Brain Tumor
Overview
Tumors that affect the brain and spinal cord are known as central nervous system tumors. A brain tumor is a bundle of abnormal cells that grows over time and expands inside the brain. This can increase pressure inside the head (known as intracranial pressure) and change brain tissue function, leading to a variety of symptoms. These growths are categorized as primary brain tumors, which originate in the brain, and metastatic brain tumors, which spread to the brain from elsewhere in the body. Brain tumors are also categorized as benign (noncancerous) or malignant (cancerous).
Learning about these abnormal growths, including brain tumor symptoms, diagnosis and types, empowers patients and their loved ones to make informed care decisions.
Types
There are many types of brain tumors, including:
- Gliomas. These are malignant brain tumors that occur in the glial cells, which help support and protect critical areas of the brain. Gliomas are the most common type of brain tumor in adults. Astrocytomas, which typically affect the cerebrum, are the most common type of glioma. Others include oligodendrogliomas, ependymomas and glioblastoma multiforme.
- Meningiomas. These are benign tumors that begin in membranes surrounding the brain and spinal cord.
- Schwannomas. These benign tumors originate in nerves. Acoustic neuromas, which arise in a nerve that links the brain and ear, are the most common type of schwannoma.
- Medulloblastomas. Malignant tumors that typically affect children, medulloblastomas occur in the cerebellum, which controls balance and coordination.
Symptoms
- Excessive sleepiness
- Difficulty walking or maintaining balance
- Headaches, especially in the morning
- Loss of appetite
- Mood changes
- Nausea
- Problems with vision
- Seizures
- Trouble speaking or hearing
- Vomiting
- Weakness
Prevention
It is not possible to prevent a brain tumor.
Avoiding radiation therapy to the head and imaging tests that involve radiation, such as X-rays and CT scans, may slightly reduce your risk of developing a brain tumor.
Risk Factors
- A weakened immune system
- Certain genetic conditions, including neurofibromatosis types 1 and 2, tuberous sclerosis, von Hippel-Lindau disease, Li-Fraumeni syndrome and Turcot syndrome
- Family history
- Radiation exposure
Diagnosis
Medical history and physical exam. You and your physician will discuss your health history and symptoms. The physician will conduct an exam to assess your physical function and look for any abnormal signs.
Neurological exam. This is a combination of tests and questions that allows your physician to gauge your cognitive ability, balance, coordination and reflexes.
Imaging exams. MRI and CT scans can help your medical team locate a brain tumor. Advanced imaging tests, such as a PET scan, may be necessary to find a tumor or determine whether a tumor is primary or metastatic.
Tumor marker test. This test may reveal signs of a tumor in a blood, tissue or urine sample.
Biopsy. A surgeon may obtain a sample of tumor tissue during an open procedure or by inserting a needle into the brain using imaging guidance, which is known as a stereotactic biopsy. A pathologist will analyze the tissue sample to determine if the tumor is cancerous.
Treatment
A variety of brain tumor treatment options are available. Your medical team may recommend a single form of treatment or a combination of treatments based on several factors, including the type of tumor you have and its stage. Treatment options include:
Active surveillance. If you have a slow-growing tumor and are not experiencing symptoms, your medical team may recommend frequent tests to monitor the tumor for changes, which might necessitate more robust treatment.
Surgery. You may undergo a stereotactic biopsy to obtain a tissue sample and, later, a craniotomy. This latter procedure involves creating an opening in the skull and removing as much of a tumor as possible.
Radiation therapy. This treatment can destroy any cancer cells that remain after surgery. If you cannot undergo surgery, radiation therapy may be your primary treatment. Several types of radiation therapy are available, including ones that precisely target tumors while sparing surrounding tissue.
Chemotherapy. Typically used with surgery or radiation therapy, drugs that destroy or impede cancer cells help treat fast-growing, advanced and recurrent brain tumors.
Targeted therapy. These drugs disrupt cancer cells that have specific mutations. Targeted therapy may be an effective alternative to standard chemotherapy for some patients.
Follow-up Care
Work with your physician to create a survivorship plan that includes the type and frequency of necessary follow-up tests, how to cope with long-term side effects of treatment, and steps you can take to stay healthy.
You may need to undergo regular tests or exams to monitor for tumor recurrence, so be sure to keep all of your follow-up appointments.
Your physician may recommend that you see other specialists to treat side effects of the tumor or treatment.
If you develop any new symptoms, report them to your physician quickly.