Brain Tumors: New Advances in Treatment
A diagnosis of a brain tumor sounds like a scary thing. Certainly, a brain tumor can be a serious diagnosis. However, life expectancies can vary widely depending on the type of tumor and how far the disease has progressed. But the good news is that there are many amazing new treatments that are giving many patients much longer, more fulfilling lives than what they could have expected in decades past. Doctors have highly effective surgical as well as nonsurgical options in their toolkit.
Are all brain tumors cancer?
No. Brain tumors can be benign or more aggressive cancerous forms. Benign tumors usually don’t spread or invade like cancerous tumors, but they can cause problems due to growth. If a benign tumor remains small and is not causing symptoms we will usually just keep an eye on it.
Cancerous tumors, on the other hand, will usually advance and cause problems at some point.
What causes brain tumors?
Brain tumors have a diverse set of causes. We hypothesize that somewhere deep inside one of the cells in the brain or in another part of the body, a malfunction occurs in the DNA. This malfunction can be caused by exposure of the body to a certain chemical or an outside factor like radiation. Other times a mutation can be inherited from the patient’s parents or sometimes there is a completely random mutation in the genetic code.
This error in the DNA causes the cell to no longer follow the rules that typically dictate a cell’s growth and division pattern. It starts to divide and form clumps of cells that are abnormal. How fast these cells divide and whether they tend to split apart and spread determines how benign or how malignant a given tumor is.
What are the symptoms of a brain tumor?
Because the brain controls so much of what our bodies do, the symptoms of a brain tumor can vary widely and mostly depend on where in the brain the tumor occurs. Sometimes, brain tumors are completely asymptomatic and may be found during imaging for an unrelated issue.
Common symptoms include headaches, problems with speech or walking, weakness, numbness, problems with your vision or a new onset of seizures. Of course, those symptoms can be caused by many other things besides brain tumors. if you are experiencing any concerning symptoms it is recommended to discuss with your primary care provider to determine if further testing is a good idea.
How common are brain tumors?
Unfortunately, brain tumors are very common. About 200,000 people a year in the United States are diagnosed with a tumor in the brain that comes from another part of the body, most often from lung cancer or breast cancer. That’s a lot of people for one country. Sometimes, these tumors may result from melanoma and kidney cancer.
There are also tumors that originate in the brain itself that are cancerous. Most common are a type of cancerous brain tumor called gliomas. About 20,000 to 40,000 of those occur every year in the United States.
If we discover a cancerous tumor in the brain, we screen the rest of the body to try to determine the source. Getting the big picture helps doctors come up with a smart plan for treating the tumor.
How are brain tumors treated?
Brain tumor treatment is typically a multidisciplinary effort through specialties such as oncology, radiation oncology and neurosurgery. We have an ever-expanding arsenal of therapies to target brain tumors which may include medications, radiation, and/or surgery.
The goals of treatment of brain tumor can range from cure of cancer to limiting cancer progression and improving quality of life. The specific treatment for a given brain tumor depends on a wide range of factors such as tumor type, patient age and health, tumor location, and tumor size. For this reason, having a comprehensive team helps coordinate care to develop a plan that makes sense for each unique patient.
What advances have been made in brain tumor care?
For surgery, advances revolve around making the resection more accurate while causing less side effects for the patient. We use sophisticated computers to help guide us within the brain – kind of like GPS for surgery. Sometimes a brain tumor can appear very similar to the surrounding brain. Fluorescent compounds have been developed that make abnormal brain tumor cells glow. The glowing tissue can be easily differentiated from the normal tissue during surgery.
Sometimes a tumor is located very close to an important center in the brain, such as a speech or strength center. In these situations, awake brain surgery can help monitor a patient’s neurologic status during a procedure. These procedures require an expert neurosurgery team to coordinate care before, during and after the surgery.
Targeted therapies are another exciting advancement in brain tumor treatment. With targeted therapy, oncologists use medications that target a tumor's specific genes, proteins or the tissue that is contributing to a tumor's growth and survival. This type of treatment blocks the growth and spread of tumor cells and limits the damage to healthy cells. Former President Jimmy Carter is a good example of someone who has benefited from this type of treatment. President Carter had melanoma and numerous cancerous growths in the brain. Things were not looking good for the president. But then, he got this new targeted therapy and his tumors all vanished. He’s still building houses for Habitat for Humanity in his mid-90s.
How long does it take to recover from brain tumor surgery?
The answer to the question is highly variable and depends a lot on the type of tumor, location and the individual patient’s symptoms. Some people who have brain surgery might go home as early as 24 hours, but the average person usually stays in the hospital for two to five days.
Learn more about neurosurgery at Ochsner.