Brain cancer treatment in Turkey

What is the diagnosis of brain cancer?

Diagnosis of brain cancer, like all other brain formations, is difficult because of the difficulty of accessing education and because of the existence of a large number of brain formations, it is difficult to make a differential diagnosis between them.

Basic diagnostic methods:

• Examination by a neurologist-neurological disorders, such as unsteadiness of gait, changes in the fundus or tremor of the hands, if there is no other reason for them, are a reason for conducting additional research methods,
• CT with intravenous contrast,
• MRI with intravenous contrast — used when it is necessary to determine the involvement of blood vessels in the tumor process,
  Biopsy-performed in the case of primary diagnosis. In cases of suspected metastatic process, it is also desirable, since the histological properties of metastases may differ from the characteristics of the main tumor, but if taking a biopsy is associated with high risks, the diagnosis can be limited only to CT or MRI.
• The material taken for the study is examined under a microscope, in addition, the most
  important mutations and features of the tumor are studied. This is done to prescribe the right chemotherapy, immunotherapy, targeted and hormone therapy.
• Oncomarkers — an indirect diagnostic method, used for evaluation in dynamics and is important for complex diagnostics.

What is the treatment of brain cancer in Turkey?

The main methods of treatment of brain cancer in Turkey:

• Stereotactic surgery. This is the destruction of the tumor using a linear accelerator. For surgery for brain cancer or brain metastases, the most modern devices are used — Gamma knife, Cyber knife, installations that are equipped with computer navigation and IMRT function, so as not to leave areas of the tumor and not to damage vital structures such as the visual nuclei, blood vessels of the brain or the respiratory center.
• If the removal of the tumor by radiosurgery is not possible (due to ingrowth into vital structures or due to the fact that vital structures may be damaged due to edema during treatment), an endoscopic operation is performed through the nasal passages. This is a more invasive procedure than linear accelerator treatment, but it is much safer than traditional craniotomy.
• In the case when radiosurgery is not possible, and endoscopically it is impossible to provide adequate access, it is necessary to resort to invasive surgery. It is safest if it is performed on a Da Vinci robot.
  Sometimes in the brain, the visualized metastasis is not 1 to 2 distinct forms, but a large number in different places, but within the same area or lobe. In such a situation, it is necessary to give radiation not to the metastasis itself, but to a certain area of the brain. At the same time, the need for computer navigation and correction of the beam direction during irradiation becomes even more important.
• Neurosurgical operations. Sometimes the removal of a tumor is impossible without the intersection of neurons and blood vessels of the brain. In order not to invalidate the patient, these structures are stitched according to neurosurgical principles.
• Rehabilitation — depending on the complexity of the operation, neurological defects may remain after treatment, which requires several weeks or several months of rehabilitation.

Depending on the type of formation, less often for cancer, more often for metastases:

• Systemic chemotherapy,
• Targeted therapy,
• Immunotherapy