“I heard those words, and everything seemed to just stop…”
Over 80,000 adults in the US are diagnosed with a primary tumor of the
brain or spinal cord each year, with approximately 25% of these tumors
considered to be malignant (cancerous). In addition to primary brain tumors,
over 100,000 people each year are diagnosed with a brain or spinal cord
metastasis (spread to the nervous system of a cancer that started elsewhere
in the body).
Despite these high numbers, brain tumors are overall relatively rare. Because
they are rare, and because they are generally not a hereditary condition
and have no clear factors that predispose someone to developing a brain
tumor, there is no recommended screening for them.
Being diagnosed with a brain tumor can be a fundamentally life changing
event. As important as providing clinical expertise, our team is committed
to providing compassionate, empathetic care and emotional support as patients
and families navigate this difficult time. We believe that taking the
time to answer every question is crucial to provide peace of mind, and
that getting to know our patients and their families are fundamental to
providing the best possible medical care.
“I didn’t really feel much different, just some headaches…”
Symptoms of a brain tumor are nonspecific, meaning they can occur in many
medical conditions not just due to a brain tumor. Non-specific symptoms
can include feelings like a headache, lightheadedness, or blurry vision,
which for most people are not signs of a tumor.
Most often, tumors are found when evaluating for the cause of new neurologic
symptoms. Symptoms that could indicate the presence of a brain tumor or
other neurologic condition, and therefore should prompt a person to get
a neurologic evaluation, include:
New onset moderate to severe headaches, or a change in character of headache
in someone who suffers from a headache disorder
Difficulty coming up with words or understanding someone who is speaking to them
Unexplained loss of vision
Unexplained loss of hearing, onset of dizziness or vertigo
Facial droop
New unexplained onset weakness in a limb or half of the body
New unexplained sensory change involving a limb or half of the body
New onset of seizure
New confusion or personality changes
New onset of memory, concentration, or multitasking
Studies like a computed tomography (CT or CAT) scan of the head or a magnetic
resonance (MRI) study of the brain can identify a tumor, but they cannot
tell specifically what kind of tumor is present. Most frequently, a tumor
diagnosis will be followed by seeing a neurosurgeon for evaluation and
surgical treatment. This may include either a biopsy, in which surgery
is performed to take part of the tumor, removal of the whole tumor, or
further testing to determine the cause of the tumor.
While the thought of surgery is understandably concerning, each year advancements
are made to improve safety, and recovery from such procedures. Some surgeries
can be done in a minimally invasive fashion allowing for shorter recovery
times. New techniques are being used to assist surgeons with safely achieving
more complete tumor removal, sometimes resulting in better patient outcomes.
Once a tumor has been removed, the tissue is examined by a pathologist
and, in some instances, special tests are performed to provide information
about the tumor all the way down to the molecular structure. These tests
can help to distinguish closely related tumor types from one another,
as well as provide information on the nature of a tumor’s behavior.
Obtaining an exact diagnosis is important to determine whether further
treatment is needed once surgery has been performed, and if so, what type
of treatment is needed.
For some tumor types, all that is needed after surgery is to follow with
routine brain imaging to make sure the tumor has not come back. For other
types of brain tumors further treatment with radiation, chemotherapy,
or a combination of treatments may be indicated.
Radiation therapy
Radiation treatment for a tumor in the nervous system can take several
forms. Many types of brain tumors, at least initially, are treated with
fractionated radiation, which is a form of radiation in which many beams
of radiation coming from different directions are “shaped”
to treat a tumor while sparing surrounding normal tissue of the side effects
of treatment. In stereotactic radiosurgery, or SRS, a single high dose
treatment of radiation is used to treat a tumor. For some treatments,
a hybrid combination of approaches may be employed.
Chemotherapy
The term “chemotherapy” is often used broadly to describe a
“systemic” treatment, or a treatment given by mouth or by
vein, used to treat cancer. In actuality, there are a number of different
types of treatments that can be used systemically to treat brain tumors,
ranging from traditional chemotherapies to newer targeted therapies, monoclonal
antibodies, and/or immunotherapies. In addition to these therapies, depending
on the tumor type and the stage of care, tumor treating fields may also
be recommended.
Clinical trial enrollment
In addition to standard therapies, brain tumor treatment can be undertaken
through a clinical trial, in which a new treatment is being explored to
see if it is a more effective than standard treatments. The idea of participating
in clinical research can be intimidating, especially when already dealing
with the stress of a new diagnosis. If you have questions or concerns
about clinical trials or are interested in exploring your eligibility
to participate in a clinical trial as part of your treatment, be sure
to discuss the role of clinical trials in your care with your doctor.
In addition to the numerous technical advances in cancer care, one of the
most important factors in a person’s treatment relies on the expertise
of their doctors. It is widely accepted that a comprehensive multidisciplinary
approach in which care is delivered by a team of doctors who specialize
in specific types of cancer, and who focus on a different aspect of care,
plays an important role in making sure that a person is getting the best
possible cancer care.
The best care is delivered by a team of Neurosurgeons, Radiation Oncologists,
Neuro-Oncologists, Neuropathologists, Neuroradiologists, and other supportive
specialists with expertise in treating brain tumor patients. The team
works together and routinely discusses aspects of a person’s care,
often in the setting of a “tumor board,” or multidisciplinary
conference where all aspects of a person’s case are discussed to
navigate challenges and formulate a treatment plan.
West Jefferson Medical Center, in conjunction with the LSU Brain Tumor
program, is at the forefront of brain tumor care in Louisiana. Our team
of specialists is one of very few in the state, and the first in the region,
to include a fellowship trained Neuro-Oncologist, or doctor specifically
trained in the management of brain tumors, at the heart of the team.
We are the only program in the state to have the ability to utilize intraoperative
MRI or the use of innovative compounds like “5-ALA” to optimize
brain tumor surgery and insure the most complete removal of some tumor types.
We are also one of the few centers who offer patients the broadest opportunity
to incorporate international clinical trial options in their care.
“The good physician treats the disease; the great physician treats
the patient who has the disease.” – William Osler
