Types of surgery for brain cancer
Different types of operations may be used to remove brain and spinal cord tumours.
Learn more about:
- Removing a brain tumour (craniotomy)
- Awake craniotomy
- Removing a pituitary tumour (endoscopic transsphenoidal surgery)
- Removing a spinal cord tumour (laminectomy)
- Computer guidance
Removing a brain tumour (craniotomy)
This is the most common type of brain tumour operation. A craniotomy removes all or part of the tumour (total or partial resection) and may be done while you are asleep under general anaesthetic.
The surgeon cuts an area of bone from your skull to access the brain and cut out the tumour. The bone is then put back. The surgeon will insert small plates and screws to hold the piece of skull in place.
If you have a high-grade glioma, you may be given a solution to drink before surgery that makes the tumour glow under a special blue light. This may help the surgeon remove as much of the tumour as possible, while avoiding normal brain tissue.
This operation may be recommended if the tumour is near parts of the brain that control speech or movement. All or part of the operation is done while you are awake (conscious) but relaxed, so you can speak, move and respond.
The surgeon asks you to speak or move parts of your body to identify and avoid damaging those parts of the brain. An electrode is also placed on the outside layer of the brain to stimulate and pinpoint important areas of the brain (known as brain mapping).
You may be worried that an awake craniotomy will be painful, but the brain itself does not feel pain and local anaesthetic is used to numb surrounding tissues.
It is now usual for a craniotomy to be done using a computer system to guide the surgeon. This is known as stereotactic surgery.
The computer uses the results of planning scans to create three‑dimensional images of the brain and tumour.
During the operation, the computer monitors the position of the surgical instruments, allowing the surgeon to be very precise.
Stereotactic surgery is safer, more accurate and requires a smaller cut in the skull than non-computer‑guided surgery.
Removing a pituitary tumour (endoscopic transsphenoidal surgery)
The most common surgery for tumours near the base of the brain (e.g. pituitary gland tumours) is called endoscopic transsphenoidal surgery. To remove the tumour, the surgeon inserts a long, thin tube with a light and camera (endoscope) through the nose and into the skull at the base of the brain. An ear, nose and throat (ENT) surgeon may assist with this type of surgery. You will be given a general anaesthetic for this operation.
Removing a spinal cord tumour (laminectomy)
The most common surgery for spinal cord tumours is called a laminectomy. In this procedure, the surgeon makes an opening through the skin, muscle and a vertebra in the spinal column to remove the tumour. A laminectomy is usually performed under general anaesthetic.
For more on this, see our general section on Surgery.
It is now usual for a craniotomy to be done using a computer navigation system to guide the surgeon. This is known as stereotactic surgery.
The computer uses the results of planning scans to create three-dimensional images of the brain and tumour. During the operation, the computer monitors the surgical instruments, allowing the surgeon to be very precise.
Stereotactic surgery is safer, more accurate and requires a smaller cut in the skull than non-computer-guided surgery.
You will be given drugs (anaesthetic or anaesthesia) to temporarily block any pain or discomfort during the surgery. For more information about the different types of anaesthetic, see our general section on Surgery.
A/Prof Lindy Jeffree, Neurosurgeon, Royal Brisbane and Women’s Hospital, QLD; Emma Daly, Neuro-oncology Clinical Nurse Consultant, Cabrini Health, VIC; A/Prof Andrew Davidson, Neurosurgeon, Victorian Gamma Knife Service, Peter MacCallum Cancer Centre and Department of Neurosurgery, Royal Melbourne Hospital, VIC; Beth Doggett, Consumer; Kate Fernandez, 13 11 20 Consultant, Cancer Council SA; Melissa Harrison, Allied Health Manager and Senior Neurological Physiotherapist, Advance Rehab Centre, NSW; A/Prof Rosemary Harrup, Director, Cancer and Blood Services, Royal Hobart Hospital, TAS; A/Prof Eng-Siew Koh, Radiation Oncologist, Liverpool Cancer Therapy Centre, Liverpool Hospital and University of New South Wales, NSW; Andy Stokes, Consumer.
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