Surgery is often the main treatment for a brain tumour. The operation you have depends on the size of the tumour and its position. Only highly specialised surgeons do brain surgery. It is done in specialist centres or hospitals. They use technology that makes operations safer and easier to do.
You can have surgery to:
- take a sample of the tumour (a biopsy) for further tests or to diagnose the type of brain tumour
- remove all of the tumour (complete resection)
- remove as much of the tumour as is safe and possible (partial resection or debulking)
- reduce pressure in the skull.
To remove part or all of the tumour, you have an operation called a craniotomy.
Some people also have chemotherapy given directly into the brain during surgery.
If a brain tumour blocks the flow of cerebrospinal fluid (CSF) around the brain, pressure can build up and cause symptoms. To reduce the pressure, some people have a small operation to place a long, thin tube called a shunt into the brain.
Some tumours cannot be removed with surgery. A tumour may be too difficult to reach, or the risk of damaging the brain could be too high. Your surgeon will talk to you about other treatment options.
You will have tests before surgery to make sure you are well enough to cope with it. These are usually done a few days before your operation at a pre-assessment clinic. They may include heart and lung tests.
If you smoke, try to give up or cut down before your operation. This will help reduce your risk of problems, such as a chest infection. It will also help your wound to heal after the operation. Your GP can give you advice and support to help you stop smoking.
If you are not already taking them, you may be given steroids. These drugs help to reduce swelling caused by the tumour. Always take steroids exactly as your doctor has prescribed. You usually take them for a while before and after surgery.
You are usually admitted to hospital the day before or morning of your operation. The nurses will give you elastic stockings called TED stockings to wear during and after surgery. These help prevent blood clots in your legs.
You will meet a doctor from the surgical team and a specialist nurse who will talk to you about the operation. You will also meet the anaesthetist. This is the doctor who gives you the anaesthetic.
Any operation to the brain is major surgery. So it is natural to feel worried and frightened about it. You may have questions about:
- the risks of surgery
- whether the operation will change how your brain works in some way
- how you will feel after the operation
- how you will look and whether you will have scars.
Your surgeon and specialist nurse will talk to you about the operation and the possible risks and benefits. If there is a risk of damage to the brain during surgery, they will explain how this may affect you.
The surgeon may need to shave some of your hair during the operation. Some people find the thought of waking up with part of their head shaved very upsetting. If you are worried about this, your nurse or surgeon can explain what to expect before the operation.
Your specialist nurse can give you and your family support. Make sure you have as much information as you need. Talk about any concerns and ask any questions you have. Knowing what to expect can make it easier to cope and less frightening.
When you wake up, you may be in the intensive care ward or high-dependency unit for about 24 hours. Or you may go straight back to a neurosurgical ward.
The doctors and nurses will monitor you carefully. They will do neurological checks, such as testing your reflexes and seeing how your eyes react to light. They will also take your temperature and blood pressure.
Your face and eyes may be swollen and bruised. This swelling should go down within 48 hours and the bruising should get better within a few days. Sometimes a swelling filled with fluid develops under the operation scar. This may take longer to go down, but will also get better over time.
Drips and drains
You may have some tubes in place when you wake up. These are used to give you fluid and drugs, or to drain body fluids. They are not usually painful. Tell your nurse if something you are connected to is uncomfortable. Your nurse will remove each drip or drain when you no longer need it.
You may have some of the following:
- A tube going into a vein, called a drip or infusion – this is used to give you fluids until you can eat and drink again.
- A drain from your wound – this is used to drain blood or fluid into a bottle. It is usually removed 1 to 2 days after the surgery.
- A fine tube that passes up the nose and into the stomach – this is called a nasogastric tube. It removes fluids from the stomach, to stop you being sick.
- A catheter – this is a tube that drains urine from your bladder. It is usually taken out when you are able to move around more.
When you go home and how quickly you recover will depend on the type of operation you have. Your healthcare team during recovery may include:
- a physiotherapist
- an occupational therapist
- a speech and language therapist (SLT), if needed.
They can help you plan to go home and arrange any further support you might need.
You will still be recovering when you leave hospital. Remember to take things slowly and follow the advice from your healthcare team. Contact the hospital straight away if you have any problems or new symptoms, including:
- a fever (high temperature)
- redness, swelling or leaking from your wound
- feeling or being sick
- feeling very drowsy
- weakness in your arms or legs
- problems with speech
- a seizure.
It is normal to feel very tired for several weeks or longer. For a few people, this may continue for a year or more. Getting enough rest and eating healthily will help you recover. Try to balance rest with some gentle exercise, such as regular short walks. This will help give you more energy.
Your surgeon and healthcare team will tell you what to expect and how you can help with your own recovery. It is a good idea to make an appointment to see your GP when you go home. They can give you advice and support. You will usually go back to the hospital a few weeks after your operation for a check-up.