If you have experienced any neurological symptoms that concern you, tell your doctor about them. The doctor will probably perform a basic neurological exam, including:
If your doctor finds any cause for concern, you will probably have some imaging tests done to look for clues to the source of the symptoms. Those imaging tests typically include:
After the imaging tests, a surgical biopsy may be performed to help confirm a diagnosis if it appears that a tumor may be present. In this procedure, a neurosurgeon extracts a small sample of abnormal cells to test in a pathology laboratory. Depending on the location and type of tumor, a biopsy is not always possible. Often, if a tumor is large or causing pressure on part of the brain, the neurosurgeon will advise removing the entire tumor and performing a biopsy as part of that larger procedure.
An accurate diagnosis can be difficult, but pinpointing the exact type of tumor an individual helps the medical team create the most effective treatment plan. Once the tumor has been identified, your treatment plan may include:
Surgery: Surgery to remove a brain tumor (called resection) is usually possible, and depends on the location and type of tumor. A benign tumor can often be completely cured with resection surgery. Treatment of a malignant tumor usually includes surgery to remove as much of the tumor as possible. Since malignant tumors often intrude into healthy tissue, complete removal of all cancer cells may not possible, so the neurosurgeon will removes as much as possible without damaging nearby brain tissue and causing neurological damage. (See Surgery for Brain Tumors.)
Chemotherapy: The term chemotherapy is a general one that means the use of cancer-fighting medicines. It is given systemically (meaning to the whole body, not just to the site of the tumor) and may be a pill, an injection, or an IV drip. Chemotherapy may be used before surgery to help shrink a tumor, or as follow-up after surgery to kill off any cancer cells left behind. The challenge with chemotherapy for brain tumors is that the brain has a defense mechanism called the blood-brain barrier that protects the brain against toxins in the blood stream. Chemotherapy drugs are usually not able to cross the blood-brain barrier to attack the tumor itself. Researchers at Weill Cornell are currently testing new drugs, new ways of delivering those drugs, and a combination of the two, as strategies for fighting brain tumors.
Radiation: Precisely targeted beams of radiation can be an alternative to surgery, or radiation therapy can be used to kill cancer cells left behind after surgery. Radiation treatment plans may include multiple sessions over weeks or even months. For many cancers, radiation is the best treatment choice available, although it can have long-term side effects. A radiation oncologist will work with the other brain tumor specialists managing your care to be sure the treatment plan is the most effective option. Researchers at Weill Cornell are testing a treatment called brachytherapy where radioactive seeds are implanted during surgery and give off radiation after surgery is completed.
Other options may include steroid treatment to reduce swelling, or anti-epileptic medication to control seizures. Physical or occupational therapy or other rehabilitation may help a patient regain lost motor skills and muscle strength; speech, physical, and occupational therapists may be involved in the healthcare team.
Researchers are now investigating other treatments, including immunotherapy and gene therapy.
Patients who have been treated for a brain tumor will have ongoing follow-up visits to manage any effects of the treatments and to continue imaging to detect any regrowth of the tumor.
At Weill Cornell Medicine Neurological Surgery, our neurosurgeons are highly skilled in the most advanced minimally invasive procedures for treating brain tumors. Our relationship with top NewYork/Presbyterian Hospital allows our surgeons access to the very best facilities and specialists, as well as the most leading-edge research laboratories, to ensure that you gets the very best treatment available.
Reviewed by Rohan Ramakrishna, MD
Last reviewed/last updated: December 2020