Brain Cancer

What is brain cancer?

Brain cancer occurs when abnormal cells form in the brain and grow uncontrollably, forming a mass called a tumor. These tumors can be either benign (noncancerous) or malignant (cancerous). While benign tumors don't spread to other parts of the body, they can still cause problems by pressing on brain tissue. Malignant tumors, however, can grow rapidly, invade surrounding brain tissue, and sometimes spread to other parts of the central nervous system.

Brain tumors are relatively rare compared to other types of cancer. The American Cancer Society estimates that annually there will be around 25,000 cases of malignant tumors of the brain or spinal cord. It is important to note that these statistics can vary based on age, genetics, and environmental factors.

If you or a loved one has been diagnosed with brain cancer, we will be with you every step of the way. From your first evaluation through treatment and beyond, our focus is always each patient’s unique care.

The specialists at AHN Cancer Institute prioritize each patient’s treatment so that it can contribute to the best quality of life while receiving comprehensive, effective treatment. Our whole-person care approach includes robust services such as support groups, palliative care, and cancer genetics — a program that harnesses your genome to inform treatment.

AHN Neuro-Oncology Center of Excellence

Our experts in the AHN Neuro-Oncology Center of Excellence offer some of the newest, most innovative care for patients with benign and malignant brain tumors. We use the latest tools and procedures to make the diagnosis process as minimally invasive as possible. You can get numerous tests done on the same day and in one location to reduce your wait and travel time. With innovative treatment options, comprehensive care, and empathetic compassion, AHN is focused on you during this difficult and stressful time. Whether it’s answering your questions, guiding you to find support services, or simply listening to concerns, the care we offer isn’t just medica —  it’s for your whole health.

Why choose AHN for your brain cancer treatment?

Our highly experienced team of neuro-oncologists (brain cancer specialists) and neurosurgeons (brain surgeons) performs treatments that are only available at the very best hospitals in the country. By choosing AHN for your care, you will find:

• Improved survival rates: We use aggressive treatments while making sure you are feeling as well as you can. Helping you live a longer, more comfortable life is our priority.
• Advanced technology: Sophisticated tools, such as ChemoID®* and genome analysis, allow us to understand how the tumor will respond to different treatments before we prescribe them. Our goal is to tailor a unique treatment plan to your specific needs and find the one that will be most effective for you.
• Minimally invasive treatments: Many of our treatment options are outpatient procedures that involve a short recovery time. Instead of spending all your time in a hospital, you can live your life and enjoy your family and friends.
• A collaborative approach: We discuss all our patients in a weekly meeting with our brain cancer experts. You benefit from the combined experience of a team that includes neuro-oncologists, radiation oncologists, neurosurgeons, medical oncologists, and neuroradiologists. Because we are always up to date on your progress, we are able to give you the best possible care.
• Robust support: We invite all patients with brain cancer to join our weekly support group to share feelings, discuss symptoms, and help one another cope. It may help you feel better during treatment and experience an improved state of mind.
• Clinical trials: If you meet the eligibility requirements, you may be able to participate in an experimental clinical trial. You could gain access to a groundbreaking treatment before it is widely available. Learn more about our clinical trials program.

Quick guide to brain cancer

Brain cancer symptoms and signs

Brain cancer screening and diagnosis

Types and stages of brain cancer

Brain cancer treatment

Brain cancer FAQs

Contact us

Brain cancer symptoms and signs

The symptoms and signs of brain cancer can vary widely depending on the size, location, and rate of growth of the tumor. They are often caused by the tumor pressing on parts of the brain, affecting their function. Some general symptoms and signs of brain cancer that are often caused by the tumor’s pressure in the brain include:

• Headaches: These are often persistent and may become more frequent or severe over time. They might be worse in the morning.
• Nausea and vomiting: Especially if accompanied by headaches, and can be more severe in the morning.
• Seizures: This can be a first sign in some individuals, and can range from brief staring spells to full-blown convulsions.
• Changes in mental function or behavior: This can include personality changes, confusion, difficulty concentrating, memory problems, or altered judgment.
• Fatigue: Unusual or extreme tiredness that doesn't improve with rest.
• Weakness or numbness: On one side of the body (face, arm, or leg).
• Speech difficulties: Trouble speaking, understanding speech, or finding the right words (aphasia).
• Vision problems: Blurred vision, double vision, loss of peripheral vision, or sudden blindness in one eye.
• Hearing problems: Ringing in the ears or hearing loss. 
• Balance and coordination issues: Dizziness, clumsiness, difficulty walking, or loss of balance.
• Changes in sense of smell or taste: A rarer symptom, but these sensory symptoms can cause altered or lessened smell or taste.
• Hormonal changes: If the tumor is near the pituitary gland, it can affect hormones, leading to issues like unexplained weight gain or loss, irregular periods, or problems with lactation.

Causes and risk factors

Understanding the causes and risk factors for brain cancer can be complex, as in many cases, the exact cause isn't definitively known. For most brain cancers, there isn't a single identifiable cause. Instead, they often arise from genetic mutations within brain cells that lead to uncontrolled growth. These mutations can happen spontaneously, or they might be influenced by a combination of genetic predisposition and environmental factors. Some risk factors for developing brain cancer that have been identified include:

• Age: The risk of most types of brain tumors increases with age, particularly in older adults. However, some types, like certain pediatric brain tumors, are more common in children.
• Radiation exposure: Exposure to high-dose radiation, especially to the head, from previous cancer treatments (like for leukemia or certain head and neck cancers) is a known risk factor for developing a secondary brain tumor later in life.
• Weakened immune system: People with a weakened immune system, such as those with HIV/AIDS or organ transplant recipients taking immunosuppressants, have an increased risk of developing certain types of brain lymphomas.
• Family history and genetic syndromes: While most brain cancers are not hereditary, a small percentage are linked to inherited genetic syndromes that increase the risk of developing various cancers, including brain tumors. Examples include:
  • Neurofibromatosis type 1 and 2 (NF1, NF2): These can lead to tumors of the nervous system.
  • Li-Fraumeni syndrome: Increases risk of various cancers, including brain tumors.
  • Von Hippel-Lindau disease: Increases risk of tumors in various parts of the body, including the brain and spinal cord.
  • Tuberous sclerosis: Can cause benign tumors to grow in the brain and other organs.

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Brain cancer screening and diagnosis

At Allegheny Health Network Cancer Institute, our highly skilled neuropathology team (experts in nervous system disorders) uses the most advanced techniques to get you a swift and accurate diagnosis. The correct diagnosis helps us create a comprehensive, personalized treatment strategy designed for your specific needs.

In order to diagnose brain cancer, we first ask you about your symptoms. Common symptoms include severe headaches, feeling off balance, weakness on one side of the body, or having a seizure for the first time.

After a physical exam, we use diagnostic imaging tests, including:

• Computed tomography (CT) scan: A combination of X-rays and computer technology produces detailed images of the brain.
• Magnetic resonance imaging (MRI): Powerful magnets and radio waves give technicians a detailed picture of the head, brain, and spinal cord. MRI perfusion is also used as a diagnostic test for brain cancer. With this, MRI perfusion assesses blood flow within brain tissue, which can help differentiate between healthy tissue, tumors, and areas of necrosis. By identifying abnormal vascular patterns, it aids in diagnosing brain cancer, determining tumor grade, and monitoring treatment response.
• Magnetic resonance angiography (MRA): This special form of MRI allows us to look at the blood vessels in the brain.
• Magnetic resonance spectroscopy (MRS): This test is similar to an MRI but instead of providing an image of the brain, it measures radio wave interactions with different chemicals in the brain. It can detect some features of brain tumors that may not be detected on a traditional MRI.
• Positron emission tomography (PET) scan: For this test, we use a small, safe amount of radioactive material. Before the test, we inject a special radioactive sugar solution into your arm. A scanner captures images of your body. We can detect the tumor tissues because they absorb the sugar more than normal tissues do.

Diagnosing brain cancer: brain biopsy

Even though imaging tests can detect a brain tumor, they are unable to tell us the type of cancer and its stage (how severe it is). In order to tell us that information, a surgeon must perform a biopsy to collect the cancer cells so we can examine them under a microscope. There are two ways to do a brain biopsy.

Stereotactic (needle) biopsy

 For this minimally invasive outpatient procedure, we:

1. Give you a local anesthetic or general anesthesia, so you will not feel any pain.
2. Place your head into a rigid frame, to ensure the tumor is precisely targeted and that you don’t make any sudden movements during the procedure.
3.  Make a very small incision in the scalp and access the skull using specialized tools.
4. Use an MRI or CT scan to help guide a hollow needle into the tumor to remove small pieces of tissue.

Craniotomy (open biopsy)

If imaging tests show that the surgeon can remove the tumor with surgery, the neurosurgeon may not do a needle biopsy. Instead, the team removes all or most of the tumor during an operation. This surgery determines the presence of cancer, its stage, and serves as a treatment at the same time. You will stay at the hospital and be given general anesthesia for this procedure.

Once we grade and diagnose the tumor, you are ready to begin treatment. You meet with your entire care team within three days of diagnosis. At the Cancer Institute, we use leading-edge practices and technology.

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Types and stages of brain cancer

Brain cancers are broadly categorized into two main types: primary brain tumors and secondary (metastatic) brain tumors.

Primary brain tumors

These tumors are named based on the type of brain cell or tissue they develop from. The types of primary brain tumors include:

• Gliomas: These arise from glial cells (supportive cells in the brain). This is the most common type of primary malignant brain tumor. Glioma subtypes include:
  • Astrocytomas: Develop from astrocytes (star-shaped glial cells). Astrocytomas can range from low-grade to high-grade tumors.
  • Glioblastoma (GBM): Most aggressive and common astrocytoma in adults. Glioblastoma tumors can present as low- or high-grade tumors.
  • Neuroepithelial: These tumors are more common in younger adults, they are commonly benign, and often cause seizures.
  • Pilocytic astrocytoma: Often low-grade, common in children/young adults.
  • Oligodendrogliomas: Develop from oligodendrocytes (produce myelin). Usually slow-growing.
  • Ependymomas: Develop from ependymal cells (located in the spinal cord and brain ventricles). They are more common in children.
  • Brain stem gliomas: Form in the brainstem. Often challenging to treat due to location.
  • Meningiomas: Arise from the meninges (the membranes surrounding the brain and spinal cord). Most are benign (noncancerous) and slow-growing, but some can be atypical or malignant. They are common in women and older adults.
    
• Medulloblastomas: These tumors occur in the cerebellum (the part of the brain controlling balance and coordination). They are aggressive, fast-growing, and they are a common malignant brain tumor in children.
• Schwannomas (including Vestibular Schwannomas / Acoustic Neuromas): These tumors occur in the Schwann cells (these cells, which form a protective sheath around nerves). The tumors are usually benign. Vestibular schwannomas grow on the eighth cranial nerve, affecting hearing and balance.
• Craniopharyngiomas: Occurring in the pituitary gland and hypothalamus, these tumors are rare and usually benign. They can cause hormonal issues, vision changes, and headaches.
• Pituitary tumors (adenomas): Originating in the pituitary gland, most are benign and slow-growing. They can cause problems by pressure or excess hormone production.

Secondary brain tumors

Secondary brain tumors occur when cancer cells from another part of the body travel to the brain and form new tumors. They are much more common than primary brain tumors. The brain tumors are composed of the original cancer cells (e.g., metastatic lung cancer to the brain means lung cancer cells growing in the brain). Some of the most common cancers that can cause secondary brain tumors include:

• Brain
• Breast
• Lung
• Colon
• Melanoma

Brain tumor staging

Instead of staging, primary brain tumors are primarily categorized by their grade, which indicates how aggressive the tumor cells look under a microscope and how quickly they are likely to grow. The World Health Organization (WHO) grading system is most commonly used, typically ranging from grade 1 to grade 4. The WHO grading system includes:

• Grade 1 (least aggressive): Cells look almost normal, grow very slowly, and are often well-defined. They may be curable with surgery alone.
• Grade 2 (low-grade): Cells are somewhat abnormal, grow slowly, but can sometimes spread into nearby tissue and may recur after treatment. They have the potential to progress to a higher grade over time.
• Grade 3 (high-grade/anaplastic): Cells are clearly abnormal, grow actively, and spread into nearby brain tissue. These tumors are considered malignant.
• Grade 4 (most aggressive): Cells are highly abnormal, grow very rapidly, and easily spread into nearby brain tissue. These are the most malignant and life-threatening.

For secondary brain tumors, the staging actually refers to the original cancer elsewhere in the body. For example, if someone has metastatic lung cancer to the brain, their stage would be determined by the stage of their lung cancer, which usually means it's advanced (stage 4) because it has spread. The number and size of the brain metastases are then described as part of the overall disease burden but aren't given a separate brain tumor stage.

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Brain cancer treatment

At the Cancer Institute, we develop a comprehensive and customized treatment plan to meet the individual needs of each patient. Treating brain cancer usually requires a combination of different modalities including surgery, radiation therapy, chemotherapy, and clinical trials.

Surgery

The first step in brain cancer treatment is for the neurosurgeon to remove as much of the tumor as is safe without affecting normal brain function. We always aim for the most minimally invasive surgical procedure possible.

GammaTile Brachytherapy^®

Our surgeons were the first center in Pennsylvania to implant radiation tiles at the end of a brain tumor resection. GammaTile Brachytherapy^{® **} allows patients to receive necessary radiation treatment to their brain tumor while recovering surgery, sometimes minimizing the need to travel back to the hospital for postoperative radiation.

Gamma Knife^® Radiosurgery

We have one of the busiest radio-surgical programs in the country, treating over 300 patients a year with minimally invasive radiation therapy for benign and cancerous brain tumors. The Gamma Knife^{® ***} is a sophisticated form of stereotactic radiosurgery (SRS) that uses highly focused beams of radiation to target and treat tumors and other abnormalities in the brain.

Laser interstitial thermal therapy (LITT)

 The LITT procedure results in less pain and a faster recovery compared to traditional surgery. Here’s what you can usually expect:

1. We will give you general anesthesia, so you won’t feel any pain.
2. The neurosurgeon will use a specialized drill to make a tiny hole in the skull near the tumor.
3. With MRI guidance, the surgeon will maneuver a laser wire toward the cancerous area in the brain.
4. The wire will destroy the tumor cells using thermal heat.
5. The surgeon then removes the wire and will close the small open area with stitches.
   

Optune^® device

The Optune^®**** device is a noninvasive, FDA-approved therapy that slows the growth of brain cancer cells without harming the surrounding healthy tissue. The physician places electrodes on the scalp connected to a portable electric field generator, which delivers low-intensity electric fields targeted directly at the tumor.

The device must be used for 18 hours per day to see the best results. You can put the generator in a small bag or backpack and use it while you go about your normal activities.

Temozolomide (Temodar^®)

This chemotherapy drug, temozolomide (Temodar^®*****), is commonly used to stop or slow cell growth in certain types of brain tumors. It breaks DNA strands inside tumor cells, which slows or prevents their growth. You may experience side effects, such as constipation, nausea, and fatigue. Our team works with you to minimize side effects, while maximizing the effectiveness of the drug.

Advanced radiation therapies

We use advanced technologies to target the radiation beam directly to a tumor. This approach minimizes overall exposure and results in a more precise treatment and less harm to healthy tissue. The Cancer Institute is the only radiation oncology network accredited in western Pennsylvania by both the American Society for Radiation Oncology and American College of Radiology. These accreditations mean that our facilities meet specific guidelines for patient safety, quality control, and equipment performance.

Our radiation therapies all use advanced imaging to optimize the radiation dose and precisely target radiation beams to the tumor. Types of radiation therapies include:

• Intensity-modulated radiation therapy (IMRT)
• Volumetric arc radiotherapy (VMAT)
• 3D conformal external-beam radiation therapy (3DCRT)
  

We also pioneered an advanced radiation therapy technique here at AHN, called stereotactic radiosurgery (SRS). It has dramatically improved our ability to control the growth of tumors. This method delivers high, effective doses of radiation in as few as five treatments.

Clinical trials

You have access to a variety of promising active clinical trials right here. Clinical trials are studies designed to test the newest approaches to care. You may not have to travel for additional treatment options.

Rehabilitation after brain cancer treatment

We offer a wide range of rehabilitation options that will help you lead an active, full life after brain cancer treatment. Visit one of our 10 convenient locations. You can also request a home visit from a rehabilitation therapist through our Healthcare@Home service. Our rehabilitation program services include:

• Weekly support group
• Occupational therapy
• Physical therapy
• Speech and language therapy
• Pain management

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Brain cancer FAQs

At AHN, we want to provide you the necessary information and support to feel informed and educated on a brain cancer diagnosis. Your AHN care team is here to help answer your specific questions and talk with you about your options. To help you in your conversations, we’ve included answers to our patients most frequently asked questions. 

How long can you have brain cancer without knowing?

Some brain tumors grow very slowly and may not cause noticeable symptoms for months or even years. Others are fast-growing and aggressive, leading to symptoms that are more noticeable. The location of the tumor also plays a crucial role in how quickly symptoms may appear: a small tumor in a sensitive area might cause symptoms earlier than a larger tumor in a less sensitive region of the brain. Early symptoms can often be subtle and easily mistaken for other common ailments, further delaying diagnosis.

What is the survival rate for brain cancer?

The survival rate for brain cancer depends heavily on several factors, including the type of brain cancer, its grade (how aggressive it is), the patient's age and overall health, and how well the cancer responds to treatment. For primary brain and central nervous system tumors, the overall five-year survival rate is approximately 36%. However, this is an average, and rates can vary widely. For instance, some low-grade tumors have very high survival rates, while highly aggressive tumors like glioblastoma have much lower rates. 

Can you recover from a cancerous brain tumor?

Recovery from a cancerous brain tumor can be defined in various ways. For some types of brain cancer, particularly those that are low-grade and detected early, complete removal of the tumor and successful treatment can lead to a long period of remission, and in some cases, a cure. However, many cancerous brain tumors, especially high-grade ones, are challenging to cure completely due to their invasive nature. In these cases, treatment often focuses on controlling the tumor's growth, managing symptoms, and improving quality of life. Advances in surgery, radiation therapy, chemotherapy, and targeted therapies are continually improving outcomes for many patients.

What is the most aggressive brain cancer?

The most aggressive type of brain cancer is generally considered to be glioblastoma. It is a highly malignant, fast-growing tumor that arises from astrocytes, a type of glial cell in the brain. Glioblastoma is known for its rapid progression, tendency to invade surrounding healthy brain tissue, and resistance to standard treatments. Despite aggressive treatment including surgery, radiation, and chemotherapy, the prognosis for glioblastoma remains challenging. Researchers are actively working on new therapies to combat this aggressive form of cancer.

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Contact us

To schedule an appointment or learn more about AHN neuroscience services, call 412-359-6200 in Pittsburgh or 814-452-7575 in Erie.

Second opinions

If you want a second opinion regarding a cancer diagnosis, treatment options, or prognosis, our team of oncology specialists can review your medical records at AHN. To get started, fill out our Second Opinion Request form. Our Navigation Team will contact you within the next 24 – 48 hours to discuss next steps and schedule.

Our locations

Visit our locations page to find a Cancer Institute location near you.

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