Brain Cancer: What to watch out for and other FAQs

You know the feeling: You have a headache coming on and do a quick web search to figure out what’s going on. One internet spiral later, and you’re convinced you have brain cancer — but what are the chances, really? Brain tumors are rare, scary and can be quite serious. Bakhtiar Yamini, MD, Interim Chief of Neurosurgery at the University of Chicago Medicine, shares some insights on what to watch out for, and when you should be concerned.

What are the symptoms of brain cancer?

Brain cancer is characterized by a malignant growth of cells in the brain or spinal cord. These malignant growths are called tumors, and the growth may spread to other areas of the brain. Some tumors are benign, meaning that they are not cancerous, but they can still cause problems in the brain.

Tumors in the brain and spinal cord can put pressure on brain tissue, induce swelling in the brain, and block the flow of cerebrospinal fluid (CSF), all of which can lead to increased intracranial pressure — pressure inside the skull. The location and nature of the tumor can influence its symptoms, as different regions of the brain control different behaviors and senses.

Increased intracranial pressure can cause symptoms such as:

• Headache
• Nausea and vomiting
• Vision changes and balance problems
• Personality and behavioral changes
• Difficulty thinking or speaking
• Seizures, drowsiness or coma

Most headaches are not caused by tumors, but headaches are one of the most common symptoms of a brain tumor. While most seizures are also not caused by brain tumors, seizures are experienced by up to half of all people with brain tumors, and often are the first warning sign that a tumor is present.

What causes brain cancer?

Usually the cause of brain cancer or a brain tumor is not clear. However, in some cases, individuals with a family history of brain tumors are more likely to have a brain tumor themselves. Individuals who are exposed to ionizing radiation (such as those used for radiation therapy for cancer and the radiation produced by atomic bombs) are also at increased risk of brain tumors.

Brain tumors can also be secondary to cancerous tumors elsewhere in the body, which may spread to the brain through cancer metastasis; in those cases, there may be underlying genetic predispositions or lifestyle choices that contribute to the development of the primary cancer.

Brain tumors cannot be caused by stress, and aside from radiation, there are no known lifestyle or environmental exposures that have been found to cause brain tumors.

What kinds of brain tumors are there?

There are many different kinds of malignant and benign brain tumors, depending on the location and cellular makeup of the tumors. These include:

• Astrocytoma
• Glioblastoma
• Medulloblastoma
• Meningioma
• Acoustic neuroma
• Oligodendroglioma
• Pituitary adenoma
• Choroid plexus papilloma

How are brain tumors diagnosed?

The first step is a neurological exam, where a doctor will check your vision and hearing as well as your balance, coordination and strength. These diagnostic tests can help narrow down what areas of your brain are affected by a tumor.

The next step may be an imaging test, such as an MRI (magnetic resonance imaging) or a CT scan (computerized tomography). These tests can allow doctors to identify possible tumors in the brain and develop a treatment plan. Doctors may also use imaging tests to look for possible cancerous tumors in other areas of the body, if they think the tumor is a sign of metastasis.

Finally, doctors may conduct a biopsy to collect a sample of the tumor tissue. This can be done with a very fine needle, or tissue may be collected as part of a larger surgery (such as a tumor removal). The biopsy sample can be examined in the laboratory and provides doctors with a great deal of information about the tumor type and prognosis, as well as informing treatment options.

Is brain cancer curable?

Whether or not a brain cancer is curable depends on the type of cancer and its location. If the cancer has not spread, some kinds of brain tumors can be cured by a complete surgical removal. However, brain tumors often reoccur.

Brain cancer can be treated in a variety of ways, including surgery to remove tumors, radiation therapy and chemotherapy to kill cancer cells, and targeted therapies to kill or block the cancer’s growth, depending on the tumor type. New therapies, such as immunotherapy, are also becoming available.

At UChicago Medicine’s Brain Tumor Center, a multidisciplinary team of neurosurgeons, neuro-oncologists, radiation oncologists, and hematologist/oncologists work together to provide the most effective, individualized treatment plans. As an academic medical center, our providers have access to leading-edge diagnostic technologies, such as minimally invasive biopsy tools, and innovative clinical trials to test new, personalized treatments for specific kinds of brain and spinal cord tumors.