Understanding Brain Tumors
A brain tumor is a collection of abnormal cells in the brain tissue. Some tumors are benign (non-cancerous) and others are malignant (cancerous). We name tumors by their type of cells or where they tend to occur. The type of brain tumor affects what type of treatment will work best for you.
We combine the best in technology and modern medicine with the most personalized attention possible. The result is an integrated treatment plan designed just for you, to attack your specific brain tumor from many angles to speed your recovery. Below are brief descriptions of the most common brain tumors, with more descriptions provided by the National Cancer Institute.
- Acoustic neuromas are benign tumors thataffect the vestibular nerve and cause hearing loss, ringing in the ear, and occasionally unsteadiness.
- Colloid cysts are the most common brain tumor located within the third ventricle. A colloid cyst is a benign tumor that can cause a blockage of cerebrospinal fluid, leading to increased intracranial pressure.
- Chordomas are a rare type of tumor that occurs in the bones of the skull and spine.
- Ependymomas originate in the ventricular lining of the brain.
- Gliomas begin in the glial cells that surround and support nerve cells.
- Hemangioblastomas are usually non-cancerous brain tumors made of stem cells that the body uses to make blood vessels or blood cells.
- Meningiomas are slow-growing tumors that form in the thin layers of tissue that cover and protect the brain and spinal cord.
- Metastatic tumors are any tumors resulting from the spread of cancer from one part of the body to another.
- Pediatric brain tumors include astrocytomas, medulloblastomas, and ependymomas.
- Pineal region tumors form in and around the pineal gland, which is deep within the brain.
- Pituitary tumors are usually benign and forms in the pituitary gland, a pea-sized organ at the base of the brain above the back of the nose that makes hormones that affect other glands and many body functions, especially growth.
- Skull base tumor is any tumor that grows from the base of the skull.
Our program gives you access to doctors and staff from many different departments, from initial diagnosis through treatment and follow-up. We work together with these departments and services:
- Neuro-oncology is the department that specializes in both neurology and cancer (oncology). These doctors are responsible for the evaluation and management of patients with brain tumors and the neurological complications of cancer. They use chemotherapy, biological response modifiers and immunotherapy, as well as novel drugs to treat brain tumor patients.
- Imaging performs radiographic studies to assess the extent of the disease and the effectiveness of our treatment. Our expert neuro-radiologists provide the most innovative diagnostic imaging protocols, including magnetic resonance imaging with three Tesla scanners; magnetic resonance spectroscopy; and diffusion, perfusion, diffusion tensor, and functional imaging. Our radiologists also perform digital angiography, positron emissions tomography, and other nuclear medicine studies.
- Ophthalmology has specialists trained in neuro-ophthalmology.
- Psychiatry enters in if you have problems with memory, concentration, cognitive function, or mood. These difficulties can be caused by the tumor itself or by the side effects of treatment.
- Radiation therapy is a common treatment for primary and metastatic brain tumors. In addition to conventional radiation, we also offer intensity modulated radiation therapy and stereotactic radiosurgery.
- Rehabilitation provides state-of-the art facilities for inpatients and outpatients focused specifically on the needs of brain tumor patients, such as motor, speech, and cognitive skills. Brain tumors produce symptoms such as dizziness, headaches (including migraines), poor sense of balance, overall weakness, seizures (although more common in low-grade gliomas), sensory loss, and changes in vision. We are happy to discuss managing any symptoms with you.
Primary brain tumors arise within the brain and can be malignant (cancerous) or benign. The most common primary brain tumor is meningioma, a benign tumor that develops slowly in the meninges (the thin layers of tissue covering the brain and spinal cord). Another other common type of primary brain tumors is a glioblastoma, a highly malignant tumor that is generally found in the cerebral hemisphere. A third common primary tumor is low-grade glioma, which are slow-growing tumors that develop from the support cells in the brain and have a tendency to cause seizures.
Other types of primary brain tumors include:
- Anaplastic gliomas
- High-grade gliomas
- Primary central nervous system lymphoma
- Pituitary tumors
- Secondary Brain Tumors
Secondary brain tumors are becoming more common as novel advancements in chemotherapy prolong life, allowing the tumors to migrate and change.
At IBS Hospital, we are pioneers in computer-assisted stereotactic techniques. These approaches allow us to operate on tumors previously thought inoperable. We use techniques such as state-of-the-art navigational microscopes and a computerized navigation system.
When possible, we perform brain mapping to preserve brain function during the surgical removal of brain tumors. Brain mapping reduces surgical risk and improves patient outcome. We perform endoscopic surgery when applicable to remove tumors less invasively and more accurately. This less invasive surgery is well tolerated and promotes speedy recovery. We perform the following types of treatment for brain tumors.
Computer-assisted neurosurgery is appropriate for anybody who need brain surgery and wants a precise and minimally invasive operation. This includes people with brain tumors of all types. Computer-assisted neurosurgery makes it easier to:
- Use small skin and bone opening
- Find the lesion quickly
- Remove the tumor without touching the healthy parts of the brain
- Plan and simulate the surgery beforehand
- Know exactly where tumor ends and normal brain begins, which decreases the risk to the surrounding brain tissue
- Get better results so that you need less rehabilitation and can return to work sooner than with traditional procedures Awake and asleep brain mapping are advanced neurosurgical procedures to remove brain tumors.
- During awake brain surgery, you remain alert and responsive at various times while we perform the procedure. This approach is particularly appropriate for brain tumors infiltrating into the parts of the brain responsible for producing and understanding language, which are located in the left frontal and temporal lobes in most right-handed people. These procedures are also effective if we need to search for the areas of the brain responsible for seizures (epilepsy). Having you awake helps us more precisely locate the boundary between the tumor and critical structures near the surface and deep within the brain. There are also many functions, such as movement, hearing, and vision, which we can map or monitor while you are asleep. The more precise we can be, the safer the procedure. Brain mapping usually occurs in conjunction with a computer-assisted imaged-guided craniotomy.
- Stereotactic needle biopsy is appropriate when we suspect that there is a brain tumor anywhere in your body, to diagnose the tumor type and guide further care. Biopsies in the brain are complicated, so we routinely use computer-assisted image guidance to direct the procedure.
- Endoscopic Transnasal Resection is a surgical procedure that goes through the nose in a minimally invasive way to remove a tumor or a cyst. Tumors may also be removed without affecting surrounding areas. Most patients can be discharged 2 to 3 days after surgery.
It can be helpful to know what to expect and how to prepare for surgery and recuperation.
Before the procedure
You will meet with your surgeon to discuss the type of tumor you have and what procedure we will perform. We will schedule your surgery give you instructions to make sure you are healthy enough to have the procedure performed safely. You may need to get bloodwork, additional imaging studies, and a check-up from a primary care doctor or specialist if you have a pre-existing condition. We will give you a personalized medical plan to prepare for the procedure.
Day of surgery
We will tell you when to arrive at the hospital and where to go. After you check in, nurses will prepare you for the operating room (OR). You and your family will meet with your surgeon, anesthesiologist, and the rest of the operating room team. The staff will then take you into the OR and show your family members where they can wait. We will let your family know when your procedure is finished.
Recuperation in the hospital
The type of tumor you have and its location in your brain will determine how long you have to stay in the hospital after the procedure, but you can plan on at least one or two days. During this time, our nurses will monitor you closely and you will work with therapists to speed your recovery. We may perform additional testing to monitor your progress. Before you leave, we will give you a discharge plan, which may include transfer to a rehabilitation or skilled nursing facility.
Recuperation at home
Your surgeon will tell you how to take care of your incision at home, what medications to take, what you can and cannot eat, and any precautions you should take. We will schedule a follow-up appointment with your surgeon to discuss your results and recovery progress. We may recommend outpatient physical, occupational, or speech therapy.
Follow up care
You will have follow-up visits with your surgeon; the frequency will depend on the type of tumor you have. You may also need to have consultations with other specialists for additional treatment such as radiation therapy or chemotherapy. We may monitor you with periodic imaging tests.