Glioma: Surgery Eligibility and Risks
- Like any surgery, a procedure to remove glioma does come with risks.
- The risk depends on several factors, like the patient’s overall health and where their tumor is located.
- The surgery may be less painful than patients expect, Dr. Ryan Osmond, a neurological surgeon at University of Colorado Health, tells SurvivorNet. “Most patients are off narcotics before they leave the hospital and sometimes patients don’t use narcotics at all. They use NSAIDs, Tylenol, ibuprofen, things like that are enough, at least within the first few days of surgery for many patients.”
- Risks associated with surgery include infection, bleeding, stroke, swelling in the brain, neurological effects, seizures, and blood clots.
One of the first questions your cancer team will try to answer is whether or not you are a candidate for surgery. Regardless of your eligibility, a neurosurgeon will be an integral part of your treatment team, helping guide decisions and offering the best possible approach to managing your condition.
Read MoreWho is a Candidate for Surgery?
Determining whether surgery is the right option for you depends on several factors. Your medical team, including your neurosurgeon and oncologist, will consider:- Tumor Location: If the tumor is in a part of the brain that is safely accessible, surgery may be recommended. Some tumors are located near critical brain structures that control speech, movement, and other essential functions, making complete removal more challenging.
- Tumor Size and Type: Larger tumors or those that infiltrate multiple areas may be harder to remove completely. Your doctor will assess how much of the tumor can be safely taken out.
- Overall Health: Your ability to tolerate surgery will be considered. Patients with underlying health conditions may need additional tests to ensure they can safely undergo the procedure.
- Symptoms: If the tumor is causing significant symptoms such as seizures, headaches, or neurological changes, surgery may help alleviate these issues and improve quality of life.
Your medical team will conduct imaging tests such as MRI or CT scans to evaluate your tumor and discuss the risks and benefits of surgery.
How is Brain Surgery Performed?
Brain surgery to remove a glioma is called a craniotomy.
“What surprises a lot of people: they’re not as painful as a lot of other operations that people get,” Dr. Ormond explains. “Most patients are off narcotics before they leave the hospital and sometimes patients don’t use narcotics at all. They use NSAIDs, Tylenol, ibuprofen, things like that are enough, at least within the first few days of surgery for many patients”
The procedure involves the following steps:
- Anesthesia and Preparation: You will be placed under general anesthesia, though in some cases, an “awake craniotomy” may be performed to monitor brain function during surgery.
- Creating an Opening in the Skull: The neurosurgeon will carefully remove a small section of the skull to access the tumor.
- Tumor Removal: Using advanced surgical tools and imaging technology, the surgeon will remove as much of the tumor as possible while avoiding damage to healthy brain tissue.
- Closing the Skull: The removed section of the skull is replaced, and the scalp is stitched closed.
- Post-Surgical Monitoring: You will be closely monitored in a specialized unit to ensure a smooth recovery.
Advanced surgical techniques, including intraoperative MRI, neuronavigation, and fluorescence-guided surgery, help improve the precision and safety of the procedure.
Potential Complications
As with any surgery, there are risks involved. While neurosurgeons take every precaution to minimize complications, it’s important to be aware of possible risks, including:
- Infection: Although rare, infections can occur and may require antibiotics or further treatment.
- Bleeding: Some bleeding is expected, but excessive bleeding may require additional interventions.
- Stroke: The risk of stroke varies based on the tumor location in the brain.
- Swelling in the Brain: This can cause temporary neurological symptoms and may be managed with medications such as steroids.
- Neurological Deficits: Depending on the tumor’s location, some patients may experience speech, movement, or cognitive changes. Rehabilitation therapies can help with recovery.
- Seizures: Surgery may temporarily increase the risk of seizures, which can often be managed with medication.
- Blood Clots: These typically can occur in the legs and are called DVTs (Deep Venous Thrombosis)
Your surgeon will discuss the risks specific to your case and how they plan to minimize them.
Dr. Osmond notes that for generally health patients, DVT is the biggest concern.
“Their biggest risk is at the time of surgery or getting a blood clot in their legs after surgery, what’s called a DVT,” he says. “Because you’re healing from surgery and you have cancer, those are two things that drive up your clotting factors in your body.”
How Long is the Recovery Period?
Recovery time varies from person to person, but here’s a general outline of what to expect:
- Hospital Stay: Most patients stay in the hospital for a few days to a week, depending on their condition.
- Initial Recovery: Fatigue, headaches, and mild cognitive changes are common in the first few weeks.
- Physical Therapy and Rehabilitation: If necessary, therapy may help with regaining strength, balance, or speech functions.
- Return to Normal Activities: Most patients can resume light activities within a few weeks, but full recovery may take several months.
- Follow-Up Care: Regular check-ups and imaging tests will monitor your recovery and detect any signs of recurrence.
Your medical team will provide personalized guidance on when you can safely return to work, driving, and other daily activities.
If My Cancer Returns, Can I Have Surgery Again?
In some cases, gliomas can return even after successful surgery.
Whether additional surgery is an option depends on several factors, including:
- Location of Recurrence: If the tumor returns in a surgically accessible area, another operation may be possible.
- Previous Treatments: If you have already undergone radiation or chemotherapy, your medical team will assess whether surgery is still a viable option.
- Your Overall Health: Your ability to tolerate another procedure will be carefully evaluated.
- Alternative Treatments: If surgery isn’t a good option, other therapies such as radiation, targeted therapy, or clinical trials may be recommended.
Your doctor will work closely with you to develop the best plan for managing a recurrence.
Understanding your surgical options for glioma can help you feel more empowered in your treatment journey. While surgery is a critical part of treatment, it is often combined with other therapies such as radiation or chemotherapy to improve outcomes.
If you or a loved one is facing a glioma diagnosis, seeking care from a specialized neuro-oncology team can ensure the best possible treatment and support throughout your journey.
Questions to Ask Your Doctor
- Am I a good candidate for surgery?
- What treatment side effects am I most at risk for?
- What will the recovery period look like after surgery?
- How long will I need to stay in the hospital?
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