Brain tumors

A brain tumor is a growth in the brain that leads to increased pressure inside the skull and the destruction and compression of normal brain tissue, causing loss of function. A brain tumor may cause headaches and seizures as well as many other nervous system problems. Tumors can either originate in the brain itself (primary brain tumor) or come from another part of the body and travel to the brain (metastatic or secondary tumor). Brain tumors can be classified as either benign (noncancerous) or malignant (cancerous), depending on their behavior.

A benign tumor does not contain cancer cells and usually, once removed, does not recur. Most benign brain tumors have clear borders, meaning they do not invade surrounding tissue. These tumors can, however, cause symptoms similar to cancerous tumors because of their size and location in the brain. 

Malignant brain tumors contain cancer cells and are usually fast growing and invasive. They very rarely spread to other areas of the body but may recur after treatment. Sometimes, brain tumors that are not cancerous are called malignant because of their size, location and the damage they can do to vital functions of the brain.

If you have been diagnosed with a brain tumor, your oncologist will explain all your treatment options and create a treatment plan tailored to your specific needs and goals. Throughout your treatment, you will work closely with a dedicated team of specialists in medical oncology, surgical oncology and radiation oncology who collaborate to ensure seamless coordination of your care. Because every brain tumor diagnosis is unique, the physicians providing your treatment will meet regularly to share ideas and review every step of your care.

As part of your brain tumor treatment plan, you may have opportunities to participate in clinical trials. These trials study new chemotherapy drugs, radiation technologies and surgical approaches. While not every patient is a candidate for clinical trials, your care team will work with you to determine eligibility. Learn more about clinical trials at Northwell Health.

Brain tumors are normally discovered in patients experiencing symptoms such as:

• Headache
• Vomiting (usually in the morning)
• Nausea
• Personality changes
• Irritability
• Drowsiness

Be aware that these symptoms could be due to conditions other than a brain tumor, so it’s best to see a doctor right away.

The cause of most primary brain tumors is not yet known. In secondary brain tumors, which make up the majority of brain cancers, the cause is cancer that has spread, or metastasized, from one part of the body to the brain.

Risk factors for brain tumors include:

• Age—Risk for most types of brain tumors increases with age.
• Race—Brain tumors are more common in Caucasians. However, African-Americans are more likely to develop meningiomas.
• Chemical or radiation exposure—Exposure to certain types of chemicals or to ionizing radiation can increase your risk of developing brain cancer.

The first step in diagnosing a brain tumor is usually a thorough examination, during which your doctor will also review personal and family medical history. If a brain tumor is suspected, you will likely need additional tests.

Doctors use a variety of imaging tests and other diagnostic methods to deliver an accurate brain tumor diagnosis, including:

• Angiogram—Catheters are inserted into the arteries and guided to the brain. After injection of a dye, X-rays obtain multiple detailed images of the brain's blood vessels to detect and potentially help treat certain types of brain tumors.
• Bone scan—After a dye is injected and absorbed by bone tissue, X-rays are taken to detect tumors and bone abnormalities.
• CT or CAT scan (computerized axial tomography)—This procedure uses a combination of X-rays and computer technology to produce detailed 3D images. This test is normally used to detect and monitor tumors and can be used to guide treatment procedures.  
• MRI scan (magnetic resonance imaging)—A powerful magnet, radio waves and computer imaging combine to create highly detailed pictures of areas to show if and where the cancer has spread.
• fMRI scan (functional magnetic resonance imaging)—This specialized MRI for brain tumor diagnosis shows more detailed images of the brain than a regular MRI. This type of scan can be used to localized areas of the brain used for functions such as language, memory or movement. It is also used before surgery to maximize tumor resection while minimizing the possibility of weakness, blindness or speech loss.
• MR SPECT (magnetic resonance spectroscopy or MRS)—This specialized brain scan can diagnose whether an unexpected finding on MRI is a tumor or not.
• Neurological exam—The physician tests reflexes, muscle strength, eye, and mouth movement, coordination and alertness.
• Biopsy—For some patients, a surgical procedure called a biopsy—much smaller than a complete tumor removal—may be preferred to a larger operation as a way to diagnose what kind if the tumor is present.
• Spinal tap—The physician uses a thin needle to remove fluid from the lower spine. The fluid is then checked by a pathologist for cancer cells or other problematic signs.