When it comes to medical conditions, few diagnoses are more frightening than “cancer” and “brain tumor.” It can be difficult to understand just what a brain tumor is and how it can affect the body.
Here, James Snyder, D.O., a neuro-oncologist at Henry Ford Health, answers important questions about brain tumors, including treatment options and who may be at risk.
Q: What is a brain tumor?
Dr. Snyder: A brain tumor is a mass of abnormal cells that grow in the brain. Primary brain tumors start in the brain and do not typically spread to other parts of the body. Metastatic tumors are cancerous tumors that start in another part of the body and spread to the brain, most commonly from the lung, breast, colon, kidney or skin (melanoma).
The most common primary brain tumor is a meningioma. While typically non-cancerous, this type of tumor can cause serious issues depending on its location and behavior.
The World Health Organization (WHO) classifies primary brain tumors by grades. Grade 1 tumors are the least aggressive and are sometimes referred to as benign, whereas grade 4 tumors are the most aggressive (malignant) and are life threatening, even with treatment. Glioblastoma is a grade 4 malignant brain tumor. It’s also the most aggressive and common primary brain tumor adults are diagnosed with. While the overall survival rate is less than two years, every case is different. Through treatment, our goal is to give patients the longest, healthiest life possible.
Q: Does a brain tumor automatically indicate cancer?
Dr. Snyder: It truly depends. Primary brain tumors do not meet the classical definition of cancer because they don’t tend to spread to other parts of the body. That being said, if a patient has a grade 4 tumor, I often refer to it as cancer so that they understand that this is a malignant disease that behaves like advanced stage cancer.
Q: What treatment options are available?
Dr. Snyder: Treatment depends on the type of tumor. Whether it’s an aggressive tumor or not, the first step is typically surgery to determine what type of brain tumor it is. Most often the goal is to remove as much of the tumor as possible without causing harm to the patient. Depending on the type of tumor, patients may be treated with chemotherapy, radiation, clinical trials or a combination of these options. At Henry Ford, this recommended treatment plan is reviewed and agreed upon by a group of brain tumor-specialized doctors and nurses at what is known as a tumor board. If the tumor is benign, we may elect to just monitor it with imaging.
When it comes to surgery, we have many advanced technologies to operate on even the most difficult of tumors. The most common limiting factor for surgery is the impact of the tumor or surgery on areas of the brain that control important functions. Some of the unique tools we have at Henry Ford help our surgeons visualize critical brain connections so they can be protected. Brain tumors located on the brain stem, for example, are extremely dangerous. Think of your brain as a bundle of wires. The area where that bundle of wires comes together is the brain stem. There’s a lot of important information in that area. If those pathways are disrupted, it could result in severe damage.
Q: Can brain tumors be cured?
Dr. Snyder: Most of the malignant brain tumors do not currently have a cure, but we are working hard to change this. While this is a devastating disease, we do see some patients who have a brain tumor diagnosis with a two-year expected average survival rate and they’ve been living well for more than 10 years. There are several extremely promising new treatments for brain tumors that have researchers and doctors more excited and hopeful than ever before that we can find a cure.
Q: Do we know who is at risk for developing a brain tumor?
Dr. Snyder: We really cannot predict who is at risk for developing a brain tumor. While we know those who smoke are at greater risk of developing lung cancer, the same connections have not been identified for brain tumors. There are rare associations, such as patients who were treated with radiation therapy as children being at a greater risk. But association between something a patient does, an environmental factor or even a genetic predisposition (outside of a handful of rare syndromes) has not yet been shown.
Q: If I have a brain tumor, will my personality change?
Dr. Snyder: In most situations, we don’t recommend treatment options that would directly affect quality of life or cause changes in a patient’s personality. Our treatment solutions are meant to maximize quality of life so patients can continue to live their best lives for as long as possible. The symptoms of a tumor are very location specific. Many of the problems patients encounter with a brain tumor diagnosis are directly related to where in the brain the tumor has developed.
Q: Can you share advice for those who have brain tumors?
Dr. Snyder: Brain tumors are rare and complicated conditions. I recommend that those diagnosed with a brain tumor be treated — or at least meet with doctors — in a specialized multidisciplinary clinic dedicated to brain tumors. Beyond treatment, a specialized center may have resources and experience with caring for all the other concerns that come with a brain tumor, such as nutrition, counseling, family support and rehabilitation.
For any disease that does not have optimal treatment options or is incurable, I recommend participation in a clinical trial. This way, patients can contribute to finding new therapies for these devastating diseases and in the process possibly be treated with what may be the next breakthrough therapy.
Reviewed by Dr. James Snyder, a neurologist specializing in neuro-oncology at the Hermelin Brain Tumor Center. He sees patients at Henry Ford Hospital in Detroit and Henry Ford West Bloomfield Hospital.