Conditions & Treatments
A brain tumor is defined as any abnormal or uncontrolled growth of cells in the brain. Tumors can be either benign, meaning non-cancerous, or malignant, meaning they may be cancerous. However, because they are located in the brain, it is important to recognize that even a benign brain tumor can be dangerous. As brain tumors grow, they press upon normal brain tissues which can cause inflammation and brain swelling. It is therefore very important that both benign and malignant brain tumors be treated as early as possible.
Diagnosing Brain Tumors
The National Cancer Institute (NCI) describes the various means by which a brain tumor may be diagnosed:
- Physical exam - The doctor checks for general signs of health.
- Neurologic exam - The doctor checks for alertness, muscle strength, coordination, reflexes, and response to pain. The doctor also examines the eyes to look for swelling of the nerve that connects the eye to the brain because of tumor caused pressure in the head.
- CT scan - An x-ray machine linked to a computer takes a series of detailed pictures of the head. The patient may receive an injection of a special dye so the brain shows up clearly in the pictures. The pictures can show tumors in the brain.
- MRI - A powerful magnet linked to a computer makes detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed. Sometimes a special dye is injected to help show differences in the tissues of the brain. The pictures can show a tumor or other problem in the brain. Special scanning called magnetic resonance spectroscopy can determine metabolism of brain abnormalities giving extra diagnostic information.
- Positron Emission Tomograpy - Imaging of the brain's use of the sugar glucose in a scanner that works much like a CT scan, but detects signals from a radioactive dye that is injected at the beginning of the scan.
- Myelogram - This is an x-ray of the spine. A spinal tap is performed to inject a special dye into the cerebrospinal fluid. The patient is tilted to allow the dye to mix with the fluid. This test helps the doctor detect a tumor in the spinal cord.
- Biopsy - The removal of tissue to look for tumor cells is called a biopsy. A pathologist looks at the cells under a microscope to check for abnormal cells. A biopsy can show cancer, tissue changes that may lead to cancer, and other conditions. A biopsy is the only sure way to diagnose a brain tumor.
Surgeons can obtain tissue to look for brain tumor cells in three ways:
- Stereotactic Needle biopsy - The surgeon makes a small incision in the scalp and drills a small hole into the skull, called a burr hole. The doctor passes a needle through the burr hole and removes a sample of brain tumor tissue.
- Stereotactic biopsy - An imaging device, such as CT or MRI, guides a needle through the burr hole to the location of the brain tumor. The surgeon withdraws a sample of brain tumor tissue with the needle.
- Biopsy at the same time as treatment - Sometimes the surgeon will take a brain tumor tissue sample at the same time when patient has surgery to remove the tumor.
Sometimes a brain tumor biopsy is not possible. If the tumor is in the brain stem or other difficult to reach areas of the brain, the surgeon may not be able to remove tissue from the tumor without damaging normal brain tissue. The doctor uses MRI, CT, or other imaging tests to make the best diagnosis possible instead.
Treating Brain Tumors
As a world-renowned medical and research center specializing in the treatment of brain tumors and their symptoms, Emory offers a range of brain tumor treatments and treatments for related neurological disorders:
- Radiation oncology (including stereotactic radiosurgery and IMRT)
- Neuroradiology (MRI, PET, MR Spectroscopy)
- Neuroendoscopy for intraventricular and skull base lesions
- Transphenoidal approach to pituitary tumors
- Craniotomy for tumors
- Awake craniotomy for language mapping
- Intraoperative cortical and subcortical motor pathway mapping
- Combined skull base approaches with ENT Ophthalmology, and Plastic and Reconstructive Surgery
- Molecular targeted therapy
- Clinical trials
Because a standard curative treatment is not available for all brain tumors, investigative and research treatment protocols are available for the therapy of new or recurrent brain tumors. Emory offers a diverse number of studies in an effort to meet the widely varying needs of brain tumor patients.
About the Emory Brain Tumor Program
Emory's Brain Tumor Program is part of Emory's Department of Neurological Surgery, which not only has the modern diagnostic and imaging equipment and new treatment options to treat brain tumor patients with the latest technology available, but also possesses the faculty and experience to be one of the top centers of its kind in the country.
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