Vaishali, Ghaziabad, Uttar Pradesh 201010
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Neuro-Oncology · Brain Tumor Surgery
Dr. Gajendra Singh SandhuBrain Tumor Surgeon & Neuro-Oncology Care in Ghaziabad
MS, Neurosurgery · Consultant Neurosurgeon, Manipal Hospitals & Mariam Hospital · Over a decade of experience
- Brain tumor surgery
- Gliomas & meningiomas
- Brain metastases
- Minimally invasive neurosurgery
- Second opinions
Book a consultation Call +91 73574 80534
Clinic: W-3, Ashok Marg, near Radisson Blu Hotel, Sector-1, Vaishali, Ghaziabad 201010 · Mon–Fri 10:00–17:00, Sat & Sun 10:00–13:00
Short answer
Dr. Gajendra Singh Sandhu is a neurosurgeon in Vaishali, Ghaziabad who evaluates and treats brain tumors. Neuro-oncology is the diagnosis and treatment of tumors of the brain, spinal cord and nerves: he reviews your MRI, confirms the tumor type through tissue and molecular testing, then plans surgery, radiotherapy or monitoring with the oncology team, based on the tumor type, its location and your health.
A brain tumor diagnosis raises hard questions fast: is it cancer, does it need surgery, what happens next. This page explains how brain tumors are classified, how they are diagnosed and treated today, and what a first consultation involves. It is general information and does not replace an examination of your own scans.
What is a brain tumor?
A brain tumor is any abnormal growth of cells in or around the brain. It can start in the brain itself (a primary tumor) or spread there from cancer elsewhere in the body (a metastasis). Brain metastases are much more common than primary brain tumors, and they are treated differently.
Not every brain tumor is cancer. Many are benign and slow-growing, but a benign tumor can still press on critical brain tissue, so position matters as much as the label.
How common are they in India? Registry-based estimates put primary brain and central nervous system tumors at roughly 5 to 10 new cases per 100,000 people a year, with reports of a rising trend. These figures are estimates and likely undercount cases where scanning is not available.
Types of brain tumors we evaluate
The current WHO classification (CNS5, 2021) lists more than 100 tumor types and subtypes. It names tumors using tissue appearance and molecular findings, which is why a tissue sample and lab testing matter. The groups below cover most adult cases.
| Tumor | Where it starts | Usual approach |
|---|---|---|
| Glioma (astrocytoma, oligodendroglioma, glioblastoma) | Brain tissue itself | Surgery to remove as much as is safe, then radiotherapy and/or chemotherapy based on the molecular diagnosis |
| Meningioma | Membranes covering the brain | Monitoring if small and symptom-free; surgery if growing or symptomatic; radiosurgery in selected cases |
| Brain metastases | Spread from cancer elsewhere | Surgery, stereotactic radiosurgery, radiotherapy and systemic therapy, planned with the treating oncologist |
| Pituitary adenoma | Pituitary gland at the skull base | Hormone tests and imaging; medicines or endoscopic surgery depending on type and size |
| Vestibular schwannoma (acoustic neuroma) | Hearing and balance nerve | Observation, radiosurgery or surgery, based on size, hearing and age |
| Childhood brain tumors | Varies (for example medulloblastoma) | Combined surgery, radiotherapy and chemotherapy, guided by molecular group |
| Spinal cord and spinal tumors | Spinal cord, its coverings or the spine | MRI-based planning; surgery when the tumor is compressing the cord or nerves |
Grades run from 1 (slow-growing) to 4 (most aggressive). Under CNS5, glioblastoma refers only to IDH-wildtype tumors, and some tumors that look low-grade under the microscope are upgraded on molecular findings.
What are the warning signs of a brain tumor?
Tumor symptoms usually build over weeks to months. A stroke arrives in seconds to minutes and is an emergency. Signs that should prompt an evaluation:
- Headache that is new, steadily worsening, worse in the morning or lying flat, or paired with vomiting or vision change
- A first seizure in an adult, which is the single most important red flag
- Weakness, numbness or clumsiness on one side of the body
- Changes in speech, vision or balance
- Persistent nausea or vomiting without another cause
- Gradual changes in memory, concentration or personality
Almost everyone with a headache does not have a tumor, and most of these symptoms have other causes. The point is not to panic but to get new, persistent or progressing symptoms checked.
Go to an emergency department now for a seizure, sudden weakness or numbness, sudden trouble speaking or seeing, severe headache with repeated vomiting, or unusual drowsiness or confusion.
How is a brain tumor diagnosed?
Diagnosis is a sequence, and each step changes the plan:
- Neurological examination. Strength, sensation, vision, balance, speech and memory are checked to help localize the problem.
- Contrast-enhanced MRI. MRI is the main scan. Advanced sequences such as perfusion MRI, spectroscopy or functional MRI can help characterize the tumor and map nearby functional areas. CT is used when MRI is not possible.
- Tissue diagnosis. Imaging suggests a tumor; a tissue sample from biopsy or surgery confirms the type and grade.
- Molecular testing. Markers such as IDH mutation, 1p/19q codeletion and MGMT promoter methylation are part of the final diagnosis for many gliomas and influence treatment and outlook.
How are brain tumors treated?
Treatment is chosen by tumor type, grade, molecular profile, location, and the patient's age and overall health. Often more than one modality is used, planned together with radiation and medical oncology.
Surgery
For most tumors that can be reached, the aim is maximal safe resection: remove as much tumor as possible without damaging function. Surgery also provides the tissue needed for diagnosis. Modern neuro-oncological surgery draws on several tools, chosen case by case:
- Neuronavigation (an image-guided map of the brain during surgery)
- Intraoperative neuromonitoring to protect movement and other functions
- Fluorescence guidance (5-ALA) to help show the edges of high-grade gliomas
- Awake craniotomy for tumors near speech or movement areas, so function can be tested during the operation
- Intraoperative ultrasound to check tumor location as the brain shifts
Which techniques apply depends on your tumor and the facility; Dr. Sandhu explains what is suitable for your case before any decision.
Radiotherapy and radiosurgery
Radiotherapy follows surgery for many gliomas and higher-grade tumors. Stereotactic radiosurgery delivers focused radiation in one or a few sessions and is used for selected small tumors, residual tumor and some metastases, sparing more normal brain than whole-brain radiation.
Chemotherapy and targeted therapy
For glioblastoma, the standard pathway is surgery, then about six weeks of radiotherapy with temozolomide, then maintenance temozolomide. Tumors with MGMT promoter methylation tend to benefit more. Tumor Treating Fields, a wearable device, extended survival in a randomized trial and is used in selected patients. In grade 2 IDH-mutant glioma, the targeted drug vorasidenib was approved by the US FDA in August 2024 after it delayed progression in a phase 3 trial; this is one example of why molecular testing now shapes treatment. Availability of newer therapies in India varies and is discussed case by case.
Monitoring (watch and scan)
Some small, silent, slow-growing tumors, often meningiomas found by chance, are safest followed with regular MRI. Treatment starts if the tumor grows or causes symptoms.
Supportive care
Seizure control, medicines to reduce brain swelling, physiotherapy and rehabilitation are part of treatment, not an afterthought.
What does the research say about outlook?
Outlook depends heavily on tumor type and grade, so no single number applies to everyone. As a general guide from published trials:
- Glioblastoma is the most aggressive common primary brain tumor in adults. With standard treatment, median survival in trials is around 14 to 16 months, and longer in MGMT-methylated tumors. Individual results vary widely.
- Meningioma: about 80% are WHO grade 1. After complete removal of a grade 1 tumor, recurrence is low, and radiosurgery has high control rates for suitable small tumors.
- Brain metastases: outcome is tied to the underlying cancer and its systemic treatment, which has improved survival for many patients.
These are population figures from the medical literature, not predictions for any one person and not outcomes of this practice.
What happens at a first consultation?
- History and examination. Symptoms, timeline, medicines and any seizures are reviewed.
- Scan review. Dr. Sandhu goes through your MRI with you in plain language.
- Plan. Options are explained: monitoring, biopsy, surgery, radiosurgery or referral for oncology treatment, with the reasons for each.
- Coordination. Where radiation or medical oncology is needed, care is coordinated with those specialists.
- Surgery and recovery. If surgery is advised, the process, hospital stay and rehabilitation are outlined in advance.
- Follow-up. A scan schedule is set, since regular MRI is how recurrence is caught early.
What to bring
- MRI/CT scans (films or digital disc) and their reports
- Any biopsy or pathology reports and slides
- List of current medicines and any seizure record
- Records of earlier surgery, radiotherapy or chemotherapy
- A family member or caregiver, if possible
Second opinions on scans and treatment plans are welcome.
About Dr. Gajendra Singh Sandhu
Dr. Sandhu is a consultant neurosurgeon (MS, Neurosurgery) with over a decade of experience across leading institutions in India. His training includes residencies at Medanta, IPGME&R SSKM Hospital and Dr. Baba Saheb Ambedkar Medical College, and he currently consults at Manipal Hospitals and Mariam Hospital. His practice covers brain tumor surgery, minimally invasive neurosurgery, spine surgery, neurotrauma, epilepsy and stroke-related care, and pediatric neurosurgery.
Clinic
W-3, Ashok Marg, near Radisson Blu Hotel, Sector-1, Vaishali, Ghaziabad, Uttar Pradesh 201010
Hours
Mon–Fri 10:00–17:00
Sat & Sun 10:00–13:00
Patients consult from Vaishali, Indirapuram, Vasundhara, Kaushambi, Raj Nagar Extension, Sahibabad, Noida, Greater Noida, East Delhi and across Delhi NCR.
Frequently asked questions
What is neuro-oncology?
Neuro-oncology is the field of medicine that diagnoses and treats tumors of the brain, spinal cord and nerves. It combines neurosurgery, radiation oncology, medical oncology, neuropathology and neuroradiology so that surgery, radiotherapy and drug treatment are planned together for each patient.
Is every brain tumor cancer?
No. A brain tumor is any abnormal growth of cells in or around the brain. Many are benign and slow-growing, such as most meningiomas, while others, such as glioblastoma, are malignant. Even benign tumors can cause problems by pressing on nearby brain tissue, so they still need specialist evaluation.
What are the first signs of a brain tumor?
Common warning signs are a new or changing headache pattern, a first-ever seizure in an adult, weakness or numbness on one side, changes in speech or vision, balance problems, persistent nausea or vomiting, and gradual changes in memory or personality. These symptoms have many other causes, but when they are new, persistent or worsening they should be evaluated.
Does a headache mean I have a brain tumor?
Almost never. Most headaches are not caused by tumors. The features that warrant evaluation are a headache that is new, steadily worsening, worse on waking or when lying flat, or accompanied by vomiting, vision change, weakness, confusion or a seizure.
How is a brain tumor diagnosed?
Diagnosis starts with a neurological examination and a contrast-enhanced MRI of the brain. A tissue sample from biopsy or surgery is needed to confirm the tumor type and grade. Molecular tests on that tissue, such as IDH, 1p/19q and MGMT, are now part of the final diagnosis for many tumors.
Do all brain tumors need surgery?
No. Small, symptom-free tumors such as some meningiomas can be monitored with regular MRI scans. Surgery is advised when a tumor is growing, causing symptoms, needs a tissue diagnosis, or can be removed safely. Radiosurgery, radiotherapy and drug therapy are alternatives or additions depending on the tumor.
What is awake brain surgery?
Awake craniotomy is a technique in which the patient is kept awake for part of the operation so that the surgeon can test speech, movement or other functions while removing a tumor near critical brain areas. It is used to remove as much tumor as is safe while protecting function. Whether it is suitable depends on the tumor location and the patient.
How is glioblastoma treated?
The standard approach is maximal safe surgical removal, followed by about six weeks of radiotherapy with temozolomide chemotherapy, then maintenance temozolomide. Tumor Treating Fields may be added in selected patients. Tumors with MGMT promoter methylation tend to respond better to temozolomide.
Can a brain tumor come back after treatment?
It depends on the type and grade. Low-grade tumors such as WHO grade 1 meningiomas have a low recurrence rate after complete removal, while high-grade gliomas often recur. This is why regular follow-up MRI scans are a core part of treatment.
What should I bring to a brain tumor consultation?
Bring the MRI scans (films or the digital disc) with their reports, any biopsy or pathology reports and slides, a list of current medicines, a record of any seizures, and records of earlier treatment. Bringing a family member is helpful.
When is a brain tumor symptom an emergency?
Go to an emergency department for a seizure, sudden weakness or numbness, sudden difficulty speaking or seeing, severe headache with repeated vomiting, or unusual drowsiness or confusion. Symptoms that appear within minutes may indicate a stroke and need immediate care.
Do you see brain tumor patients from outside Ghaziabad?
Yes. Patients regularly consult Dr. Sandhu from Vaishali, Indirapuram, Vasundhara, Noida, Greater Noida, East Delhi and across Delhi NCR, including for second opinions on imaging and treatment plans.
Related reading
- Expert brain care near Indirapuram
- Neurosurgeon in Vaishali, Ghaziabad
- Brain surgery myths vs. reality
- Technological innovations transforming neurosurgery
Book a consultation Call +91 73574 80534
Sources
- The 2021 WHO Classification of Tumors of the CNS: clinical implications, Neuro-Oncology, 2021
- Types of brain and spinal cord tumours, Canadian Cancer Society
- Brain tumor diagnosis, MD Anderson Cancer Center
- Common brain tumor symptoms, MD Anderson Cancer Center
- Radiotherapy in glioblastoma: evolution, limitations, and molecularly guided future, Biomedicines, 2025
- Awake surgery for brain tumors, IntechOpen
- 5-ALA-guided tumor resection during awake speech mapping in gliomas, Frontiers in Oncology, 2022
- FDA approves vorasidenib for grade 2 astrocytoma or oligodendroglioma, US FDA, August 2024
- EANO guideline on meningiomas, Neuro-Oncology
- Meningioma overview, UChicago Medicine
- Treatment options for adults with multiple metastatic brain tumors, Congress of Neurological Surgeons
- How common are brain tumours in India (registry-based estimates)
Medical disclaimer. This page is for general education and is not a diagnosis or a substitute for consultation. Treatment decisions depend on your scans, pathology and health, and outcomes vary from person to person. If you have an emergency symptom, go to the nearest emergency department.