Cancer Guide

What is a Brain Tumor?

At Ocean Radiation Oncology, we offer some of the most sophisticated radiation treatments for brain tumors available in the New York metropolitan area, including the cutting-edge technology of the TomoTherapy Hi-ART treatment delivery system and Stereotactic Radiation Therapy. Our medical expertise and advanced technology allow us to treat even those tumors that are located in some of the most critical areas of the brain.

Definition

Brain tumors include both malignant (glioblastoma, astrocytoma, brain metastases, etc.) and benign (meningiomas, acoustic neuromas/vestibular schwannomas, etc.) conditions. Radiation therapy is often a critical component of the care of both malignant and benign brain tumors. Multi-modality care is sometimes indicated for the treatment of brain tumors, including radiation therapy, surgery, and/or chemotherapy.

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Causes

When you're told that you have a brain tumor, it's natural to wonder what may have caused your disease. However, no one knows the exact causes of brain tumors. Doctors seldom know why one person develops a brain tumor and another doesn't.

Researchers are studying whether people with certain risk factors are more likely than others to develop a brain tumor. A risk factor is something that may increase the chance of getting a disease.

Studies have found the following risk factors for brain tumors:

Ionizing radiation: Ionizing radiation from high dose X-rays (such as radiation therapy from a large machine aimed at the head) and other sources can cause cell damage that leads to a tumor. People exposed to ionizing radiation may have an increased risk of a brain tumor, such as meningioma or glioma.

Family history: It is rare for brain tumors to run in a family. Only a very small number of families have several members with brain tumors.

Researchers are studying whether using cell phones, having had a head injury, or having been exposed to certain chemicals at work or to magnetic fields are important risk factors. Studies have not shown consistent links between these possible risk factors and brain tumors, but additional research is needed.

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Symptoms

The symptoms of a brain tumor depend on tumor size, type, and location. Symptoms may be caused when a tumor presses on a nerve or harms a part of the brain. Also, symptoms may be caused when a tumor blocks the fluid that flows through and around the brain, or when the brain swells because of the buildup of fluid.

These are the most common symptoms of brain tumors:
Headaches (usually worse in the morning)
Nausea and vomiting
Changes in speech, vision, or hearing
Problems balancing or walking
Changes in mood, personality, or ability to concentrate
Problems with memory
Muscle jerking or twitching (seizures or convulsions)
Numbness or tingling in the arms or legs

Most often, these symptoms are not due to a brain tumor. Another health problem could cause them. If you have any of these symptoms, you should tell your doctor so that problems can be diagnosed and treated.

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Diagnosis

If you have symptoms that suggest a brain tumor, your doctor will give you a physical exam and ask about your personal and family health history. You may have one or more of the following tests:

Neurologic exam: Your doctor checks your vision, hearing, alertness, muscle strength, coordination, and reflexes. Your doctor also examines your eyes to look for swelling caused by a tumor pressing on the nerve that connects the eye and the brain.

 

MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of areas inside your head. Sometimes a special dye (contrast material) is injected into a blood vessel in your arm or hand to help show differences in the tissues of the brain. The pictures can show abnormal areas, such as a tumor.

 

CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your head. You may receive contrast material by injection into a blood vessel in your arm or hand. The contrast material makes abnormal areas easier to see.

Your doctor may ask for other tests:

Angiogram: Dye injected into the bloodstream makes blood vessels in the brain show up on an x-ray. If a tumor is present, the x-ray may show the tumor or blood vessels that are feeding into the tumor.

Spinal tap: Your doctor may remove a sample of cerebrospinal fluid (the fluid that fills the spaces in and around the brain and spinal cord). This procedure is performed with local anesthesia. The doctor uses a long, thin needle to remove fluid from the lower part of the spinal column. A spinal tap takes about 30 minutes. You must lie flat for several hours afterward to keep from getting a headache. A laboratory checks the fluid for cancer cells or other signs of problems.

 

Biopsy: The removal of tissue to look for tumor cells is called a biopsy. A pathologist looks at the cells under a microscope to check for abnormal cells. A biopsy can show cancer, tissue changes that may lead to cancer, and other conditions. A biopsy is the only sure way to diagnose a brain tumor, learn what grade it is, and plan treatment. 
Surgeons can obtain tissue to look for tumor cells in two ways:

- Biopsy at the same time as treatment: The surgeon takes a tissue sample when you have surgery to remove part or all of the tumor.

Stereotactic biopsy: You may get local or general anesthesia and wear a rigid head frame for this procedure. The surgeon makes a small incision in the scalp and drills a small hole (a burr hole) into the skull. CT or MRI is used to guide the needle through the burr hole to the location of the tumor. The surgeon withdraws a sample of tissue with the needle. A needle biopsy may be used when a tumor is deep inside the brain or in a part of the brain that can't be operated on.

However, if the tumor is in the brain stem or certain other areas, the surgeon may not be able to remove tissue from the tumor without harming normal brain tissue. In this case, the doctor uses MRI, CT, or other imaging tests to learn as much as possible about the brain tumor.

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Treatment

Surgery

Radiation Therapy

Chemotherapy

People with brain tumors have several treatment options. The options are surgery, radiation therapy, and chemotherapy. Many people get a combination of treatments.

The choice of treatment depends mainly on the following:
- The type and grade of brain tumor
- Its location in the brain
- Its size
- Your age and general health

For some types of brain cancer, the doctor also needs to know whether cancer cells were found in the cerebrospinal fluid.

Your doctor can describe your treatment choices, the expected results, and the possible side effects. Because cancer therapy often damages healthy cells and tissues, side effects are common. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. You and your health care team can work together to develop a treatment plan that meets your medical and personal needs.

Your doctor may refer you to a specialist, or you may ask for a referral. Specialists who treat brain tumors include neurologists, neurosurgeons, neuro-oncologists, medical oncologists, radiation oncologists, and neuroradiologists.

Your health care team may also include an oncology nurse, a registered dietitian, a mental health counselor, a social worker, a physical therapist, an occupational therapist, a speech therapist, and a physical medicine specialist. Also, children may need tutors to help with schoolwork.

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Cancer reference provided by the Website of the National Cancer Institute (www.cancer.gov). The NCI Website is periodically revised, and content may be deleted or moved. We try to ensure that existing links will redirect to the new page(s).

Cancer Guide