Post-Brain Tumor Treatment
1. What is a brain tumor?
Tumor is a mass of tissue formed by the abnormal cells in the body. Although the word tumor is sometimes used synonymously with cancer, every tumor does not mean cancer. There are benign (benign) and malignant (malignant) tumors. Benign tumors usually do not spread to other parts of the body; however, they can grow bigger where they are located over time. They respond well to treatment. Malignant tumors mean cancer. They can spread beyond where they originate. In medical language, this is called “metastasis”, and it is difficult to treat.
Benign tumors that develop in the brain are more dangerous than benign tumors in any part of the body. Although they are benign, they do not spread elsewhere and grow slowly, these brain tumors can pose a life-threatening risk. This is mainly due to the fact that the skull is a closed box, and there is not enough room for the growth of extra tissues. The mass effect of the tumor can lead to compression of the normal brain tissue, stroke, speech disorder, seizures, increased intracranial pressure and hernia in the brain, or even death. Therefore, the benign tumors in the head are often removed by surgical operation.
Primary brain tumors are tumors that originate from the brain tissue. The spread of cancer that develops in another part of the brain is called a metastatic brain tumor. Primary brain tumors can be either benign or malignant. The most common benign brain tumors are meningiomas. Gliomas constitute the majority of malignant primary brain tumors. The most common of these tumors is the glioblastoma multiforme.
2. Treatment of Brain Tumor
Benign brain tumors can be treated with surgery, radiotherapy, or a combination of the two methods. Gamma Knife Radiotherapy is a technique commonly used in this field. Sometimes periodical follow-up may be sufficient instead of the interventional treatments. This option may be preferred in elderly patients and the case of small tumors. If the tumor does not grow during the follow-up, surgery may not be necessary.
After the brain tumor surgery, most people exhibit functional improvement compared to their condition before the surgery. Nonetheless, due to the damage caused by the tumor removed from the brain, there are risks such as paralysis and cerebral edema in the clinical picture of stroke. Despite the fact that this risk decreases with the advancing techniques, it never disappears. Therefore, after brain tumor surgery, the patient should be evaluated by a physiotherapy and rehabilitation specialist. Hence, clinical pictures of early functional loss and paralysis can be overcome quickly with a comprehensive and customized physical therapy and neurorehabilitation program in the early period. When the physical therapy and rehabilitation program is started late despite the necessity, the proportion of the benefit that can be obtained from the program may decrease. Hence, the golden rule in brain lesions is also valid in this period: USE or LOSE !!!
3. How Does a Patient Spend a Day in Comprehensive Treatment?
The treatment program to be taken by the patient is determined by the physician on a weekly basis according to the rehabilitation potential and condition. Depending on the patient’s needs, treatment can be applied at the following treatment stations.
3.1 Daily Sample Treatment Program
4. Recovery Process After Brain Tumor
Recovery takes time after the brain tumor surgery. The recovery process is different for all individuals. The location of the brain tumor, the areas affected in the brain during surgery, the age and the overall health condition of the person are some of the factors that affect this process. While being discharged from the neurosurgery service, the patients and their relatives are informed about the recovery process. Major issues that are important during the early period are wound care, correct use of medicines, knowing about the conditions for presenting to a health institution and planning of the follow-up appointments.
While some patients are discharged directly after the brain tumor surgery, some patients may require additional physical therapy and rehabilitation. Brain tumor and brain surgery can affect the physical skills, cognitive functions, and psychology of a patient. In addition, functional losses may occur and result in stroke. In this case, rehabilitation approaches such as physical therapy, occupational therapy and speech therapy come to the forefront. The physical therapy and rehabilitation specialist examines the patient, determines the functional status, sets rehabilitation goals together with the rehabilitation team, family and the patient, prepares the treatment plan to be followed in order to achieve the goals.
5. Physical Therapy and Rehabilitation After The Brain Tumor
Neurorehabilitation, which corresponds to the physical therapy process after brain and nerve injuries, requires a team work. Health professionals such as the physical therapy and rehabilitation specialist, physiotherapist, rehabilitation nurse, occupational therapist, speech therapist, physical therapy technician, orthotic and prosthetic technician, psychologist and social worker are involved in the process. When necessary, consultations are made with the physicians specialized in fields such as brain and nerve diseases, oncology, neurology, psychiatry, internal diseases and infectious diseases. After the brain tumor surgery, physical therapy can be planned in 3 ways: inpatient, outpatient or at home. The overall condition of the patient, the learning potential, and the time the patient can actively participate in therapies during the day are taken into consideration when determining the most appropriate treatment method for the patient.
6. Robotic Physical Therapy After Brain Tumor Surgery
After the brain tumor surgery, robotic therapy is an important part of the comprehensive physical therapy and rehabilitation program in the early period. Robotic bed and robotic walking technology is utilized to ensure standing and walking, especially in the early period. When the patient is successful at this stage, Lokomat with Free D, which is the walking robot produced by the Swiss company Hocoma as the pioneering and best company in the field of robotic rehabilitation technologies worldwide, is used for the walking training with active assistance, reinforcing learning with virtual reality. When the patient succeeds in sitting, the next step of the training begins with the full-fledged hand-arm robot known as Armeo Power with Manova, which is also produced by Hocoma.
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