Brain tumors

A brain tumor is a mass of abnormal cells located in the brain. The most common types of tumors in the brain are metastatic (secondary) tumors that spread to the brain from cancers that started elsewhere in the body. Secondary tumors spread through the bloodstream and lymph system.

Tumors that originate inside the brain are called primary brain tumors. These can be benign brain tumors (slow growing and unlikely to recur) or malignant brain tumors (fast growing, likely to recur brain cancer).

Brain cancers are dangerous because they grow quickly and put pressure on other areas of the brain. But even benign brain tumors can be disabling or life-threatening if they put pressure on areas of the brain that control vital functions.

Brain tumor symptoms

Symptoms of brain tumors vary depending on the type of the tumor, size of the tumor, how fast it’s growing and where it’s located inside the brain. For example, changes in vision are likely to occur from a tumor that’s close to the vision centers of the brain. Brain tumor symptoms also vary from person to person.

In general, symptoms of brain tumors may include:

• Sudden or severe brain tumor headaches
• Seizures – especially if you have no history of them
• Weakness, tingling or numbness in the arms or legs (often on one side)
• Confusion, or changes in behavior or personality
• Changes in vision or hearing
• Changes in balance
• Difficulty speaking or understanding speech
• Difficulty using fine motor skills
• Nausea or vomiting

Brain tumor risk factors

Some brain tumors don’t have identified risk factors. Previous exposure to radiation is a risk factor for some brain tumors. Other risk factors for some brain tumors are conditions or genetic disorders such as:

• Constitutional mismatch repair deficiency syndrome
• Li-Fraumeni syndrome
• Lynch syndrome
• Neurofibromatosis type 1 or type 2 (NF1 or NF2)
• Schwannomatosis, a genetic disorder
• Tuberous sclerosis
• Turcot syndrome

Diagnosis

To make a brain tumor diagnosis, your doctor will first ask about your potential brain tumor symptoms and health history. They’re likely to recommend an MRI or a CT scan to get a better view of any tumor’s location and how it might be affecting surrounding tissue.

You may be referred to a neuro-oncologist or neurosurgeon for their expertise in these complex conditions. Specialists have more access to the latest updates in treatment for benign and malignant brain tumors.

Final diagnosis of your tumor may depend on testing of a biopsy (tissue sample) gathered during surgery. Your doctor will base their diagnosis on the appearance of the tumor’s cells and the apparent rate of growth. They’ll also consider results of biomarker testing, which looks at the mutations and changes that show up in the genes and chromosomes inside the cells of benign and malignant tumors.

Biopsies are sometimes done using a needle biopsy procedure, which requires only a small hole in the skull. Needle biopsies may be guided by the use of MRI or CT scans.

Brain tumor treatment options

For benign brain tumors that have mild symptoms, your doctor may recommend observing the tumor at intervals to see if it’s growing faster or causing more symptoms. You’ll be scheduled for periodic imaging tests and meetings with your doctor to discuss your condition.

For brain cancers or benign brain tumors that are causing problematic symptoms, brain surgery may be the first recommended treatment. For tumors within the brain, surgery is often done with two goals in mind – to remove as much of the tumor as possible and to gather a biopsy (tissue sample) to guide diagnosis and future treatment. The procedures are done at the same time to minimize stress on the brain and the skull.

We perform minimally invasive brain tumor surgeries when possible, including:

• The expanded endonasal approach (EEA), a minimally invasive procedure in which the tumor is removed through the nasal passages, resulting in no incisions, a shorter hospital stay and faster recovery than with conventional surgery.
• Open surgery with a minimally invasive craniotomy using an enhanced optical system, BrainPath^® and robotic arm.

Nonsurgical treatment

Brain cancers may be treated with embolization with a liquid embolic agent such as Onyx or nBCA glue. Embolization blocks blood vessels that provide blood to the tumor to stop the cancer from growing.

Depending on your brain cancer type and the results of surgery, your treatment may include a combination of the following treatments:

• Radiation therapy: High dose radiation that shrinks the tumor, including CyberKnife® stereotactic radiosurgery (also known as gamma knife).
• Chemotherapy: Medicines that may shrink or destroy tumors, slow the tumor’s growth or make brain cancer less likely to return.
• Immunotherapy: Helps the immune system find cancer cells and stop them from growing.
• Targeted therapy: Delivers medicine directly to the brain cancer cells to destroy them.
• Clinical trials: Ongoing research that explores new ways to treat cancer.

Brain tumors can be hard to remove through surgery when they’re in places that are hard to reach and treat. They can also be hard to treat with medicines because of the blood brain barrier – a feature of blood vessels in the brain that makes it harder for medicines to get into the brain.

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