Learn more about brain tumors from neuro-oncologist Alyx Porter, M.D.
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Alyx Porter, M.D., Neurosurgeon, Mayo Clinic. I'm Dr. Alyx Porter, a neuro-oncologist at Mayo Clinic. In this video, we'll cover the basics of brain tumors: What is a brain tumor? Who gets it? The symptoms, diagnosis and treatment. Whether you're looking for answers for yourself or someone you love, we are here to give you the best information available. First, let's talk about what a brain tumor is. DNA tells our cells what to do. Sometimes this DNA mutates and tells cells to duplicate abnormally, dividing rapidly and living longer than healthy cells are supposed to. These cells collect into a mass, in this case, in various parts of the brain. And since the brain is the control center for the rest of our bodies, this can affect all kinds of other functions. There are many kinds of brain tumors. Some are benign or non-cancerous. In other words, it's an overgrowth of cells that produces a mass. But the cells themselves are normal. Some are malignant or cancerous. This means the mass is composed of abnormal cells that will continue to spread and invade to other tissues. Tumors that originate in the brain or surrounding tissues are known as primary brain tumors. More often, the tumor is known as a secondary or metastatic brain tumor - the result of cancer from elsewhere in the body that is spread to the brain.
Who gets it?
We often just don't know why primary brain tumors form. Statistically, in adults, age increases your risk of having a primary brain tumor. And they are more common in women than men. Exposure to some kinds of radiation, including prior cancer treatment, can increase your risk. And there are some rare inherited syndromes that seem related to brain tumor development. But they're not really predictable nor preventable. When it comes to secondary tumors, we know that they spread from cancer in other parts of the body. And the cause of that original cancer, depending on where it started, could have resulted from genetic or external factors. It's not common, but sometimes a brain tumor can be the first indication of cancer elsewhere.
What are the symptoms?
Usually, the first sign of a brain tumor is a headache, generally in conjunction with other symptoms. These may include: seizures, difficulty thinking or speaking, changes in personality, anxiety, depression, disorientation, fatigue, abnormal eye movements, numbness or tingling on one side of the body, weakness on one side of the body, loss of balance, vision changes, memory loss, nausea, generalized pain, trouble swallowing, trouble walking, drooping on one side of the face, loss of appetite, weight loss, and slurred speech. That doesn't mean if you have a headache or even a headache with these other symptoms that you have a brain tumor. But if you notice a headache that awakens you from sleep, that seems to be at its worst in the early morning hours, along with dimming of your vision, this could be a sign of increased intracranial pressure. And you should make an appointment with your doctor.
How is it diagnosed?
There are a variety of tests and procedures your doctor may recommend for determining the cause of your symptoms. First, you will most likely be given a neurological examination. This will evaluate your vision, hearing, balance, coordination, strength, sensation, and reflexes. They may recommend imaging tests, such as an MRI, a CAT scan or a PET scan, to get a clearer picture of the brain. If a tumor is detected, a surgical procedure may be done to determine the nature of the mass or its type.
How is it treated?
Although a brain tumor diagnosis can be overwhelming and scary, know that there are experts in the field who will work with you to figure out the best strategic course for your individual situation. So the most important thing you can do is to find a specialized treatment center that feels like a good fit and get a second opinion or even a third. It's important to feel confident in your care team and their support as you fight this battle together. Treatment depends on a lot of factors: the type, size, and location of the tumor, as well as your overall health and personal preferences. You and your care team will collaborate to map a course for the best quality of life ahead. If the tumor is in a place where removal is a viable option, surgery may be recommended to take out as much of the mass as possible. Even if the entire thing can't be removed safely, eliminating a portion can help alleviate symptoms. Another possibility is radiation. There are a few different forms of delivery, but all use high-energy radiation to target and destroy cancerous cells. There's chemotherapy, in which powerful drugs that combat cancer cells are taken either orally or through an IV. For certain kinds of cancer, targeted drug therapy may also be an option. These block specific abnormalities within the cancer cells, causing them to die. You may qualify for clinical trials as well, for experimental measures that are showing promise. Your doctors can help guide you and recommend to you if this seems like the best plan of action. All of these treatments have side effects - some quite severe. These can include issues with memory and thinking, motor skills, vision, and speech, as well as other physical or emotional symptoms. Your doctors can recommend a course of supportive and palliative care to help you get through the treatment itself. In addition, physical therapy, speech therapy, occupational therapy, and, in children, tutoring may be necessary.
When preparing for appointments, make sure you are aware of any pre-appointment restrictions, such as diet. Write down your symptoms - even things that may seem unrelated. Write down any recent life changes or major stressors. Make a list of your medications and any other supplements. Write down the questions you have and bring a friend or relative along with you to help you remember what your doctors say. While each person's prognosis and treatment can differ greatly, huge strides have been made in the field overall. And our understanding continues to grow, giving your expert medical team an ever-expanding set of tools to help you navigate this difficult journey as you maintain a manageable and positive quality of life. If you'd like to learn even more about brain tumors, watch our other related videos, or visit mayoclinic.org. We wish you well.