Pineal tumours occur in and around the pineal gland, almost in the centre of the brain. They are rare, accounting only for around 1 per cent of all brain tumours diagnosed in the UK. The several different kinds of pineal tumours all have differing characteristics and they often require a combination of treatments, including surgery, radiotherapy and chemotherapy. The London Clinic can offer all of these under the one roof.
A pineal tumour may cause a rise in the pressure inside your brain, give you problems when looking up, or cause your walk to become unsteady. Your treatment as with all brain tumours will be planned and monitored by a team of specialists (a multidisciplinary approach), involving a neuroncologist (cancer specialist), neurologist (brain specialist), neuropathologist (tissue specialist), endocrinologist (hormone specialist) as well as the skills of Peter Bullock (neurosurgeon).
In order to build up a picture of your brain, The London Clinic may offer the following:
CT scan: this machine takes a series of x-rays to build up a 3D image of your brain. It takes 10 minutes and is painless, and the radiation level used is very low. You should not eat or drink for four hours beforehand, and you may be given an injection of contrast to allow certain areas to show up more clearly under the CT scanner.
MRI scan: this is similar to a CT scan but uses magnetism rather than x-rays. The MR images are used for planning the optimum surgical approach. It can be slightly uncomfortable and noisy, and can make some patients feel claustrophobic: it takes around 30 minutes. You cannot have an MRI if you have a pacemaker or any kind of metal implant in your body.
Surgery with biopsy only may be required for deep tumours: this will involve Peter Bullock removing a small section of the tumour for testing by our neuropathologist Dr Safa Al-Sarraj. Once the type of tumour has been diagnosed, your treatment can be planned.
Blood tests: blood tests will be done to establish the nature of your pineal tumour and whether yours will require biopsy, surgery or only radiotherapy.
Surgery: Peter Bullock will remove as much of the tumour as possible via surgery However, because the pineal gland is located deep in the centre of brain, it may not possible to remove all of a tumour, so surgery may be followed by radiotherapy and chemotherapy.
Radiotherapy: if your tumour cannot be entirely removed by surgery and a small part of it has to be left in place, then a range of radiotherapy options are considered by the multidiscipinary team.
Chemotherapy: a range of chemotherapy treatments may be offered to you. In addition, you may be offered the opportunity to participate in clinical drug trials.
Follow-up: all pineal tumour patients have follow-up scans for several years.