE	The cells in the case of low grade gliomas look near normal cells.	The cells seem highly abnormal and unorganised.
TUMOUR    GROWTH	The cells of low grade glioma are slow growing in nature.	The cells in the case of high grade gliomas are quick growing and fast developing.

Glioblastoma (GBM) — Stupp protocol in India

Let us now understand about the Glioblastoma or the GBM- Stupp Protocol in India. Neurological exams are done to check the effects of brain tumour over the parts of a brain that are connected to coordination, vision and hearing. Biopsy, imaging tests like EMI and diagnostics help in finding out the exact effect of Glioblastoma over the entire human body. 

Stupp protocol plays a very pivotal role in managing the symptoms and Glioblastoma treatment in India. Stupp protocol is important for brain tumour treatment in India for international patients. Here is how the entire Stupp protocol works in India : 

• Firstly the entire gravity of the problem is understood by MRI and other important Diagnostic techniques.
• Nextly computer tomography or CT scan helps in finding out the tumor location.
• A biopsy is performed to understand the tumor tissues well under a microscope.
• Later a molecular and genetic testing is done to get the most accurate diagnostic results.
• Glioblastoma is treated with a perfect combination of radiation, chemotherapy and surgery. 

Meningioma, pituitary tumours — curative options

Curative options for pituitary tumors and meningioma mainly include surgical procedures, targeted therapies and radiation therapies along with radiosurgery. Meningioma and Pituitary tumours need treatment according to the location, gravity of the issue and aggressiveness of the tumour. Here is the curative alternative explanation regarding Pituitary tumours : 

Pituitary Tumors or Adenomas

Pituitary tumour or adenoma are treated according to the real diagnosis. Doctors plan to treat the tumour in the most efficient manner. Here are the treatment options available for pituitary tumors : 

Radiation Therapy: There are certain pituitary tumors that cannot be got rid of by surgical procedures. In such a situation Radiation therapy helps in ruling out the possibility of growth and development of such tumors. Options like Gamma knife and Radiosurgery help in tackling these types of tumours in the most efficient manner.

Surgery or Endoscopic Transsphenoidal Surgery : Surgeons reach the tumor via the nasal cavity without making incisions on the face. This helps in removing the tumours in the most efficient manner. This is among the basic choices of treatment against adenomas. 

Medication Therapy: Medications help in tackling the growth of tumours and reducing the hormones responsible for tumour growth. Some pituitary tumors, generally prolactinomas, can be  normalized with the help of dopamine agonists. 

Meningiomas

Meningiomas are those tumours that hail from the protective membranes or meninges encircling the spinal cord and brain. Most of them are benign but some can be fatal or malignant. Here are some  brain tumour treatment in India for international patients for Meningiomas : 

Radiation Therapy: Radiation therapy has always been helpful in treating brain tumors including Meningiomas. These types of therapies help in restricting the growth and development of brain tumours.

Observation : Observation is one of the most recommended treatment options available for Meningiomas. Observation or watchful waiting helps in understanding the real growth of tumours. Doctors suggest it to find out the gravity and real effect of tumours.

Craniotomy or Endonasal Surgery : Removing the entire tumour is always recommended to reduce the chance of bouncing back. Based on its location surgeons may perform a traditional open craniotomy to reduce complications. 

Neurosurgery & Radiosurgery Options in India

India is currently emerging as an international medical tourism hub. This is the exact reason why cancer treatments including Radiosurgery and Neurosurgery options are on the rise here. It offers some of the cheapest brain tumour treatments in India for international patients. Non-invasive treatments like CyberKnife and Gammaknife are greatly available at most of the hospitals in the metropolitan regions of the country. Here are the popular hospitals in India for Neurosurgery and Radiosurgery:

Delhi & NCR

Fortis Memorial Research Institute at Gurgaon is well known for successful radiosurgery and Gamma Knife experts. Artemis Hospital at Gurgaon is also a leading hospital for the brain tumour extractions. Indraprastha Apollo Hospital at New Delhi is also famous for radiosurgery technologies.

Mumbai & Western Region

There are some hospitals in the Mumbai and Western zone like Apollo Hospitals in Navi Mumbai, Kokilaben Dhirubhai Ambani Hospital in Mumbai, Nanavati Super Speciality Hospital at Mumbai that are well known for radiosurgery and neurosurgery treatments.

Southern Region

Apollo Hospitals in Bangalore, Chennai and Hyderabad are popular in Southern India for Robotic and neurosurgery treatments.

Doctors like Dr.Aditya Gupta, Dr.Sandeep Vaishya and Dr.Paresh K Doshi are some popular and expert doctors in India known for their expertise in neurosurgeries and radiosurgeries. 

Stereotactic radiosurgery (Gamma Knife/CyberKnife)

India offers some well advanced treatment against brain tumours. Stereotactic radiosurgery (SRS) like Gamma Knife and CyberKnife are among these popular surgeries. These are non-invasive and purely accurate traditional surgeries that help in ruling out the possibility of tumour spread.  

These surgeries offer focused sub-millimeter radiation beams to kill tumors in the spine and brain. The best part of the story is the surrounding tissues are left intact. No longer hospital stays, incisions or invasive procedures are involved in these surgeries. These surgeries are effective against malignant as well as non malignant tumours. Gamma Knife and CyberKnife are efficient procedures making cancer eradication quite convenient and precise. Brain tumour treatment in India for international patients is easier due to the availability of such treatment advancements in the country. Let us know more about both these procedures.

Gamma Knife

Gamma Knives are popular for targeting malformations and brain tumours in the most efficient manner possible. 

Gamma Knife brain surgery in India makes use of 192 to 201 tiny, accurately aimed beams of gamma rays to kill the tumour cells. Gamma Knife needs the use of an invasive, fixed metal head frame that is put to the patient's skull to make sure there is no movement.

CyberKnife

CyberKnife makes use of a linear accelerator onto a dynamic, computer-based robotic arm that encircles the patient to deliver X-rays from numerous angles. CyberKnife has the capability of treating tumours not only in the brain but also in other parts of the body like the lungs and prostate. The sessions are highly flexible in nature. 

Awake craniotomy — available in top centres

Awake craniotomies or awake brain surgeries are latest treatment procedures basically used to extract tumors or treat epilepsy situated near important "eloquent" brain parts. These are those parts of the brain that are responsible for speech, vision and movement. Awake craniotomy surgeries allow real time treatment by keeping the patient's conscience intact.

Here are some famous hospitals in India for awake craniotomy procedures : 

Medanta - The Medicity (Gurgaon)

This is an internationally well known hospital for its latest and upgraded spine and brain surgeries. 

NIMHANS (Bangalore)

NIMHANS in Bangalore is India's premier autonomous organisation for neurosciences. 

D. Hinduja Hospital (Mumbai)

D. Hinduja Hospital (Mumbai) provides awake brain surgery pioneered by well qualified and experienced neurosurgeons.

Bombay Hospital (Mumbai)

Bombay Hospital in Mumbai is also popular for awake craniotomy procedures and other brain related surgeries.

Apollo Hospitals 

Apollo Hospitals at Chennai, Bangalore or Delhi are also among the top centres in India for brain tumour treatment in India for international patients.

Cost comparison for brain surgery India vs Germany

Brain cancer surgery costs in India are truly lesser than in Germany. The cost is up to 70 to 80% less than that in a developed country like Germany. In India, brain tumor surgery is between the range of $3,000 and $11,000 and on the contrary the same cost can be between $20,000 and $52,000 in Germany. Brain tumour treatment in India for international patients is extremely cheaper. Let us have a look at a the detailed cost comparison between India and Germany for brain surgery : 
 

FEATURE	INDIA	GERMANY
HOSPITAL STAY	The stay in the hospital is nearly 7 to 12 days.	The stay at hospitals is nearly 7 to 10 days.
MEDICAL TOURISM	Bengaluru, New Delhi and Mumbai are some famous medical tourism hubs in India for brain tumour treatment in India for international patients.	Hamburg, Frankfurt, and Berlin are some popular medical tourism hubs in Germany.
INCLUSIONS	Surgeon fees, Diagnostics, OT fees and ICU stays are included in the cost.	Standardized DRG and Diagnostics cost is included in the cost.
AVERAGE BASE COST	In India, brain tumor surgery is between the range of $3,000 and $11,000.	In Germany, brain tumor surgery is between the range of $20,000 and $52,000 in Germany.

What Should You Consider While Choosing? 

Travel and Logistic Networks: You need to consider travel expenses including flight ticket expenses, visa fees and accommodation costs while travelling to India or Germany. Generally this cost is lesser in India than in Germany. 

Germany's Medical Standard: Germany offers a good quality neurosurgical technology including intraoperative MRI and DRG system. Brain tumour surgery cost in India is quite lesser than in Germany due to this reason too. 

Frequently Asked Questions

1Q: What is the best hospital for brain tumour treatment in India? 

Ans: India has numerous top class centers offering neuro-oncology care. The best hospital will highly depend upon your personal medical needs, and budget. There are a lot of leading hospitals in India that offer cancer care such as Kokilaben Dhirubhai Ambani Hospital at Mumbai, Medanta at Gurgaon, and Apollo Hospitals across numerous Indian cities. 

2Q: Is Gamma Knife surgery available in India?

Ans: Yes, Gamma Knife surgery is available at most of the hospitals in India. It is available as a non-invasive radiosurgery at famous high class hospitals in metropolitan areas.