For Patients

Receiving the diagnosis of a brain tumor may be the most frightening news anyone can get. It’s only natural to begin learning all one can about brain tumors – causes, symptoms, treatments. We hope you will find some answers at the Wells Brain Tumor Center at UF.

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Understanding diagnosis

After diagnosis, one of the first things people do is research tumors.

Brain tumors are abnormal growths of cells located in the brain, or arising from the coverings of the brain. Tumors are generally separated into two categories: 1) primary brain tumors (those arriving within the head itself) or 2) metastatic tumors (tumors that spread from different areas of the body). If you know what type of tumor you or your loved one has, click below to read more about tumor types.

Tumor Grading

Once diagnosed with a brain tumor, many patients will undergo a biopsy or surgical removal of the tumor. The tissue is given to a pathologist for analysis and a formal diagnosis. The diagnosis usually involves giving the tumor a grade which is an indicator of how aggressive it will behave. Most grading scales for primary brain tumors go from I (least aggressive) to IV (most aggressive). Stage is not a part of characterizing primary brain tumors.

Alternatively, metastatic tumors are characterized by stage (how many organ systems the tumor has spread to). Once cancer has spread from an organ in the body to the brain it is usually considered stage IV cancer.

The prognosis for a particular tumor is usually dependent on the grade or stage, the genomic markers in the tumor, the age of the patient, and the patient’s ability to live independently. Treatment is often also based on these factors and can include biopsy, surgical removal, laser ablation, stereotactic radiosurgery (such as Gamma Knife), chemotherapy, proton beam radiation, photon radiation, immunotherapy, targeted small molecule inhibitors, and alternating electrical fields (Optune). All of these and more are offered at the UF Wells Brain Tumor Center. We will partner with you to ensure the best possible outcome for you and your loved one.

Primary Brain Tumor FACTS

Primary brain tumors include gliomas, meningiomas, pituitary or pineal gland tumors, medulloblastoma or PNET, schwannomas and others. We have experts in neurosurgery, neuro-oncology, radiation oncology, neurology, neuro-pathology, medical physics, computer guided surgery, ENT, endocrinology, plastic surgery, immunology, oncology, and psychology that work together to bring the most cutting edge treatment for these tumors.

Gliomas

These are tumors that include astrocytomas, oligodendroglioma, ependymoma and glioblastoma. They often infiltrate normal brain tissue. Having prior radiation exposure is a risk factor for developing a glioma. The first step of treatment is often surgical resection or biopsy or laser ablation. The pathologic diagnosis involves a grade (I-IV) and several genomic markers that are important for prognosis such as IDH1/2 mutation and MGMT methylation status. If a tumor has an IDH mutation, that confers a better prognosis. If a tumor has methylation of MGMT, their tumor is more sensitive to treatment with chemotherapy (temozolomide). Other genomic markers are also evaluated.  At UF, your treatment will be delivered by an interdisciplinary team that includes neurosurgery, neuro-oncology, radiation-oncology, psychology, social work, and immunology to ensure you have the best possible outcome and access to novel clinical trial options.

Meningiomas

These are tumors that arise from cells associated with the dura (covering around the brain). They are more common in women. They can be caused by prior radiation exposure. Meningiomas are characterized as Grade I (benign), II (atypical) or III (malignant). Depending on the size and location treatment can be just observation with serial MRI scans, surgical removal, stereotactic radiosurgery (SRS) or fractionated radiation with photons or proton beam. In rare cases, small molecule inhibitors such as somatostatin inhibitors can be used for cases in which other therapies have failed.   At UF, your treatment will be delivered by an interdisciplinary team that includes neurosurgery, neuro-oncology, radiation-oncology, psychology, social work, ENT, neuro-ophthalmology, and endocrinology, to ensure you have the best possible outcome and access to therapies not offered at community care locations.

Pituitary Tumors

Pituitary tumors can include a variety of tumors including adenomas, craniopharyngiomas, meningiomas, cysts and other more rare tumors. Management of patients with pituitary tumors requires an interdisciplinary team of neurosurgeons, ENT surgeons, endocrinologists, radiation oncologists, neuro-ophthalmologists, neuro-oncologists, social work and others. Pituitary tumors and treatment may affect the regulation of hormones and/or vision. Therefore, these factors are carefully considered when creating a treatment plan. Minimally invasive options with endoscopic techniques, radiosurgery and other novel approaches are pioneered here at UF.

Cerebellopontine angle (CPA) tumors including vestibular schwannomas

Tumors in the CPA region are often benign but can also include rare entities that may behave aggressively. Patients may present with hearing loss, ringing in the ear (tinnitus), facial numbness or weakness or swallowing problems. When these tumors are small, they may be treated with radiosurgery which is a one-time, outpatient dose of radiation which is curative. If the tumors are larger, then surgical resection is required. This is performed by neurosurgery in collaboration with ENT for the best possible outcome with special intraoperative monitoring to preserve the function of nerves that control facial movement and swallowing.

Call 352.273.6990 for a second opinion or for a medical evaluation.