Brain Tumors and Brain Cancer

Symptoms and risk factors

Brain tumors can cause seizures or changes in vision, personality, or movement.

Brain tumor symptoms can vary based on the tumor's location and the symptoms may worsen if the tumor grows. Signs and symptoms of a brain tumor may include:

• Persistent headaches
• Unexplained nausea and/or vomiting
• Seizures or limb shaking
• Weakness in the arms or legs
• Numbness or tingling in the face, arms, or legs
• Changes in vision or speech
• Dizziness or vertigo
• Trouble balancing or difficulty walking
• Confusion
• Unexplained changes in personality or behavior
  
   

Don't wait until symptoms become severe to seek care. If you notice anything concerning, it's critical you discuss it with your primary care provider.

Screening and prevention

You can't prevent brain tumors.

Unlike other types of cancer, lifestyle factors don't affect a person's chances of developing a brain or spinal cord tumor. As a result, there are no preventative or screening measures for these lesions.

Metastasis is when a tumor originates in another part of the body and spreads to the brain. Therefore, if you have a history of cancer, it's important to follow your surveillance plan to minimize the risk of recurrence or spread and ensure progression is diagnosed early when it may be more easily treated. If you notice any warning signs of a tumor, seek care immediately.

Diagnosis

The diagnosis of a brain tumor type is determined by a biopsy of the tissue. 

A neurosurgeon is one of the specialists many people meet with when referred for neuro-oncology care. During the initial visit, the surgeon will ask about your symptoms and review your medical history. They'll also review any imaging studies, including MRI, PET scan, or CT scan results. They may order additional tests to gather more information about your tumor. Our multidisciplinary team also includes neuroradiologists with additional training in diagnosing brain tumors using advanced imaging. This high level of expertise ensures we can accurately diagnose your tumor, leading to more effective, personalized treatment.

In some instances, your doctors may recommend a biopsy of the brain lesions or primary cancer site. During a brain biopsy, a trained neurosurgeon will collect a sample of the tumor tissue for diagnosis and further treatment planning. This may be done in several ways depending on the tumor's location, including one of the following:

• Stereotactic needle biopsy: This approach uses an advanced navigation system, similar to how GPS works, to collect the tissue using a needle through a small scalp incision.
• Endoscopy: Brain tumors near the skull base may require the surgeon to obtain a tissue sample through the nose.
• Tumor resection: When appropriate, resection involves surgically removing the bulk of the mass while providing tissue diagnosis.

Once we have a tissue sample, a pathologist trained to evaluate brain tumors will analyze the tissue to provide information about its specific characteristics. This will help to predict how your tumor may respond to standard and experimental treatments. Genetic testing may be done to further characterize the tumor subtype and guide treatment.

Types of tumors

At MedStar Health, we have the tools, training, and experience necessary to treat all types of central nervous system (CNS) tumors. The CNS includes the brain and spinal cord. Primary tumors begin in the brain and there are many different subtypes of these tumors, such as:

• Glioma: A glioma is one of the most common types of brain tumors and there are many different grades of gliomas based on characteristics. Not all gliomas are malignant, and treatment will vary based on the type and grade of your tumor.
  
• Meningioma: A meningioma is a tumor that grows from the membranes surrounding your brain and spinal cord, known as the meninges. A meningioma is typically benign.
• Acoustic neuroma: An acoustic neuroma is a benign brain tumor that grows on the vestibulocochlear nerve, influencing balance and hearing. Acoustic neuromas are rare and usually slow growing.
• Pineal tumor: Pineal tumors originate in the pineal gland, a small gland deep within the brain. These tumors can be malignant or benign.
• Pituitary tumor: A pituitary tumor arises from the pituitary gland, the gland primarily responsible for regulating your hormones. We work closely with endocrinologists and ophthalmologists at MedStar Health to treat the full range of pituitary tumors. These tumors may respond to medical treatment too.

Secondary or metastatic brain tumors: Metastatic brain tumors are tumors that have spread to the brain from elsewhere in the body. Cancers that commonly spread to the brain are lung, breast, skin, colon, and kidney cancers.

Treatments

Customized brain tumor treatment options, backed by the latest research.

The brain and spine are complex, which is why it’s critical that you have access to experts who specialize in treating tumors affecting these structures. At MedStar Health, our neuro-oncology program leverages the expertise of fellowship-trained specialists in neurosurgery, neurology, medical oncology, radiation oncology, neuroradiology, neuropathology, and others. These experts focus exclusively on diagnosing and treating adult patients with tumors affecting the brain, both malignant and benign. Our specialists work together to determine the best approach to your care, considering your personal health, preferences, and tumor characteristics such as:

• Location
• Cell type
• Growth rate

Treatment options will vary based on your individual tumor. Depending on the tumor type and characteristics, some tumors may be monitored while others may warrant more prompt surgery. As a result of this, we are diligent about follow-up for our patients.

Surgery

When surgery is recommended, the goal is to remove as much of the tumor as is safely possible while preserving the critical surrounding structures. The type of surgery varies based on the location and severity of the tumor. For example, skull base tumors may be removed endoscopically, which is a minimally invasive procedure performed through the nasal cavity.

Most patients require a craniotomy, which is when a neurosurgeon will access the tumor through the skull. Our surgeons use the latest technology to map and guide these procedures, which ensures greater precision and safety to preserve brain function. Some patients also benefit from radiation therapy, chemotherapy, and/or other advanced therapies following surgery, and this decision is made on a case-by-case basis.

Learn More About Neurosurgery

Chemotherapy

Your treatment team may also include a medical oncologist who is trained in administering chemotherapy to directly target the tumor cells. Our medical oncologists and fellowship-trained neuro-oncologists focus on treating central nervous system tumors, and we also have a neuro-oncologist with fellowship-training in treating patients with cancer affecting the brain and spine.

In collaboration with your neurosurgeon and other members of your care team, a medical oncologist will determine whether chemotherapy is appropriate based on your tumor type. Some chemotherapies are delivered systemically (affecting the whole body), while others may be administered during surgery. Chemotherapy is not used to treat benign tumors.

Learn More About Chemotherapy

Immunotherapy and targeted therapy

Immunotherapy and targeted therapy are other advanced treatment options that may be recommended by your medical oncologist. Individualized therapy directs advanced agents to certain targets based on the type of tumor. This allows us to further personalize and pinpoint treatment while protecting healthy parts of the body. We also continue investigating the role of immunotherapy in treating brain tumors.

Learn More About Immunotherapy

Learn More About Targeted Therapy

Radiation therapy

Radiation therapy plays an important role in treating primary malignant and benign tumors in the brain, as well as metastatic brain cancer. Depending on your tumor, radiation may be used after surgery or in place of surgery. Our radiation oncologists meet frequently with the other members of your cancer team to determine which approach is best for you.

We offer the a full range of advanced radiation therapy technologies, including stereotactic radiosurgery using CyberKnife® or Zap-X®. These technologies allow us to deliver high-doses of radiation with exceptional precision, reducing side effects while improving treatment effectiveness. We were among the first in the region to use these technologies, and we have more experience using them to treat brain tumors than anyone else in the area.

Our expertise often leads to patients requesting to see our providers for a second opinion after having already sought care elsewhere. We frequently provide consultations for these patients who are seeking a second opinion. 

Learn More About Radiation Therapy

Support services

We understand a brain tumor diagnosis can be overwhelming, and we're committed to helping you. As a patient, you'll have access to specialized care throughout the region for all your physical, emotional, and mental needs.

Learn More About Cancer Support Services

Genetic counseling

After a cancer diagnosis, it's common to worry about your family's health. While only a few brain cancers are related to genetic mutations, our board-certified counselors can help you and your family identify and manage any potential predispositions to these tumors. Genetic testing can also help us gather additional information about these types of tumors that may positively impact the standard of care for future treatment.

Learn More About Genetic Counseling

Personalized rehabilitation

Many patients benefit from specialized rehabilitation services after surgery or treatment. At MedStar Health, our rehabilitation care is ranked among the best in the world. Our physical, occupational, and speech therapists are experts in helping patients regain strength, mobility, and independence. Depending on your needs, your care team may recommend inpatient, outpatient, or in-home rehabilitation to help you move and feel like yourself.

Learn More About Cancer Rehabilitation

Survivorship

Follow-up care is critical after treatment, and we're dedicated to monitoring your health through periodic imaging. This ensures we can catch and address any signs of tumor recurrence early. Through regular examinations, we can also help manage any lingering side effects from treatment to ensure you can live life to the fullest.

Learn More About the Cancer Survivorship Program