Brain Cancer

Brain tumor symptoms depend on the size and location of the tumor. Symptoms are caused by the damage the tumor does to parts of the brain, and increased pressure inside the skull. If a brain tumor grows slowly, its symptoms may appear very slowly over time. You may not notice them for a long time.

Common Symptoms

• Headaches: About half of people with brain tumors complain of headaches that are worse in the morning and become less painful throughout the day. The headaches tend not to cause sensitivity to light and sound.
• Fainting
• Seizures
• Nausea
• Weakness or loss of feeling in the arms, legs, or both.

Less Common Symptoms

• Stumbling or inability to walk
• Changes in vision or abnormal eye movements
• Changes in personality, memory, or speech
• Changes in alertness, from increased sleepiness to coma
• Weakness on one side of the body
• Trouble talking
• Reduced field of vision
• Vomiting

If your doctor thinks you might have brain cancer, exams and tests will be required to reach an accurate diagnosis. This begins with your physician asking questions about your health history, symptoms, risk factors and family history of disease. Your doctor will likely examine you for possible signs of brain or spinal cord problems. The exam will test things like your reflexes, muscle strength, sensation, eye and mouth movement, vision, coordination, and alertness. More in-depth tests include:

• Magnetic Resonance Imaging (MRI): An MRI scanner uses magnets and strong radio waves to make pictures of the brain. MRIs are very useful in diagnosing brain tumors because they allow your doctor to "see through" your skull. It can show smaller details better than other scans.
• Computed Tomography (CT) Scan: A CT scan is a type of X-ray that creates detailed pictures of the brain. A computer combines these many images into a useful picture. A special form of CT scan, known as CT angiography, may be used to look at the blood vessels around a tumor to help plan surgery.
• Positron Emission Tomography (PET) Scan: A PET scan can help your doctor tell the difference between an active, growing tumor and damage from radiation therapy or a scar from surgery. For a PET scan, a technician injects a small amount of a radioactive substance into your vein. Fast-growing tissue, such as a tumor, absorbs this substance and can be seen by a special type of scanner. The radioactive material used in this test is not dangerous and will leave your body in about 6 hours.
• Magnetic Resonance Spectroscopy (MRS): An MRS scan can determine the metabolites inside the tumor. Sometimes, this test is used to determine if a growth is an active tumor or a mass of radiation damage (necrosis).
• Angiogram: An angiogram is a series of X-rays taken after a technician injects a special dye into one of your blood vessels. These X-rays show the tumor and the blood vessels that lead to it, which helps doctors plan surgery. CT angiography and magnetic resonance (MR) angiography are now used more often to look at blood vessels in the brain.
• Magnetic Resonance Angiography (MRA): This is a special type of MRI which is less invasive than an angiogram, but certain types of cancer can’t be seen with this method.
• Myelogram: A myelogram is an X-ray of the spine. A technician injects special dye into your cerebrospinal fluid in the spine to help make tumors more visible. This test is rarely done because MRIs offer more information without injecting dye into the spine.
• Skull X-Ray: Skull X-Rays are very good at identifying calcium deposits left by certain types of tumors.
• Lumbar Puncture (Spinal Tap): For this test, a thin, hollow needle is placed into the lower back, into the spinal canal – the area around the spinal cord. The fluid pressure in the spinal canal and brain can then be measured and a small amount of cerebrospinal fluid (CSF) can be removed and sent for testing to see if it contains cancer cells.
• Electroencephalogram (EEG): An electroencephalogram (EEG) is a non-invasive test that uses small round discs with wires (electrodes) placed on your scalp to measure electrical activity in your brain, called brain waves.
• Brain Tumor Biopsy: If any of these tests suggest that a tumor might be present, a neurosurgeon will probably take a biopsy of the tumor. In most cases, this is the only way to know for sure if a tumor is benign or malignant (and to determine what type of tumor it is), although sometimes doctors can get enough information to make a diagnosis from the imaging tests alone. For a brain tumor biopsy, a doctor takes out as much of the tumor as possible through a bone "window" made in your skull. Another type of biopsy is the stereotactic biopsy. For this biopsy, the neurosurgeon removes a small piece of the tumor with a hollow needle.

Several types of treatment can be used for brain cancer. Which may work best for you? It depends on a number of factors. These include the type, size and location of the tumor. Other important factors include your age, overall health and what side effects you find acceptable.

• Surgery: Surgical treatment involves craniotomies of various types depending on the location of the cancer. This includes minimally invasive choices like keyhole surgery and endoscopic approaches which are through a tube. New microscope technology at INTEGRIS also allows some brain tumors to become fluorescent under the microscope so that more complete resections can be performed in some cases. Care is taken to preserve hair and keep the incisions hidden whenever possible. Many patients can leave the hospital the day after surgery. 
• Stereotactic Radiosurgery and Radiotherapy: Some brain tumors are best treated by radiation oncology and neurosurgery physicians together. These physicians collaborate to create a computer generated treatment program that provides non-invasive treatment with focused beam radiation to treat single and multiple brain lesions without an open surgical procedure.

At INTEGRIS, we offer a wide variety of support programs and services along with the Troy and Dollie Smith Wellness Center to help patients with brain cancer and their loved ones manage the physical and emotional effects of a cancer diagnosis and treatment.

Support services for brain cancer include:

• Cancer screenings
• Clinical social work services
• Counseling
• Integrative medicine clinic
• Mind, body therapies including acupuncture, massage, and yoga
• Multi-disciplinary clinic coordination
• Nutrition consultations
• Pastoral care, spiritual support and relaxation techniques
• Patient and family support groups
• Patient navigation and survivor care planning
• Research and clinical trials
• Resource Room