Brain Tumor Care

A brain tumor is an abnormal growth of tissue in the brain. It can be malignant or high-grade, low-grade, or benign.

Many brain tumors do not cause symptoms, especially in early stages. Other brain tumors may cause problems depending on where they grow and how large they are. Seizures and headaches that appear with other neurologic symptoms can be early signs.

Our specialists in Chicago and the surrounding area, including Oak Park, Oak Brook, Lisle and Aurora/Fox Valley, offer a full range of care options for these tumors. They provide advanced treatments, such as surgery, radiation and chemotherapy.

The Rush and RUSH MD Anderson Approach to Brain Tumor Care

Finding out you have a brain tumor can feel overwhelming. But having a team of experts in your corner will help you find out what steps you can take next.

Research suggests patients tend to fare better when they receive brain tumor treatment from many specialists in different fields working together.

Rush and RUSH MD Anderson Cancer Center bring together specialists in neuro-oncology, radiation oncology, neurosurgery and many others to ensure that you have high-level, effective care. They will work with you and each other to create a custom brain tumor treatment plan, from diagnosis to follow-up care, that aims to help you get back to your life.

Signs and Symptoms of Brain Tumors

Many brain tumors do not cause symptoms, especially if they are benign or in early stages. They are often found through scans for different issues, like migraines or other types of headaches.

Other brain tumors do cause symptoms. Seizures, headaches that don’t go away with usual treatments or medicine, and changes in vision or personality can be early signs of brain tumors. But these symptoms can appear with other conditions too, so it's important to see a physician for a diagnosis if you have them.

Make an appointment with your doctor if you have any of the following common brain tumor symptoms:

• Headaches (usually worse in the morning)
• Vomiting
• Changes in speech, vision or hearing
• Changes in mood, personality or ability to concentrate
• Problems balancing or walking
• Seizures

Types of Brain Tumors

Brain tumors are often categorized by the area of the brain or the types of cells in which they appear.

Types of brain tumors include the following:

• Metastatic brain tumor: This is the most common type of brain tumor that spreads to the brain from other primary cancers like breast cancer, lung cancer, kidney cancer or melanoma. Many people with cancer develop metastatic brain tumors.
• Craniopharyngioma: This is a benign tumor at the base of the brain that can be difficult to remove.
• Medulloblastoma: This is a rare, malignant brain tumor that is most common in children and young adults under age 25.
• Meningioma: This common adult brain tumor is usually benign.
• Pineal region tumor: This tumor grows near the pineal gland.
• Pituitary tumor: This is often a benign tumor on the pituitary gland, which produces hormones that control other glands in the body.
• Schwannoma (acoustic neuroma): This benign tumor can cause hearing loss, loss of balance or problems with weakness on one side of the face.
• Glioma: There are several types of gliomas. These tumors are grouped by where they grow or the types of glial cells from which they form.

Gliomas are also given grades based on how aggressive they are and how fast they grow. Physicians often refer to them as low-grade or high-grade.

Types of gliomas include the following:

• Astrocytoma: This tumor starts growing in star-shaped glial cells in the cerebrum or cerebellum. Glioblastoma is the most common and aggressive form of astrocytoma. It mostly appears in adults over age 50.
• Brain stem glioma: As the name suggests, this refers to any glioma that develops in the brain stem. It is also sometimes called diffuse infiltrating brain stem glioma, or DIPG, and it is usually an astrocytoma.
• Ependymoma: This tumor develops from ependymal cells, which line the ventricles in the brain and central canal of the spinal cord — passages that carry cerebrospinal fluid. Because of that, ependymomas can spread through cerebrospinal fluid but not outside of the brain or spinal cord.
• Oligodendroglioma: This type of glioma develops in cells called oligodendrocytes that form the protective myelin sheath around axons, which carry electrical signals from neurons.
• Optic pathway glioma: Often called OPG or optic nerve glioma, this slow-growing tumor forms in or around the optic nerve. It is a type of astrocytoma that mostly affects children and young people.

Brain Tumor Diagnosis and What to Expect During Evaluation

To make an accurate diagnosis, a specialist will first conduct a complete medical history. They will ask about your symptoms and when they first appeared, how severe they are and whether they’ve worsened over time. You may want to have a companion or someone close to you help you recall the details.

They’ll also perform a physical and neurological exam to rule out other causes of your symptoms. They may test your reflexes, muscle strength, eye movements, coordination and alertness.

Your physician may then use various other tests and imaging techniques to diagnose your condition. Some tests may require a fluid or tissue sample.

A few of the diagnostic tests they may order include the following:

• Computed tomography (CT) scan: One of the most common tests for brain tumors that uses a series of X-ray images.
• Lumbar puncture (spinal tap): A test to detect cancer cells in the cerebrospinal fluid that surrounds the brain and spinal cord.
• Magnetic resonance imaging (MRI): Another of the most common tests for brain tumors that creates 3D images of the brain to see abnormalities.
• MR spectroscopy: Tests that can be performed with an MRI scan that measure chemical differences in brain tissue.

Brain Tumor Treatment at Rush and RUSH MD Anderson

Brain tumors are often complex and require highly specialized treatment. These treatments may involve surgery, radiation, chemotherapy or other therapies, and care plans can even combine these therapies if needed.

Researchers are always developing new care options for brain tumors. Many of these cutting-edge treatments are only currently available through clinical trials. Your specialist can discuss whether you’re a good candidate for these new treatments. You can find more information on our Clinical Trials page.

Nonsurgical Brain Tumor Treatments

Some types of brain tumor treatments do not involve surgery. But many of these options are used along with surgery to ensure tumors are fully removed and do not grow back.

These nonsurgical therapies may use radiation or other methods to attack cancer cells directly, and your doctor may also prescribe supportive care to address the emotional and psychological aspects of health that can be affected by a brain tumor diagnosis.

Some nonsurgical brain tumor treatments include the following:

• Monitoring: Sometimes doctors will use a “wait-and-see" approach for tumors that are not cancerous or not growing quickly. They may recommend treatment later if the tumor grows and starts to cause issues.
• Radiation therapy: This is an option in many cases, especially when tumors are hard to safely remove with surgery. It works by focusing radiation through powerful beams that damage the DNA of tumors, which can slow or stop their growth. It can be used as a standalone treatment, or it can be combined with other therapies. For example, it may be used after surgery to prevent tumors from growing back.
  Some types of radiation therapy include the following:
  • Stereotactic radiosurgery (SRS): Using 3D imaging to guide treatment and planning, specialists focus high doses of radiation from many angles directly to the tumor. This is done very precisely to avoid exposing healthy tissue around the tumor to radiation. It usually only takes one to five treatments and is an outpatient procedure. That means patients go home the same day and get back to their normal activities within a few days. RUSH MD Anderson uses a medical linear accelerator (LINAC) to perform SRS, which is similar to Gamma Knife technology that other medical centers often use.
  • Intensity-modulated radiotherapy (IMRT): Like SRS, IMRT uses imaging and 3-D models to guide treatment. This lets specialists aim radiation beams in the precise shape of a tumor.
  • GammaTile: Rush was the first medical center in Chicago to offer this therapy. It is used after surgery removes as much tumor tissue as possible. The neurosurgeon then places titanium, radiation-emitting capsules enclosed in collagen, called GammaTiles, where the tumor was removed. They then close the incision, and the tiles emit targeted radiation doses over the next several weeks. This helps prevent or delay tumors from growing back. Eventually the collagen gets reabsorbed by the body, and the capsules become inert. A benefit of this treatment is that patients don’t need to come back to the hospital for radiation therapy.
  • Whole-brain radiation therapy (WBRT): Sometimes patients who have many brain tumors or leptomeningeal disease (LMD) need radiation therapy that targets the whole brain. It often involves coming in for many treatments over about two weeks.
  • Chemotherapy: Chemotherapy uses drugs to target the fast-growing cells that make up a tumor.
• Targeted therapy: This type of therapy, also called precision medicine or targeted drug treatment, involves drugs that can come in pill form or be delivered through an infusion intravenously. The drugs interfere with molecules that cancer cells need to multiply. These molecules are made by cancer-causing genes and cancer cells. Interfering with these molecules can slow or stop cancer growth.
• Immunotherapy: There are several medications, vaccines and other therapies that support the body’s own immune system, helping it fight off cancer. Some of these boost T-cells, which attack cancer, and others aid the immune system in identifying and responding to cancer cells.

Surgical Brain Tumor Treatments

Surgery for brain tumors relies on creating one or more incisions to directly remove tumors. It is a very common brain tumor treatment and may be used together with nonsurgical brain tumor treatments.

Your physician will work with you to determine whether you need surgery based on your individual case.

Neurosurgery involves very carefully removing tumor tissue without damaging surrounding tissue. Some of the techniques used by Rush and RUSH MD Anderson specialists include the following:

• Microsurgery: This relies on microscopes and precise tools to operate even in small blood vessels.
• Neuronavigation: Computer-assisted technology and imaging guide surgery within the skull and spinal column.
• Craniotomy: The most common surgery for brain tumors, this involves making an incision through the scalp and removing a piece of the skull to operate. It can be done under general anesthesia while a patient is asleep, or it can be done through a process called awake craniotomy where a patient remains conscious but cannot feel the surgery happening. This can help the neurosurgeon monitor the patient’s speech, senses and other brain functions in real time, making sure no critical structures are affected.
• Skull base surgery: For skull base tumors, including meningiomas, acoustic neuromas and sinus tumors, highly skilled skull base ENT surgeons and neurosurgeons can work together on care plans and use imaging and navigation tools to view tumors while they operate. Our skull base surgery team has been designated a Multidisciplinary Team of Distinction by the North American Skull Base Society, which means each patient has experts from many fields collaborating on their personalized treatment.

Second Opinion Services for Brain Tumor Patients

If you're looking to confirm your brain tumor diagnosis or fully explore all your potential treatment options, Rush and RUSH MD Anderson offer second opinion services for brain tumors. This is performed on a case-by-case basis.

To ask about a second opinion, call (312) CANCER-1, or (312) 226-2371. A care coordinator will answer your questions and help you set up any appointments you may need for evaluation. You can also learn more on our Getting a Second Opinion page.

Your physician may perform additional imaging techniques and tests to diagnose your condition and consult with other Rush and RUSH MD Anderson physicians on the best course of action.