Brain Tumors in Adults

What is a Brain Tumor?

A brain tumor is a cluster of abnormal cells that grows out of control in your brain. Some brain tumors are benign, which means the cells aren’t cancer. Others are malignant, meaning they’re cancer.

Brain tumors are called primary tumors if they started in your brain. They’re considered secondary if they started somewhere else in your body and spread to your brain.

Types of Brain Tumors

Primary brain tumors come from cells that make up the brain and central nervous system. They’re named for the kind of cell in which they first form. There are more than 100 kinds of brain tumors. The most common types in adults are:

• Gliomas. These tumors start in the glial cells, which are cells that help keep nerves healthy. They’re most often cancer. There are several categories of gliomas, based on which specific cells they target. Astrocytomas are most common in adults. A glioblastoma is the most aggressive type of glial tumor.
• Meningiomas. These form in the meninges, the thin layer of tissue that covers the brain and spinal cord. They aren’t cancer, but they can cause problems by pressing on your brain.
• Schwannomas. These damage the protective coating of nerve cells. They aren’t cancer, but they often cause hearing loss or problems with balance.
• Pituitary adenomas. These form on the pituitary gland, which sits at the base of your brain. It makes important hormones. These tumors usually aren’t cancer and are slow growing.

Benign vs. Malignant Brain Tumors

Benign brain tumors aren’t aggressive and normally don’t spread to surrounding tissues, although they can be serious and even life-threatening. Benign brain tumors usually have clearly defined borders and usually aren’t deeply rooted in brain tissue. This makes them easier to surgically remove if they’re in an area of the brain where it’s safe to operate. But they can come back. Benign tumors are less likely to come back than cancerous ones.

Even a benign brain tumor can be a serious health problem. Brain tumors can damage the cells around them by causing inflammation and putting increased pressure on nearby tissue, as well as inside your skull.

Malignant primary brain tumors are cancers that start in your brain, typically grow faster than benign tumors, and quickly invade surrounding tissue. Although brain cancer rarely spreads to other organs, it can spread to other parts of your brain and central nervous system.

Secondary brain tumors are cancer. They come from cancer that started somewhere else in your body and spread, or metastasized, to your brain. About 1 in 4 people with cancer develop a secondary brain tumor.

Brain Tumor Symptoms

Symptoms of brain tumors vary according to the type of tumor and the location. Because different areas of the brain control different functions of the body, where the tumor lies affects the symptoms you get.

Some tumors have no symptoms until they’re large and then cause a serious, rapid decline in health. Other tumors may have symptoms that develop slowly.

Common symptoms include:

• Headaches, which may not get better with the usual headache remedies. You may notice you’re getting them more often or they’re worse than usual.
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• Changes in speech or hearing
• Changes in vision
• Balance problems
• Problems with walking
• Numbness or tingling in the arms or legs
• Problems with memory
• Personality changes
• Inability to concentrate
• Weakness in one part of the body
• Morning vomiting without nausea

These symptoms can result from many conditions. Don't assume you have a brain tumor just because you have some of the symptoms. Check with your doctor.

Most of the time, doctors can’t tell what causes a brain tumor. There are only a few known risk factors for brain tumors in adults.

• Exposure to radiation. Children who receive radiation to the head have a higher risk of developing a brain tumor as adults.
• Family history. Some brain tumors are linked to certain rare genetic conditions such as neurofibromatosis or Li- Fraumeni syndrome.
• Age. People between ages 65 and 79 make up the population most likely to be diagnosed with a brain tumor.
• No history of chickenpox. One study has found that people who had chickenpox are less likely to get gliomas.

Brain Tumor Diagnosis

To diagnose a brain tumor, your doctor will start by asking questions about your symptoms, overall health, and family health history. Then they’ll do a physical exam, including a neurological exam. If there's reason to suspect a brain tumor, the doctor may request one or more of the following tests:

• Imaging studies like a CT scan or MRI to see detailed images of the brain
• Angiogram or MRA, which use dye and X-rays of blood vessels in the brain to look for signs of a tumor or abnormal blood vessels

The doctor may also ask for a biopsy to see if the tumor is cancer. They’ll remove a tissue sample from your brain. They might do it during surgery to remove the tumor. Or they could insert a needle through a small hole drilled into your skull. They’ll send the sample to a lab for testing.

Brain Tumor Treatment

Your doctor will consider several things in deciding how to treat your brain tumor, including:

• Location of the tumor
• Size of the tumor
• Type of tumor
• Whether the tumor has spread
• Your overall health
• Potential complications

Surgery to remove the tumor is typically the first option once a brain tumor has been diagnosed. But some tumors can't be surgically removed because of their location in the brain. In those cases, chemotherapy and radiation therapy may be options for killing and shrinking the tumor.

Sometimes you’ll get chemotherapy or radiation after surgery to kill any remaining cancer cells. Your doctor may treat tumors that are deep in the brain or in areas that are difficult to reach with gamma knife therapy, a form of highly focused radiation therapy.

Because treatment for cancer can damage healthy tissue, you should talk about possible long-term effects of whatever treatment is being used with your doctor. They can explain the risk and the possibility of losing certain faculties. The doctor can also explain the importance of planning for rehabilitation following treatment. Rehabilitation could involve working with several different therapists, such as:

• Physical therapists to regain strength and balance
• Speech therapists for help with speaking, expressing thoughts, or swallowing
• Occupational therapist to help manage daily activities such as using the bathroom, bathing, and dressing

10 Questions to Ask Your Doctor About Brain Tumors

If you were recently diagnosed with a brain tumor, ask your doctor these questions at your next visit.

1. What type of brain tumor do I have, and what is its grade?

2. What are the symptoms of brain cancer?

3. Which part of my brain is affected by the tumor and what does this region of the brain do?

4. Will it be possible to surgically remove my tumor?

5. If you can't surgically remove the tumor, will I need other treatments such as chemotherapy or radiotherapy after surgery?

6. What are the possible side effects of these therapies?

7. Who might my treatment team include, and for how long will I continue to see them?

8. Are there alternative treatments for my condition?

9. Will there be any lasting problems from this disease or its treatment?

10. Are there any support groups in the area that I can contact?

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