A BEAM TO REST UNDER

She was only 31 years old, a vibrant soul with an NCC certificate, excelling in every game she played. She was an education professional, brimming with life, a young mother in a loving marriage, and had dreams of achieving many more goals in the game of life.

But in 2015, everything changed. Like an unwarranted foul in a volleyball match, an invisible enemy threatened to expel her from her field. Mrinal, whose name I’ve changed, began experiencing seizures and severe headaches that felt like someone was squeezing her veins. She woke up feeling disoriented, unable to recognize her surroundings, her trembling hands desperately trying to grasp her shifting reality. These unsettling feelings were soon accompanied by bouts of vomiting, indigestion, excessive sleep, and eventually, double vision. She initially consulted a physiotherapist, thinking her symptoms were related to vertigo or cervical spondylosis. However, the physiotherapist advised her to undergo proper testing.

The results of the pre-treatment MRI revealed a grave problem, as the doctor informed her. Unbeknownst to her, Mrinal had been diagnosed with Astrocytoma, a locally invasive brain tumor. “I had never heard of this name before, and I didn’t want to hear it either,” Mrinal recalls. “I knew I had a slow-growing disease in the midline. All I wanted was to fight it, preferably without surgery, and return to my work, my baby, and my life. Cancer was not a word I wanted to associate with my condition. I let my husband handle all the discussions with doctors and everyone else, praying that the disease could be cured through medications or alternative therapies. Thankfully, my tumor was deeply rooted, making surgery extremely risky. It could have resulted in loss of sight, speech, or even paralysis.”

Although surgery was the first recommended option for Mrinal, as is the case with head and neck cancers, its potential side effects were daunting. It was understandable that she wished to avoid it. However, choosing alternative treatments meant compromising her chances of a successful outcome. Radiation therapy alone would not be as effective as surgery combined with postoperative radiation. Making compromises in cancer treatment came at a cost, as a residual disease or recurrence could severely limit the available options for oncologists.

“All cancers are frightening, but brain and lung cancers are among the most challenging,” explains Dr. Munish Gairola, Director of the Department of Radiation Oncology. “Astrocytomas, the fourth most common cancerous brain tumor, resemble a crab with its many tentacles, infiltrating deep into the tissue. That’s why they are called locally invasive or infiltrative. Unlike other cancers that can be completely removed along with a safety margin of healthy tissue, brain tumors often don’t allow for such extensive resection, especially if they are close to critical organs. To avoid causing permanent damage, neurosurgeons strive to remove as much of the tumor as safely possible, leaving behind residual disease that necessitates radiation therapy. This was the scenario when Mrinal came to us with a low to intermediate grade tumor.”

Before arriving at RGCIRC in 2015, Mrinal was informed by a renowned doctor at a well-known government institute that radiation was her only option. She knew she was receiving the second-line treatment, not the first.

“Neurosurgery has made remarkable advancements, but so has radiation therapy, which serves as the primary treatment for certain brain tumors. In some cases, surgical intervention may not be feasible due to inaccessibility or involvement of sensitive areas, such as the brain stem, responsible for vital functions. These areas are best treated with upfront radiation,” argues Dr. Gairola, advocating for radiation as the primary therapy for certain malign

. However, in Mrinal’s case, the neurosurgeons at RGCIRC recommended a different approach. They believed that a combination of surgery and radiation therapy would offer the best chance of successful treatment.

After careful consideration and discussions with her husband and the medical team, Mrinal made the difficult decision to proceed with surgery. The operation was performed by a highly skilled neurosurgeon who specialized in brain tumor resections. The goal was to remove as much of the tumor as possible while minimizing the risk of damage to surrounding healthy brain tissue.

The surgery was a success, and the majority of the tumor was removed. However, due to the infiltrative nature of astrocytomas, there was still a small amount of residual disease left behind. To target and eliminate any remaining cancer cells, Mrinal underwent a course of radiation therapy.

Radiation therapy is a localized treatment that uses high-energy radiation to kill cancer cells and shrink tumors. In Mrinal’s case, the radiation was focused on the area where the tumor had been removed, with the aim of eradicating any remaining cancer cells and reducing the risk of recurrence.

Throughout her treatment journey, Mrinal faced numerous challenges. The side effects of radiation therapy, such as fatigue and hair loss, took a toll on her physical and emotional well-being. However, she remained determined and resilient, drawing strength from her supportive family and the compassionate care provided by the medical team at RGCIRC.

Over time, Mrinal began to show signs of improvement. Her seizures became less frequent, and she regained her strength and vitality. Regular follow-up appointments and scans were conducted to monitor her progress and ensure that the cancer remained under control.

Today, several years after her diagnosis, Mrinal continues to live a fulfilling life. She has returned to her passion for teaching, cherishes precious moments with her family, and remains committed to raising awareness about brain tumors and supporting others facing similar challenges.

Mrinal’s story highlights the importance of early detection, timely intervention, and a multidisciplinary approach in the treatment of brain tumors. While every case is unique, advancements in surgical techniques, radiation therapy, and supportive care have significantly improved outcomes for patients like Mrinal.

It is essential for individuals experiencing concerning symptoms to seek medical attention promptly and consult with experts in the field. With the right treatment and support, there is hope for a brighter future even in the face of challenging diagnoses like astrocytoma.