Specialties

  • Brain Tumors

  • A primary brain tumor is a group, or mass, of abnormal cells that begins in the brain. They can start in brain cells, in the membrane surrounding the brain, or in brain nerves or glands. The tumor may act directly within the brain to destroy brain cells, or it can cause damage through inflammation, which can increase pressure within the skull.

    Once a brain tumor is identified, it will be classified based on its location, whether the cells are benign (noncancerous) or malignant (cancerous) and what type of brain tissue is affected.

    Brain tumors, benigh or malignant, rarely spread throughout the body. However, most of them can spread through brain tissue. For this reason, doctors tend to focus less on whether or not a brain tumor is benign or malignant, because even benign tumors can destroy and damage healthy brain tissue.

    There are many different types of tumors that can affect adults, but the most common are gliomas and meningiomas.

    Gliomas are not a type of cancer, but a term for a group of tumors that start in glial cells. A number of tumors can be considered gliomas, including glioblastoma, astrocytomas, oligodendeogliomas and ependymomas. Approximately three out of 10 of all brain tumors are gliomas.

    Meningiomas start in the meninges, the tissues that surround the outer part of the brain and spinal cord. Approximately one of every three brain and spinal cord tumors is a meningioma - they're the most common brain tumors in adults.

    Causes

    Very little is currently known about the causes of brain tumors, and the risk factors are diverse. Certain hereditary conditions may increase the risk of brain tumors, including:

    • Neurofibromatosis
    • Von Hippel-Lindau syndrome
    • Li-Fraumeni syndrome
    • Turcot syndrome

    In addition, previous radiation therapy to the brain (often used to treat brain cancers) will incrase the risk for additional tumors for up to 30 years after treatment. Lymphomas that begin in the brain in people with a weakened immune system are sometimes linked to the Epstein-Barr virus.

    Just as important perhaps are the factors that have NOT been proven to cause brain tumors, including: exposure to radiation via power lines or in the workplace, head injuries, hormone replacement therapy and smoking. In addition, recent studies have shown NO increased risk of brain tumors from cell phone or cordless phone use.

    Symptoms

    Each brain tumor behaves differently - some cause symptoms slowly over time, some cause sudden damage and quick onset of symptoms once they reach a large size. Generally, symptoms vary based on the size of a tumor, how far it has spread and whether or not it's accompanied by any swelling.

    Symptoms vary from individual to individual, but may include:

    • Changes in mental function or personality
    • Physical weakness, particularly in one area of the body
    • Seizures
    • Headaches
    • Balance problems
    • Changes in alertness, hearing, taste, smell or touch
    • Clumsiness
    • Confusion
    • Difficulty swallowing, reading or writing
    • Dizziness
    • Eye problems, including a drooping eyelid
    • Hand tremor
    • Lack of bladder or bowel control
    • Loss of coordination and balance and trouble walking
    • Muscular weakness, numbess or tingling, particularly on one side of the body
    • Difficulty speaking or understanding others

    Headaches related to a brain tumor often are:

    • Worse in the morning, clearing up after a few hours
    • Common while sleeping
    • Accompanied by numbness, weakness, confusion, vomiting or double vision
    • Made worse with physical activity, coughing or change in position

    Diagnostic Testing

    If a brain tumor is suspected, any of the following tests may be performed to check for a tumor and perhaps identify its location:

    • CT scan (cranial computed tomography) uses x-rays to create pictures of the head, including the skull and brain.
    • EEG (electroencephalogram) is a test to detect problems in the electrical activity of the brain.
    • Biopsy is a test of tissues removed from the tumor during surgery.
    • Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord to look for cancerous cells.
    • An MRI scan (magnetic resonance imaging) of the head uses powerful magnets and radio waves to create pictures of the brain and surrounding nerve tissues.

    Treatments

    Treatment for a brain tumor will be coordinated by a team of specialists, including a neuro-oncologist, a neurosurgeon, an oncologist, a radiation oncologist and other healthcare providers, such as neurologists and social workers. This team approach can provide the best overall outcome and will vary based on the type of tumor.

    Treatment may be focused on curing the tumor, improving brain function, or relieving symptoms.

    Treatment commonly includes surgery - some tumors may be completely removed, while some are deep enough within the brain that they may be debulked instead. Debulking involves moving some of the tissue from the tumor to make it smaller. Brain tumors can be challenging to remove because they can encroach on surrounding brain tissue. In these cases, surgery may be performed to relieve pressure and improve symptoms.

    Other treatments can include radiation therapy and/or chemotherapy, sometimes alone, sometimes in conjunction with surgery.

    One of the more recent innovations in the treatment of brain tumors is non-invasive Gamma Knife radiosurgery. The precision of Gamma Knife radiosurgery leaves surrounding healthy tissues minimally damaged, and results in fewer side effects compared to other types of radiation. Gamma Knife radiosurgery is also considered safer than traditional brain surgery because there is no general anesthesia, long hospital stay or open brain surgery involved.

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