Neuro oncology is backbone of neurosurgery. The overall incidence of brain tumors is 7 per 100000 population. Brain tumors are benign and malignant. Surgery is the mainstay in the treatment of benign tumors. When neurosurgery started diagnosis of these tumors was itself a big ordeal. One has to undergo a cerebral angiogram for the diagnosis. Angiograms those days used to be done through neck puncture and the contrast media were very toxic. Surgical resection used to end with lots of morbidity and mortality. Introduction of steroids, refinements in the fields of neurosurgery and neuro anesthesia have brought down the morbidity and mortality to a considerable extent. Rapid strides in the field of neuroradiology like CT scan, MRI, Spectroscopy and PET scan have made diagnosis of these tumors more comfortable. With technological innovations like generation next operating microscope, state of art bipolar machines, cusa and neuronavigation total cure is possible in almost all benign tumors. Meningioma is the commonest benign tumor.
Malignant brain tumors other wise called brain cancers make up 2% of all cancers in the body. Brian cancers are primary brain cancers and secondary brain cancers. Secondary tumors are more common than primary ones and the commonest secondary tumor is form the lung cancer. It is ironical that cancers from all over the body affect brain secondarily but primary brain tumors do not spread outside the nervous system. Microsurgery is once again the mainstay in the treatment of brain cancers. Some new techniques like 5 amino levulinic acid aided fluorescent microscopy has improved surgical resections in brain cancer surgery. Radiotherapy has also a major role in the management of brain cancers. We have come a long way from whole brain radiation to pinpoint methods like stereotactic radiotherapy, gamma knife and cyber knife.
Chemotherapy has only a secondary role in the over all management of brain cancers. The average 5 year survival rate for brain cancer is 33%. Lots of research is going on to improve this dismal statistics. Contrary to the popular belief mobile phone usage and cell phone towers have no role in the increasing incidence of brain tumors. The increased incidence is most probably due to availability of better of investigative modalities.