A tumor develops when the body’s cells multiply when they are not needed. A brain tumor is a mass of unnecessary or abnormal cells that grow in the brain.

2. What is the difference between malignant and benign brain tumors?

Malignant brain tumors contain cancer cells. They can grow very quickly, invade and destroy healthy tissues, and may spread to other areas of the brain.  Slower growing brain tumors, or tumors that do not contain cancer cells may be referred to as “benign” or “non-malignant.”  However, because the brain is inside the hard skull, there is no room for abnormal growths of cells.  Malignant and benign brain tumors can both be life threatening, and often require the same treatments

3. What is the difference between primary and metastatic brain tumors?

A tumor that starts growing in the brain is a primary brain tumor. These tumors may spread within the brain, but rarely travel to other sites in the body. Metastatic brain tumors are formed from cancer cells that originate in other parts of the body, and travel to the brain to form tumors. Cancers of the lung, breast, colon and melanoma often spread to the brain.

4. What are the different kinds of brain tumors?

There are many different kinds of brain tumors, and names for brain tumors. These names will often reflect the location of the tumor, the kinds of cells in the tumor, and the tumors level of aggressiveness. Scientists use the appearance of the tumor cells under a microscope to determine the kind of tumor. Tumors are also given a grade indicating the degree of malignancy. Grade 1 tumors are the slow growers, and are often considered non-malignant or benign. The most malignant tumors are given a grade of IV. This web site provides links to many other sites that provide detailed information on all tumor types.

5. What is the cause of brain tumors?

Unfortunately, the cause of brain tumors is unknown. Just as there are many kinds of brain tumors, there may be just as many causes. There is likely a combination of factors. One thing known for sure is that brain tumors are not contagious. About 5% of primary brain tumors can be associated with hereditary factors. The cause of the remaining 95% of brain tumors is studied by scientists the world over. Progress in determining causes and improving treatment is aided by statistics on brain tumor occurrence gathered at all major medical facilities.

6. What are the symptoms of a brain tumor?

Each individual and each brain tumor is unique, and so are the accompanying symptoms. Brain tumors can be difficult to diagnose because the symptoms are often vague and confusing. Often brain tumor symptoms are subtle and mimic other diseases. That said, there are some general symptoms that can be associated with brain tumors. They include: head or neck pain, seizures, memory problems, speech or communication problems, changes in temperament, vision impairment, nausea and vomiting, and fatigue. Specific symptoms depend on the tumor’s location, type and size.

7. How is a brain tumor diagnosed?

When symptoms arise that may indicate a brain tumor, the first step in diagnosis will involve a basic neurological exam. This kind of exam will measure central nervous system responses, and might include: vision testing, hearing tests, reflex responses, balance and coordination tests, sense of touch tests, sense of smell tests, and various memory and thinking tests.

Conventional x-rays do not show tumors growing behind the bones of the skull; so special scans are used to look for tumors. Computerized Tomography (CT) or Magnetic Resonance Imaging (MRI) scans both use computer graphics to create an image of the brain. For both of these scans, the patient lies on a table that slides into the imaging device. For the images to be precise, the patient must lie very still. If the patient is unable to lie still, sedation may be required. Often an injection of a special contrast material is given to help enhance the images. The scan can be very noisy, and the length of time varies. The CT and MRI are only two of the types of scans available. Other specialized scans can measure the rate of blood flow to the brain, provide brain mapping for use during surgery, or measure the magnetic fields created by nerve cells. Once the scan is complete, a radiologist interprets the computer images and provides an tentative diagnosis.

Exact diagnosis comes only from examination of the tumor cells under a microscope by a pathologist. These cells can be acquired during surgery, or as a separate diagnostic procedure called a biopsy. There are also laboratory tests that can verify the presence of a tumor by checking the cerebrospinal fluid for a variety of markers, or measure hormones taken from blood samples.

MRI (Magnetic Resonance Imaging): MR Imaging or MRI is a very precise and sensitive test for detecting tumors, and use of the contrast agent gadolinium improves its sensitivity of diagnostic imaging. MR imaging is rapidly becoming one of the most widely used diagnostic tests. However, there are cases in which CT or other test are necessary to provide the best diagnostic information. Your physician will determine which test is most appropriate for you.

PET Scanning: PET scanning or Positron Emission Tomography is a highly sensitive diagnostic test for detecting recurrent brain tumors. For PET scanning, a radioactively labeled sugar substance - deoxyglucose- acts much like a contrast agent as in other diagnostic tests. After deoxyglucose is injected into the patient's vein, the scanning takes 1 to 4 hours. By observing the pattern of uptake of the deoxyglucose by brain cells on and tumor cells on the scan, it is possible to tell whether tumor cells are recurring and to distinguish recurrent tumor from areas of dead tissue (necrosis) that have formed after previous treatment with radiation or chemotherapy.

8. What kind of treatment does a brain tumor require?

Treatments are recommended based on the type of tumor, the size and location, the patient’s medical history, age, and current health. Standard treatments include surgery to remove as much of the tumor as possible, radiation therapy to shrink or kill tumor cells, chemotherapy drugs to kill fast growing cells, and steroids to reduce swelling.

Before consenting to recommended treatment, be sure to ask some important questions. What is the purpose and likely outcome of the treatment? Are there any other treatment options to consider? What are the risks involved? What side effects can be expected, and what can be done to ease them? How will the treatments affect daily activities and quality of life? It is very important that you feel comfortable with your physician, and with the treatment plan. Your doctor will likely consult with a team of specialists before recommending treatments, and will offer you the best care possible. If you do not feel comfortable, seek out other medical opinions until you find a treatment plan that feels right for you.

9. What can I expect when having brain surgery?

Many brain tumors are treated with surgery. The purpose of surgery is to remove as much of the tumor as possible, establish an exact diagnosis, and provide access to the tumor site for other treatments. Surgery to remove a brain tumor is called a craniotomy. In most cases, the neurosurgeon cuts into the scalp and removes a piece of the skull to expose the area of the brain over the tumor. In some cases, surgeons can reach tumors by entering the skull through the sinus cavities. Computer imaging allows detailed brain mapping to be used to minimize damage to surrounding tissues. Once the tumor is located, the neurosurgeon will remove as much as possible. Following surgery, your medical team will be on hand to answer any questions you have and help you recover.

10. What is radiation therapy?

Many brain tumors are radiosensitive; their cells will shrink and die after exposure to radiation. Radiation therapy is used for both "benign"and malignant tumors. There are several different methods for delivering radiation to the treatment area, as well as varying dosages and schedules. As with any treatment, be sure to discuss radiation fully with your doctor, and make sure you feel comfortable with the recommended treatment. Radiation therapy is generally not painful, but there are a variety of potential side effects that you and your doctor will discuss. New radiation therapies are constantly under development. The Support section of this web site contains links to many sites that can provide detailed information on updated treatments options. Support groups are also great forums for sharing experiences and getting tips to help handle radiation treatments and its side effects.

11. What is chemotherapy?

Chemotherapy is the use of special drugs designed to kill tumor cells. These drugs can target tumors because cells that are actively dividing absorb them. Some normal cells can also be affected, such as those that produce hair, blood, and skin. Your doctor can discuss these potential side effects with you in detail. As with radiation therapy, there are many different kinds of chemotherapy, and several different ways the drugs are delivered. Researchers work diligently to bring us new drugs and hope for a cure. New treatments are tested on patients in clinical trials at many major medical centers. Check the Support section of this web site for many resources regarding chemotherapy and research clinical trials. If your treatments have you sidelined from support group meetings, be sure to use the Message Board here to find friends with tips and experience dealing with chemotherapy.

12. Will my brain tumor come back?

As with any cancer, it is possible that a brain tumor will recur. Cancer cells can often survive even the most successful treatment regimen. In addition, it is not uncommon for low grade tumors to recur as a higher grade tumor, or even for a “benign” tumor to recur as malignant. That said, many brain tumors are treated successfully the first time out, and do not recur.

13. How can I better understand my diagnosis, and keep track of all my treatments?

Being diagnosed with a brain tumor is an emotionally traumatic and confusing event. It is very difficult to take in the news, and be aware enough to understand all the information flying at you at a critical pace. There are things that you can do to get through it as smoothly as possible. First, always carry paper and take notes, or have someone take notes for you. Ask your doctor to spell out any medical terms that have you confused. Write down the descriptions, dates and times of your symptoms so you don’t have to rely on memory when meeting with your doctor. With help if you need it, keep a log while in the hospital, and and while receiving other therapies. Keep a separate list of all treatments you have received with dates, locations and doctors’ names. and Always keep an up to date list of the and medications you are taking with you. Before you go to your appointments, write down any questions you have for your doctor. Use the links provided in this web site to gather more information, but be careful to not overwhelm yourself with too much disturbing information. Use the support group as a resource for advice from those who have been through this before. Allow your loved ones to care for you in your time of need, and seek out spiritual support if it gives you comfort.

14. How can I, my family and loved ones cope with a brain tumor?

These are some resources for you and your family to review.

Resources

For a list of questions to keep in mind, read the Fact Sheet: Issues to Consider When Choosing a Brain Tumor Treatment Center.

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National Brain Tumor Foundation Support Group Listings
1(800) 934-CURE (2873)

Cancer Care Counseling Line
1 (800) 813-HOPE (4673)

National Family Caregivers Association
1 (800) 896-3650

Well Spouse Foundation
1 (800)838-0879

Wellness Community
(310) 453-2300 (National Headquarters)

For a copy of the NBTF Coping Brochure, please click here.

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15. How can I support the search for a cure?

First of all, awareness is the key to raising funds for research, and researchers will bring us the cure! There are many organizations working to raise awareness and support research all around the world, many of them listed in our links. Here at the Richmond Brain Tumor Support Group, we use the CureBT logo to raise awareness. CureBT lapel pins and static window decals are available on this web site in exchange for a small donation and postage. Private financial donations provide funding for research, resources organizations, and support groups. Check our Calendar for special awareness and fund raising events in Central Virginia. Local events are fueled by enthusiastic volunteers working for a cure for themselves or a loved one. Get involved to help find a cure – CureBT!

Click here to view an illustration of the parts of the brain.