Dr. Ravish Patwardhan

Dr. RavishPatwardhan comments on… Tumors (of the brain, including what is a tumor?)

Dr. Ravish Patwardhanlearned about a brain tumor the hard way… While many among us may think we knowwhat a tumor is from hearing about it, how many of us really know what a tumoris? How can we explain it to others? These questions are real ones, and atleast a basic scientific explanation could help answer some of these, accordingto neurosurgeon Dr. Ravish Patwardhan.

To understand whatthe body is capable of, let’s take the example of a knife cutting through theskin of the arm. This results in a gash, a valley which must be (over time)filled in to heal completely. The way the body heals this wound is to startgrowing a bridge of cells, which means that existing cells divide and “fill inthe gap.” However, to do this, many thousands of cells must divide many times, untilthey meet – and then STOP. If they don’t stop and keep dividing, a tumor couldresult. That is the basis of a tumor – “the unregulated division of cells.”Now, let’s say the tumor keeps growing but if the cells of the tumor can beremoved safely without the tumor returning, we label that a “benign tumor.”This is better than a “malignant tumor” which means that the cells keepdividing, merge into normal cells without a discrete boundary, and keep ongrowing. Surgery will not typically help, unless a large boundary is taken ofnormal cells (since the exact place where the tumor cells end and normal cellsbegin is not evident as it is for tumor cells); surgery is not always possiblewithout harming important structures, also. So, many malignant tumors are treatedwith radiation and chemotherapy, for cells which simply could not be removed.Malignant tumors (and often metastatic tumors) are what are commonly referredto as “cancer.”

In the same tumor,if cells were able to get into the blood stream, travel to other parts of thebody, and then grown in the place they are carried to, these are called“metastatic tumors.” Tumors which metastasize can be extremely difficulty totreat, notes Dr. Ravish Patwardhan. Many famous cases are noted; among thoseinclude Lance Armstrong, the famous 7-time Tour-de-France winner, who hadmetastatic testicular cancer to the brain. He was extremely fortunate, as afterchemotherapy and surgical removal, the tumors appeared never recur again. Hewent on to win the grueling cycling race among an elite field, despitemetastatic tumors being treated – an amazing feat.

Newer treatmentoptions for brain tumors are available now, including focused radiation(stereotactic radiation, such as Gamma Knife), polymer wafers, and radiationseeds. Many of these treatment options are last resorts in cases where patientsand doctors realize the outcome would otherwise be likely dismal, according toDr. Ravish Patwardhan.

Other novel ideasof how to treat brain tumors include immune system-mediated treatment options,such as antibodies which target a part of the tumor which is not present innormal cells. By using such novel treatment options, as well as gene therapy,side effects to normal brain (and other parts of the normal body) may beminimized, and the tumor more effectively targeted.

Of course,symptoms from brain tumors result from the specific brain portion affected –tumors in the movement area may cause weakness, those in the visual area maycause blindness, those affecting hearing can cause hearing loss, and so forth.Using safe methods such as MRI-based navigation, careful surgical technique,and use of other treatment options, the best outcome is possible. As newertechniques emerge, so does hope for better tumor treatment, according to Dr.Ravish Patwardhan.