A brain tumor occurs when errors in DNA cause cells to grow or divide abnormally. But most brain tumors are not cancerous.

A tumor can be classified as one or more of the following:

• Benign: About 60% of brain tumors are benign, or non-cancerous. A benign tumor is the least aggressive. It can start anywhere in the brain. Even though it may grow, it grows very slowly, and it does not spread into other parts of the body.
• Malignant: A malignant brain tumor contains cancer cells. It can start anywhere in the brain and may grow rapidly and spread throughout the brain and beyond. A malignant tumor can be life-threatening.
• Primary: A primary tumor can begin in the brain cells, the membranes that surround the brain, the nerves, or the glands. Although it may spread to other areas of the brain, it rarely affects other organs.
• Metastatic (or secondary): A metastatic brain tumor begins in another part of the body and spreads to the brain. The most common types of cancer to spread to the brain are melanoma, lung, breast, renal (kidney) and colon cancer.

Metastatic brain tumors are the most common type of brain tumor. Recent advances have improved prognosis (life expectancy) for many people who have cancer that has spread to the brain. Smaller tumors often can be treated with radiation beams, and larger tumors may require surgery.

Either way, many patients with brain metastases live long, fulfilling lives after treatment of their brain lesions.

Some of the other common brain tumors we treat are:

• Meningioma, a slow-growing tumor that forms in the membranes that cover the brain, called the meninges.
• Glioblastoma multiforme, an aggressive cancer that starts in the glial cells of the brain.
• Anaplastic astrocytoma, a malignant tumor that starts in the astrocytes, which are cells in the nervous system.
• Low-grade glioma, which also originates from glial cells, like glioblastoma multiforme, but is slow-growing.
• Medulloblastoma, a cancerous tumor that starts in the lower back part of the brain.
• Pituitary adenoma, a usually benign tumor on the pituitary gland, which may eventually affect vision or cause overproduction of hormones.

Before an operation, we conduct several tests to map the brain. With that information, we can personalize each surgery to remove the tumor while carefully preserving your brain function. Your surgeon may order:

• Standard magnetic resonance imaging (MRI) gives us a detailed picture of the brain to help us find the tumor.
• Functional magnetic resonance imaging (fMRI) lets us pinpoint the location of important areas in the brain in relation to the tumor.
• Magnetic resonance perfusion and spectroscopy give us insight into the biology of the tumor.

We have a dedicated neuro-anesthesiologist who follows specific steps that are proven to help patients stay safe and comfortable during surgery. This specialist will prevent pain, keep you comfortable, put you to sleep if needed and help you wake up quickly after the operation.

The specialists at Memorial Healthcare System are extensively trained and experienced in multiple advanced surgical options, including:

• Awake craniotomy: During this procedure, you are awake and alert. But don’t worry, our neuro-anesthesiologist makes sure that you feel no pain. Your surgeon removes part of the skull and takes the tumor out. The entire time, a neuromonitoring specialist talks with you and performs tests to make sure the surgery is not affecting any brain functionality.
• CyberKnife® radiosurgery: CyberKnife is often used to treat tumors that are not good candidates for other types of surgical removal. It is a sophisticated device with a robotic arm that delivers a narrow, focused beam of radiation to target the tumor. There are no incisions, and you recover quickly with very few, if any, side effects.
• Laser ablation: This precision approach uses heat from a laser to destroy tumor cells. The laser is very accurate, so it is able to avoid any healthy brain tissue.
• Surgical tumor removal: This involves taking out as much of the tumor as possible. The surgeon may enter through your skull or via the nose with an endoscope (a tube with a camera on the end). Even if the entire tumor cannot be removed, this procedure can reduce the size of the tumor. A smaller tumor causes fewer side effects and can be treated more effectively with radiation, chemotherapy or embolization.
• Tumor embolization: This procedure cuts off the blood supply to a tumor, so it shrinks. Tumor embolization may be combined with another surgical approach, chemotherapy or radiation.
• Watch and wait: Some tumors are very slow-growing. Your surgeon may not recommend an operation right away. Instead, we will test you regularly to make sure the tumor hasn’t grown or changed.

Some brain tumors cannot be removed. When that is the case, we collaborate with oncologists and radiation oncologists to treat the tumor with chemotherapy, radiation and/or laser therapy. Those treatments can help control tumor growth and relieve symptoms.

We also work closely with the Memorial Healthcare System’s palliative care specialists. They provide symptom relief, comfort and offer proven strategies to help you cope with a potentially life-threatening illness.