Primary brain tumor

Alternative names:

astrocytoma; brain tumor - primary; ependymoma; glioblastoma multiforme; glioma; medulloblastoma; meningioma; neuroglioma; oligodendroglioma

Treatment:

A primary brain tumor should have prompt treatment. Early treatment improves the chance of a good outcome for many tumors.

Treatment varies with the size and type of the tumor and the general health of the person. The goals of treatment may be cure of the disorder, relief of symptoms and improvement of function, or comfort.

Surgery is indicated for most primary brain tumors. Some may be completely excised (removed). Tumors that are deep, or that infiltrate brain tissue, may be debulked (removal of much of the mass of the tumor to reduce its size). Surgery may reduce intracranial pressure and relieve symptoms in cases when the tumor cannot be removed. Stereotactic (CT scan-guided) surgery may be helpful in removing deep tumors.

Radiation therapy may be advised for tumors that are sensitive to this treatment. Anticancer medications (chemotherapy) may be recommended.

Other medications may include:

• corticosteroids such as dexamethasone to reduce brain swelling
• osmotic diuretics such as urea or mannitol to reduce brain swelling (and associated increased intracranial pressure)
• anticonvulsants such as phenytoin to reduce seizures
• analgesics to control pain
• antacids or histamine blockers to control stress ulcers

Comfort measures, safety measures, physical therapy, occupational therapy, and other such steps may be required to improve quality of life. Counseling, support groups, and similar measures may be needed to help in coping with the disorder.

Legal advice may be helpful in formulating advanced directives, such as power of attorney, in cases where continued physical or intellectual decline is likely.

Support groups:

The stress of illness can often be helped by joining a support group where members share common experiences and problems. See cancer - support group.

Expectations (prognosis):

Prognosis and outcome vary.

Complications:

• brain herniation (often fatal)
  • uncal herniation
  • foramen magnum herniation

• permanent, progressive, profound neurologic losses
• loss of ability to interact
• loss of ability to function or care for self
• side effects of medications, including chemotherapy
• side effects of radiation treatments
• recurrence of tumor growth
• death

Calling your health care provider:

Call for an appointment with your health care provider if new, persistent headaches or other symptoms of primary brain tumor occur.

Call your health care provider or go to the emergency room if seizures develop or if there is the sudden development of stupor, vision changes, or speech changes.