Neuro-oncologist Alyx Porter, M.D., answers the most frequently asked questions about brain tumors.

I'm Dr. Alyx Porter, a neuro-oncologist at Mayo Clinic, and I'm here to answer some of the important questions you might have about brain tumors.

The reasons cancer can progress is far more complicated than the influence of dietary sugar. There have been studies in patients with high-grade glioma that showed that a ketogenic diet, which is low carb, high protein, high fat, may have a positive impact on survival. With a high protein, high fat combination, we know this may not be a healthy long-term strategy. And for many people, it's not palatable. The type of diet that has proven to have the highest health benefit is the Mediterranean diet - high in whole grains, seasonal fruit, vegetables, plant-based proteins, and fish or fish oils. This type of diet limits meat and processed foods, and has been proven to reduce systemic inflammation, which is widely beneficial for health overall, and is much more sustainable.

No. There are some brain tumors that are benign, non-cancerous and may be found by accident. Some of these tumors stay silent and don't require any intervention and don't cause symptoms. Other benign tumors may have the ability to grow and cause neurologic symptoms. While they don't cause mortality or death, they can be associated with neurologic morbidity or symptoms. These tumors may require surgery, radiation, or a combination of both.

A significant body of research has been dedicated to identifying the cause of both benign and malignant tumors. We know there are some genetic syndromes that are passed along in families that can promote tumor growth within the central nervous system. Otherwise, environmental exposures to ionizing radiation is one of the few known causes.

For malignant brain cancers, we have not yet identified a cure. For some benign and less aggressive tumors, cure may be achieved through surgical resection.

Palliative medicine is a specialty within medicine that focuses on alleviating symptom burden that individuals with serious illnesses endure. The role of the palliative medicine specialist on the treatment team is to help ensure the patient's quality of life is maximized during cancer treatment. Hospice is when treatment options have been exhausted and the patient is no longer well enough to withstand aggressive cancer therapy. Technically, an individual is appropriate for hospice if they have a disease that is likely to end their life within six months. Sometimes, patients outlive this period of time and start feeling better once the aggressive therapies have stopped. There is a spectrum of hospice care that ranges from episodic check-ins to full care in an inpatient setting.

The social worker is often part of our care team who can help patients and their families access the resources needed to promote independence and provide support where needed. Their role may range from making referrals for medical equipment to individual or family counseling.

There is a period of shock and grief that follows a brain tumor diagnosis that can be difficult to navigate. It's important that you trust your medical team. Getting a second opinion can be part of building that trust. Once you've established care, designating a friend or caregiver to help you stay organized with appointments and medications is critically important, as this journey can be overwhelming to navigate. It's important to update your healthcare directives regularly, so that your medical team and loved ones are clear about your wishes in the best and the worst case scenarios. In any successful partnership, communication is at the foundation. If it helps you, keep notes about how you feel or your questions that arise, so that you are certain to use the time with your medical team efficiently to ensure your needs are met. Never hesitate to ask your medical team any questions or concerns you have. Being informed makes all the difference. Thanks for your time and we wish you well.

July 18, 2022