Brain tumors can be benign (non-cancerous, non-aggressive) or malignant (aggressive), but both types are serious conditions that require immediate attention and expert treatment. Brain tumor treatment options vary significantly depending on the specific type of brain tumor and the stage of the disease.
Overview & Symptoms
Benign Brain & Spinal Tumors
Benign (non-cancerous-non-aggressive) brain and spinal tumors often stay in one place, grow relatively slowly, and do not spread or invade into nearby structures.
Some examples are:
- Schwannoma, a benign tumor that forms from the lining of a nerve. The most common schwannoma is a tumor that forms on the hearing nerve (called a vestibular schwannoma or an acoustic neuroma).
- Meningioma, a tumor that arises from the lining of the brain. These can be either benign or malignant, however, the vast majority of meningiomas are benign. These can occur in the spinal cord or brain.
- Chordoma, a rare tumor that arises from the bone of the spine, most commonly at either the base of the skull or the end of the spine. Although these are not felt to be malignant they can be locally invasive and come back after treatment.
- Pituitary tumor, a benign, slow-growing tumor arising from the pituitary gland. The most common tumor type is an adenoma. These can sometimes involve an increase or decrease in the production of several essential hormones.
- Hemangioblastoma, a benign, slow growing and well-defined tumor sometimes associated with Von Hippel-Lindau syndrome (VHL). They arise from cells in the lining of blood vessels.
- Ependymoma, a tumor that arises from the ependymal cells that line the ventricles of the brain and the center of the spinal cord. Subependymomas are a subtype of ependymomas that are typically slow-growing tumors that appear near a ventricle.
Malignant Brain & Spinal Tumors
Most frequently malignant brain tumors include:
- Glioma, a malignant tumor that arises in the supportive tissue of the brain. They are equivalent to cancerous lesions. These tumors are given different grades depending on how aggressive they are felt to behave. Some of the more common forms of glioma include astrocytoma, oligodendroglioma, and glioblastoma.
- Metastases, cancer cell deposits that have spread from an original or “primary site” to one or more secondary locations or organs elsewhere in the body. Brain metastases are cancer cells that have spread to the brain. These are most commonly seen from cancers of the lung, breast, melanoma (skin), and lymphoma gastrointestinal GI cancers. Secondary brain tumors from cancer of the body or skin that has metastasized to the brain. In an advanced stage, these can transition into leptomeningeal disease by spreading along the lining and fluid surrounding the brain.
- CNS Lymphoma, is a form of malignant cancer that is derived from white blood cells and starts in the brain. This is usually present in people with immunosuppression, and is also highly associated with Epstein-Barr virus infection in immunodeficient patients. In addition, we see this in people of older age, as the immune system is less effective, giving rise to an increased incidence in an aging population.
Brain Tumor Diagnosis
Your initial visit involves a neurological evaluation and a review of any existing imaging studies, for example – an MRI, that you might have. You may also need additional imaging or testing (magnetic resonance angiography, magnetic resonance spectroscopy, lumbar puncture, PET/CT, thallium scan) to find out more about the tumor and the area where it developed.
Brain tumor treatment options depend on your specific type of tumor, as well as its size and location. Our experts will take an individualized approach to your care, which may include:
Surgery is used to remove tumors (and tissue for biopsy). Our specially trained neurosurgeons perform several hundred brain tumor procedures each year. If applicable, your neurosurgeon will discuss the surgical options during your visit in our multidisciplinary brain tumor clinic.
Radiation therapy involves the use of high doses of radiation to kill tumor cells. Radiation therapy uses high-energy radiation or particles to treat tumors (both benign and malignant). High doses of radiation can kill tumor cells or keep them from growing and dividing. Your radiation oncologist will go over the different options for radiation therapy and which one(s) may be best for your care.
Chemotherapy involves the use of drugs to target cancer cells. Your neuro-oncologist will help coordinate your care and talk with you and your family about all treatment decisions. The doctor may prescribe chemotherapy with radiation, or a combination of different types of chemotherapy — systemic and/or intraventricular. Systemic chemotherapies are anti-cancer drugs that are either injected into the blood stream or ingested and distributed throughout the body to kill cancer cells. Intrathecal chemotherapy delivers anti-cancer drugs into the cerebral spinal fluid to bathe the brain and spinal cord. Intraventricular chemotherapy attacks any cancer cells that are present and may help prevent the cancer from spreading.
Brain Tumor CenterOur Brain Tumor Center offers you diagnosis and leading-edge treatment options with a multidisciplinary approach that includes medical, surgical and radiation oncologists, pathologists, nurse practitioners, nurses, social workers, and a palliative care team.