BAVINA SOOKDEO
May is both Stroke Awareness Month and Brain Cancer Awareness Month, and Dr Avidesh Panday, a neurologist at Eric Williams Medical Sciences Complex, NCRHA, spoke to Newsday to shed some light on the topics of stroke and brain cancer as well provide insight on managing these locally.
Panday graduated from the faculty of medical sciences, University of the West Indies, St Augustine Campus and received his neurology training at the University of Calgary, Alberta, Canada. He is a fellow of the Royal College of Physicians (London) and the European Board of Neurology.
Understanding brain cancer and stroke
“Brain cancers can be divided into two subgroups – primary brain tumours and metastatic tumours,” Panday explained.
“Primary brain tumours arise directly from the brain and in some instances, the surrounding surface of the brain known as the meninges. Metastatic tumours are tumours that arise in other areas of the body such as the lungs and spread into the brain.”
Panday said a leading cause of brain cancer is genetics. “The predominant risk factor is that of genetic factors. Within each of our cells, there is a genetic code which programmes the way that our cells function.”
He explained that they are responsible for how fast our cells replicate and repair themselves when damaged or attacked.
“In some persons, there can be changes in this genetic code known as a mutation which can change the way our cells divide or respond to threats leading to tumour formation or growth. This explains why genetic testing is important in some patients with cancer as it assists us in guiding treatment regimens.” Other risk factors can include certain dietary products, such as cured meats and there is some evidence about repeated head trauma/traumatic brain injury as risk factors. While tobacco is a risk factor for most cancers, the doctor said it seems the risk of metastatic cancers from sources outside of the brain are more associated with tobacco smoking rather than primary brain tumours.
As for strokes, Panday explained, “A stroke is essentially a process where brain cells die due to a lack of blood supply (oxygen) either through blockage of an artery (termed ischemic stroke – roughly 85 per cent of cases or bleeding within an artery (termed haemorrhagic).” Pointing out that strokes can have multiple presentations he said, “In fact, it is possible for a patient to have a stroke and not know, for example, if the part of the brain responsible for vision is affected by a stroke, there would be visual loss. If the area for balance is affected, you can have impaired balance without loss of power.”
While brain cancer and stroke are medically distinct, he noted they can produce similar symptoms.
“They may produce similar symptoms but via different mechanisms. Also, the presentation of symptoms may differ in terms of timing.”
For example, he said, if a patient has a stroke affecting the power area then they may have symptoms of sudden onset weakness. If the patient has a tumour in the same area of the
