Brain Tumour Surgery (Neurosurgery)

On this page you will find lots of information about different types of brain tumour surgery, to help you know what to expect.

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Awake Craniotomy

An awake craniotomy is an operation performed in the same manner as a ‘conventional’ craniotomy but with the patient awake during the procedure.

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Image Guided Craniotomy

This is the most generally used procedure, which involves removing a piece of skull and then replacing it, under a general anaesthetic.

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Craniotomy in MRI

This technology has been around for about twenty years in the USA and was pioneered by Prof. Peter Black. It is now available in the UK.

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Lasers in Brain Surgery

This is a new technique and sometimes using lasers can help to remove a brain tumour. It does require opening the skull and is used during a craniotomy. It is still experimental and is not available in the UK.

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Preparing for neurosurgery – a timeline

Preparing for neurosurgery is scary, but neurosurgeons perform hundreds of these operations each year. This timeline can help you prepare.

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I have a far better idea of what to ask my consultant when I next see him and what the long term implications will be. This has given me more sense of not only an understanding of my situation, but I feel like I have regained some control of the situation and my life again.

I really cannot thank-you enough for your help with this. I had no idea where to turn or what to do and although there is still very much a long way to go and many decisions to be made, which will no doubt be hard, I feel better prepared and feel that if I need help I am not alone, but that I can turn to you.

Thank-you, from the very bottom of my heart,

Nadia, brain tumour patient, London

Find brain tumour support on your doorstep, and current brain tumour trials at www.braintumourhub.org.uk

Brain surgery. Scary words. If you are reading this then it is highly likely you have recently learnt that you are going to have neurosurgery. This is one of the first major decisions you will face. In fact, I don’t think there is anything as frightening as facing this decision – ever. If you can make this decision – one way or the other – then nothing you do will ever be as scary as this.

But you are not facing this alone. You will have a brilliant team behind you, your family will be there and of course, you can call us any time to talk things through – 01983 292 405.

No decision is going to be straightforward. It’s all a balance of risk v. benefits and the truth is that there is seldom a good reason to remove a brain tumour unless it is thought that the vast majority can be removed. Partial resection can sometimes be a bad thing. What we’re saying here is that each case needs to be decided individually; so much depends on your quality of life, type of brain tumour, where it is. The list goes on.

First decision – whether to proceed with an attempted complete surgical removal or whether to have just a biopsy. Evidence shows that wherever possible it is better to resect as much as is possible. Surgery to remove a tumour, even malignant ones, has several advantages over a biopsy:

  • By removing tumour mass, room can be made to allow for the swelling of brain tissue which occurs both with radiation therapy and if the tumour recurs.
  • The more that can be taken out, the less that will need to be treated with other forms of therapy.
  • More tumour to diagnose, means better accuracy of the diagnosis and grading, because there are more cells to examine.

Everything depends on the individual’s well being, the nature of the tumour, and potential complications. All of these must be talked through and thought about. And thought about some more. But don’t think for too long. It can be very wearying and will occupy your head so that in the end you will not feel able to make a decision. And no decision is irreversible – until you go down to the operating theatre.

Did this information make you feel more resourced, more confident or more in control?

Date published: 17-05-2009
Last edited: 28-02-2018
Due for review: 28-02-2021

Introduction

The Brain Tumour Data Dashboard lets you explore up -to-date, population level data about the brain tumours diagnosed in England between 2013 and 2015. Using the drop down menus on the left you can select different groups of patients to view in the charts below. In these charts the number of patients for every 100 diagnoses is displayed as images of people. Patients have been grouped by date of diagnosis, type of tumour, age, gender, and region in England.

For each group of patients you can explore the different routes to diagnosis, the proportion of those who received chemotherapy or radiotherapy, as well as the survival of the patients within each group. For more information about what these metrics mean please see the glossary.

How to use

  1. Select the year of diagnosis using the drop down menu.
  2. Select your patient group of interest from the four drop down menus in the following order:
    1. Tumour group
    2. Age at diagnosis
    3. Region of England
    4. Gender of patient
  3. To view a second chart to compare different groups of patients, click the ‘compare’ button.The second chart will appear below the first chart.

*Note that the tool is best used on a laptop or tablet rather than a mobile phone*

Unavailable data

Some of the data in these charts is not available.There are two main reasons for this:

  1. How the data has been grouped

If you cannot select a patient group from the drop down menus, the data is unavailable because of how the data has been organised.

Public Health England has grouped the data like a branching tree. The bottom of the tree contains all the patients with brain tumours, and then each branch divides the data by a certain characteristics, like age, or location of tumour. But the data is divided in an order, starting with location of the tumour (endocrine or brain), then by age, region, and gender. Age is at the start because it makes a bigger difference to survival rates and treatment rates than gender or region. Sometimes, after the data has been split by type of tumour and age, there is not enough data to be split again. This is because to protect patient confidentiality groups cannot contain less than 100 patients. Because some groups cannot be split further, you cannot create ‘totals’ for everyone by region or gender. For example, you cannot see results for all ages by region, or all brain tumours by gender. If these totals were calculated and released, it might be possible to identify patients, which is why Public Health England cannot release this data.

  1. Statistical reasons and data availability

If you can select a patient group from the chart menus, but the chart does not display, the data is unavailable for one of several reasons:

  1. Data is not yet available for the selected year from Public Health England.
  2. Data is not available because the data quality is too poor to release this statistic.
  3. Data is not available as the statistic is not appropriate for this group.
  4. Data is not available because the standard error of the estimate was greater than 20% and so the estimate has been supressed.

Up to date brain tumour data

Brain tumour data may influence the decisions you make about your care. Data also helps you understand the bigger picture, or landscape, in which you find yourself.

Brain tumour data and statistics influence the focus, and work of organisations like brainstrust. The information helps us to understand the scale and impact of the problems we are setting out to solve.

This tool helps you understand the landscape in which you find yourself having been diagnosed with a brain tumour. This landscape can be particularly tricky to navigate as there are many different types of brain tumour, all of which have a different impact.

The information you see represents the most up-to-date, official, population level brain tumour data available for England. Over time we will be adding to the brain tumour data available and publishing reports, with recommendations, as a result of what we learn from this data.

The data behind this content has come from Public Health England’s National Cancer Registration and Analysis Service (NCRAS) and is a direct result of the ‘Get Data Out’ project.

This project provides anonymised population level brain tumour data for public use in the form of standard output tables, accessible here: http://cancerdata.nhs.uk/standardoutput

Incidence

The number or rate (per head of population) of new cases of a disease diagnosed in a given population during a specified time period (usually a calendar year). The crude rate is the total number of cases divided by the mid-year population, usually expressed per 100,000 population.

Malignant

Malignant tumours which grow by invasion into surrounding tissues and have the ability to metastasise to distant sites

Mortality

The number or rate (per head of population) of deaths in a given population during a specified time period (usually a calendar year). The crude rate is the total number of deaths divided by the mid-year population, usually expressed per 100,000 population.

Non-malignant

Not cancerous. Non-malignant tumours may grow larger but do not spread to other parts of the body.

Survival

The length of time from the date of diagnosis for a disease, such as cancer, that patients diagnosed with the disease are still alive. In a clinical trial, measuring the survival is one way to see how well a new treatment works. Also called ‘overall survival’ or ‘OS’.

Routes to Diagnosis

Under the ‘Routes to Diagnosis’ tab in the Brain Tumour Data Dashboard, you can explore the ways patients have been diagnosed with brain tumours. There are many ways, or routes, for cancers to be diagnosed in the NHS. A ‘route to diagnosis’ is the series of events between a patient and the healthcare system that leads to a diagnosis of cancer. The routes include:

  1. Two Week Wait

Patients are urgently referred by their GP for suspected cancer via the Two Week Wait system and are seen by a specialist within 2 weeks where they are diagnosed.

  1. GP referral

Diagnosis via a GP referral includes routine and urgent referrals where the patient was not referred under the Two Week Wait system.

  1. Emergency Presentation

Cancers can be diagnosed via emergency situations such as via A&E, emergency GP referral, emergency transfer or emergency admission.

  1. Outpatient

Outpatient cancer diagnoses include diagnoses via an elective route which started with an outpatient appointment that is either a self-referral or consultant to consultant referral. (It does not include those under the Two Week Wait referral system).

  1. Inpatient elective

Diagnosis via an inpatient elective route is where diagnosis occurs after the patient has been admitted into secondary care from a waiting list, or where the admission is booked or planned.

  1. Death Certificate Only

Diagnoses made by Death Certificate Only are made where there is no more information about the cancer diagnosis other than the cancer related death notifications. The date of diagnosis is the same as that of the date of death.

  1. Unknown

For some patients with a cancer diagnosis, there is no relevant data available to understand the route to diagnosis.

 

More information

If any of the statistical terms in this section of the brainstrust website are hard to understand, we recommend looking them up here:

Cancer Research UK’s Cancer Statistics Explained

http://www.cancerresearchuk.org/health-professional/cancer-statistics/cancer-stats-explained/statistics-terminology-explained#heading-Seven

If you are looking for help understanding terms relating specifically to brain tumours, and treatment, then the brainstrust glossary is available here:

https://www.brainstrust.org.uk/advice-glossary.php