Brain tumor - adults Health Article

Signs and tests

A doctor can often identify signs and symptoms that are specific to the location of the tumor. Some tumors may not show symptoms until they are very large and cause a rapid decline in the person's mental functions. Other tumors have symptoms that develop slowly.

Most brain tumors increase pressure within the skull and compress brain tissue because of their size and weight.

The following tests may confirm the presence of a brain tumor and identify its location:

• CT scan of the head
• MRI of the head
• EEG
• Examination of tissue removed from the tumor during surgery or CT-guided biopsy (may confirm the exact type of tumor)
• Examination of the cerebral spinal fluid (CSF) may reveal cancerous cells

Treatment

Treatment can involve surgery, radiation therapy, and chemotherapy. Brain tumors are best treated by a team involving a neurosurgeon, radiation oncologist, oncologist or neuro-oncologist, and other health care providers, such as neurologists and social workers.

Early treatment often improves the chance of a good outcome. Treatment, however, depends on the size and type of tumor and the general health of the patient. The goals of treatment may be to cure the tumor, relieve symptoms, and improve brain function or the person's comfort.

Surgery is necessary for most primary brain tumors. Some tumors may be completely removed. Those that are deep inside the brain or that enter brain tissue may be debulked instead of entirely removed. Debulking is a procedure to reduce the tumor's size.

Tumors can be difficult to remove completely by surgery alone, because the tumor invades surrounding brain tissue much like roots from a plant spread through soil. In cases where the tumor cannot be removed, surgery may still help reduce pressure and relieve symptoms.

Radiation therapy and chemotherapy may be used for certain tumors.

Other medications used to treat primary brain tumors in children may include:

• Corticosteroids such as dexamethasone to reduce brain swelling
• Osmotic diuretics such as urea or mannitol to reduce brain swelling and pressure
• Anti-convulsants such as phenytoin to reduce seizures
• Pain medications
• Antacids or histamine blockers to control stress ulcers

Comfort measures, safety measures, physical therapy, occupational therapy and other such steps may be required to improve quality of life. Counseling, support groups, and similar measures may be needed to help in coping with the disorder.

Patients may also consider enrolling in a clinical trial after talking with their treatment team.

Legal advice may be helpful in creating advanced directives such as a power of attorney.

Support Groups

For additional information, see cancer resources.

Complications

• Brain herniation (often fatal)
  • Uncal herniation
  • Foramen magnum herniation
• Permanent, progressive, profound neurologic losses
• Loss of ability to interact or function
• Side effects of medications, including chemotherapy
• Side effects of radiation treatments
• Return of tumor growth

Calling your health care provider

Call your health care provider if you develop any new, persistent headaches or other symptoms suggestive of a brain tumor.

Call your provider or go to the emergency room if you have seizures that are new, or suddenly develop stupor (reduced alertness), vision changes, or speech changes.