It’s difficult to think of a health condition more ominous than a brain tumor. But while these tumors are challenging to treat, the outlook isn’t necessarily bleak. As advancements in brain surgery techniques and other therapies continue to evolve, there are more options for removing brain tumors, slowing tumor growth and preventing recurrence.

“No one knows what causes brain tumors; however, certain risk factors have emerged, such as having a family history of brain tumors and exposure to a type of radiation called ionizing radiation,” said Tsz Lau, M.D., board-certified neurosurgeon with Houston Methodist Neuroscience & Spine Center at Sugar Land who is also fellowship trained in skull base surgery, a subspecialty in neurosurgery that focusses on treating the most complex brain tumors. Like other tumors, brain tumors are either benign (noncancerous) or malignant (cancerous).

Benign brain tumors tend to grow slowly and usually don’t invade surrounding tissues. But because they can place pressure on sensitive areas of the brain and cause serious health problems, they may require treatment as well.

Malignant brain tumors have cancer cells and are considered life-threatening because they grow and invade healthy brain tissue. They may be either primary (tumor started in the brain) or secondary (tumor that spread to the brain). Most brain tumors are secondary, or metastatic, meaning that cancer cells migrated to the brain from cancer elsewhere in the body.

A range of symptoms may suggest a brain tumor, and symptoms vary depending on the location and size of a tumor. General signs and symptoms may include:

• Difficulty with balance or walking

• Gradual loss of sensation or movement in an arm or a leg

• Headaches that become more frequent and more severe

• Personality or behavior changes

• Seizures

• Speech difficulties

• Vision problems

These symptoms, however, are not sure signs of a brain tumor and may suggest other neurological disorders.

Doctors perform a neurological exam to check for alertness, balance, coordination and reflexes as well as vision, speech and hearing. Depending on the results, the patient may undergo one or more tests using computed tomography (CT), MRI, positron emission tomography (PET) or other types of brain scans. The only way to confirm a brain tumor diagnosis is with a biopsy, in which a sample of tissue is examined under a microscope.

Treatment for brain tumors is based on individual factors, such as age, overall health and medical history as well as characteristics of the tumor (type, location and size) and how likely the tumor is to spread or recur. Specialists in neurosurgery, medical oncology and radiation oncology all work together to create a customized treatment approach to combat brain tumors.

“Therapies may include surgery, radiation, chemotherapy or a combination of these treatments,” said Lau. “If a brain tumor can’t be removed through surgery because of its size or nearness to critical areas of the brain, other types of treatment can be used to shrink it or slow down tumor growth.”

Advanced treatments and therapies for brain tumors may include:

• Surgery using intraoperative MRI is performed to detect and remove as much of the tumor as possible.

• Radiation therapy uses X-rays, gamma rays or protons to destroy tumor tissue.

• Chemotherapy is taken by mouth, by injection or intravenously to attack cancer cells.

• Brachytherapy surgically places radiotherapy “seeds” after removing the tumor.

• Intraoperative chemotherapy involves surgically implanting biodegradable devices in the brain to release anticancer drugs.

• Targeted therapy uses drugs that specifically target the molecules or pathways involved in cell growth.

• Tumor-treating fields, using a wearable device, produce electric fields to disrupt cell growth.

Experts continue to explore new surgical techniques to remove tumors, new ways to target tumor destruction and new avenues to deliver anticancer drugs. “While it’s true that treating brain tumors requires aggressive action, the prognosis is often hopeful,” said Lau.

At Houston Methodist Neuroscience & Spine Center at Sugar Land, our specialists work together to diagnose, treat and manage a range of brain tumors and other neurological conditions. To request an appointment with Dr. Tsz Lau or another specialist with Houston Methodist Neuroscience & Spine Center at Sugar Land, visit houstonmethodist.org/neuro-sl or call 281.274.7979.