Malignant brain tumors may be either primary (cancers of the brain tissue itself) or metastatic (spread from a cancer elsewhere in the body). The expected behavior of malignant tumors varies widely depending not only on whether the tumor is primary or metastatic, but if metastatic, on the type of tumor from which it arose. Many treatment options exist, including surgery, Gamma Knife, radiation and chemotherapy. Typically there is not one “best” treatment but a combination of therapies that together can provide the best outcome and most functional lifestyle possible.
Today, there are new chemotherapy agents, better radiation options and surgery is safer than it has ever been. Our specialists also have access to the latest research and development in cancer treatment, including clinical trials, so patients may have the opportunity to benefit from new treatments for specific cancers.
Benign Brain TumorsMany brain tumors are benign and include the following tumor types:
Meningiomas arise from the covering of the brain and are typically benign. Surgery is the most common tumor treatment, however many can be treated with Gamma Knife or closely observed over time if there is no expectation of growth.
Acoustic neuromas are tumors arising from the eighth cranial nerve, often presenting with dizziness, ringing in the ear and hearing loss. Other symptoms include headache and double vision.
These tumors are very complex and at times can be difficult to remove. These tumors often require the collaborative work of two surgeons during the same procedure.
Other treatment options include Stereotaxic radiosurgery with the Gamma Knife.
For additional information, you may visit Acoustic Neuroma Association.
The pituitary gland, a part of the brain in the midline behind the upper portion of the nose, controls many aspects of the hormone system of the body. Sometimes tumors arise from this gland. Approximately 10 to 15 percent of brain tumors come from this specific area. Tumors with active cells (secreting substances that encourage or inhibit hormones) are usually found when they are smaller in size, and in some cases may be treated with medication alone. Surgery is typically recommended for tumors that grow to a size that threaten the optic nerves, tracts or chiasm. Gamma Knife is often a very good option for delivering radiation to these tumors.
Spinal Canal Surgery
Spinal cord tumors make up two to four percent of the central nervous system tumors. Typically, surgery is a major portion of treatment. Symptoms of a spinal tumor depend upon its type, size, location and other factors. The most common presenting symptom is generalized back pain that is severe and cannot be relieved by activity or position change. Pain is extreme enough to disturb sleep. Other symptoms include difficulty walking, problems with gait or balance, difficulty using hands, and changes in bowel or bladder function. As in the brain, some tumors are malignant and others are curable with the correct combination of treatments. Usually patients present with pain, weakness or clumsiness and occasionally, paralysis.
Types of spinal canal tumors include:
- Metastatic Cancer
Cervical spondylotic myelopathy (degenerative pressure on the spinal cord) is the most common cause of spinal cord dysfunction in adults. Bone spurs, thickening ligaments and incompetent joints result in narrowing and pressure on the spinal cord. This is not a condition that reverses itself. There is no medical solution and physical therapy typically does not help.
Symptoms include difficulty walking and using hands and arms, numbness and poor balance. Once these develop, they are difficult to resolve and treatment is required to stop further progression.
There are two surgical approaches for treatment, from the front (anterior cervical discectomy and fusion) and from the back (posterior-cervical laminectomy). At times, both approaches may be required. .
When the material between the vertebral bodies dries out and moves from where it should be, that disc material often presses on a nerve root. Irritation of the nerve root results in pain and weakness usually in the hip and/or leg. This condition is often called sciatica (which means pain down the leg) or radiculopathy. Radiculopathy most typically improves without any intervention. Surgery is a good option for patients suffering severe pain and those who maintain notable weakness or experience prolonged symptoms. A lumbar microdiscectomy procedure is highly effective for the general population in relieving pain more rapidly than any other non-surgical treatment. Rarely, severe back and leg pain, weakness, and loss of bowel and bladder control can also develop.
Just as disc material may migrate out of place in the low back, this can also happen in the neck or cervical spine. If the spinal cord is affected, treatment is the same as that for cervical spondylotic myelopathy. The surgical options are an anterior cervical disc excision, fusion or placement of artificial disc. If there is arm pain, the same principles apply as in treatment for lumbar disc herniation. Many patients choose surgery as disc herniations can be very painful.