How to Live with a Brain Tumor and When It Requires Surgery

Daniel Marcus';

By Daniel Marcus

Posted on February 28th, 2022 in News, Myths & Tips

Right now, 700,000 people in America live with a primary brain tumor, which can be of numerous types. Nearly 30% of brain tumors are cancerous, which is a sigh of relief for many patients.

However, even though a brain tumor is benign, it can still cause severe health complications that prevent the person from leading a normal life. There are over 120 types of brain tumors, but some are extremely rare.

Currently, brain tumors are the 10th leading cause of death for both men and women across the country.

A lot of people live with a brain tumor without knowing they have it, as they are asymptomatic. The brain tumor is usually discovered incidentally while the person undergoes a CT or MRI scan for another problem.

What Are the Most Common Brain Tumors?

By far, the most prevalent type of brain tumor is meningioma, which accounts for roughly 30% of cases. They originate in the meninges, the outer three layers of tissue covering and protecting the brain under the skull. Interestingly, women develop meningiomas more often than men. Approximately 85% of meningiomas are benign and grow slowly. Only in rare cases do they come back after treatment. The typical treatment for meningiomas is surgery, but when the patient cannot undergo it for safety reasons, radiation therapy can help to a great extent shrink the tumor. These are the two most common malignant types of brain tumors:

Glioblastoma

While this is the third most common brain tumor, it is actually the most common primary brain tumor, meaning it originates in the brain. Up to 15,000 new cases are diagnosed every year in the U.S. Sadly, glioblastomas are malignant tumors, and most patients survive only for 11 to 15 months following diagnosis.

Surgical resection, radiation therapy, and chemotherapy make up the treatment plan for glioblastoma, even though this brain tumor is very aggressive. The cause of glioblastoma is unknown, but some risk factors are a family history of brain tumors, radiation exposure, and age, as most people who develop it are between 45 and 65 years old.

Astrocytoma

Originating in the brain cells known as astrocytes, this is another type of cancerous brain tumor. Some astrocytomas grow slowly, whereas others develop rapidly and aggressively. According to the American Cancer Society, low-grade astrocytomas entail a survival rate of 68% in patients between 20 and 44 and one of 44% for patients between 45 and 54.

The treatment approach for astrocytoma always involves surgery and occasionally chemotherapy and radiation therapy. Astrocytomas make up approximately half of all primary brain and spinal cord tumors. They can occur in multiple parts of the brain, but they are often found in the cerebrum. Anyone can develop astrocytomas. However, they are more prevalent in adults.

Many people are unaware they have a brain tumor until it is incidentally found during a CT or MRI head scan. This is because a lot of individuals with brain tumors have no symptoms. Nevertheless, those who experience symptoms usually report frequent headaches, behavior changes, dizziness, loss of balance, vision changes, and difficulty thinking and speaking. If you experience these symptoms and do not know their cause, we strongly advise you to go to the doctor for a checkup. If you know you have a family history of brain tumors, it is also wise to undergo regular screening, as you may not feel like there is something wrong with you when there could actually be.

Living with a Brain Tumor

Unfortunately, some brain tumors, whether benign or malignant, cannot be cured by any treatment, and the most treatment can do is slow down the progression of the brain tumor. In such cases, the person will have to come to terms with the fact that their brain tumor might eventually cause their death. It is very difficult and overwhelming news to hear, so most doctors will try their best to choose their words prudently so as to not amplify the shock. Nonetheless, living years with a brain tumor is possible, particularly if it is benign since it does not spread to adjacent tissues and organs.

As for malignant tumors, when the patient is not a good candidate for surgery, their brain tumor will inevitably grow, slowly damaging their health and ability to function in their everyday life. The 5-year survival rate greatly depends on the age of the patient. For instance, people under 15 have a 75% survival rate, whereas adults have a survival rate of 36%. However, because each body is unique, there have been cases of patients documented in medical literature who lived a full life with a brain tumor and whose death was caused by something else entirely.

To improve your prognosis if you have just been diagnosed with a brain tumor, you may find the following useful:

  • seek a second opinion: cancer is still a mysterious disease, and there is a lot, medical experts do not know about brain tumors, so what your first doctor had not discovered regarding your brain tumor another might be able to, which could be a key thing that could prolong your life expectancy
  • look for alternative treatments: you may want to consider going abroad for new, experimental treatment, as it could work for you at least partially, or just try various alternative treatments in America, including participating in clinical trials
  • complement your treatment with a healthy diet and regular exercise: a sensible exercise program combined with a healthy diet can help you with fatigue, improve strength and mobility, and help your anxiety and depression

Receiving a brain tumor diagnosis is a life-altering event, and there is no right or wrong way to react to it. You should take your time to process it and the implications it will have on your life. Even if your brain tumor enters remission and disappears, you may be wondering whether it will return. The support that comes from your family and friends is essential, and if you feel misunderstood, attending cancer support groups in your area might help more than you expect.

What Influences the Prognosis of a Brain Tumor?

To determine what the most effective treatment for you is, as well as your prognosis, your doctor will assess the following factors, which are crucial in establishing whether you will have a good or poor prognosis:

  • tumor histology: while grade I tumors grow slowly, are unlikely to divide, and can often be cured by surgery, grade IV tumors involve cells that are dividing, thereby spreading to nearby areas
  • age: younger patients have more favorable prognoses than adults or the elderly
  • symptoms: surprisingly, having symptoms such as seizures is associated with a better prognosis
  • the extent of tumor residual: this refers to how much of the brain tumor has been removed via surgery and, if you see "gross total" on your medical records, it means that the entire mass has been resected, whereas if you see biopsy only, it means that only a small portion of it was taken out to be examined by a pathologist
  • tumor location: tumors can occur on nearly any part of the brain, and if yours is located in a region that is difficult to access, you will not be eligible for surgery, which might worsen your prognosis
  • molecular features: certain genetic mutations in the tumor can help determine prognosis
  • functional neurologic status: your doctor will assess how well you are able to function and perform everyday activities by using a functional assessment scale, which can range from normal to very sick and moribund, the latter meaning that hospitalization is necessary and fatal processes are progressing rapidly
  • metastatic spread: tumors that start in the brain or spinal cord, even if malignant, rarely spread to other parts of the body, but they may grow within the nervous system, so if a tumor spreads to other parts of the brain or spinal cord, this indicates a poor prognosis
  • recurrent tumors: a recurrent brain tumor comes back after successful treatment, and if it does return, you will undergo another round of tests to make sure it does not affect your prognosis

Therefore, your life expectancy will highly depend on these factors, which your doctor will carefully examine along with their medical team.

Who Can Undergo Surgery to Have a Brain Tumor Removed?

Surgery is the first treatment doctors consider for patients with brain tumors. The tumor and a portion of the surrounding healthy tissue are removed during the procedure. Surgery is often the only treatment necessary for low-grade brain tumors. Removing the brain tumor usually has numerous benefits, such as:

  • improving neurological symptoms
  • providing tissue for diagnosis and genetic analysis
  • helping make other brain tumor treatments more effective
  • improving the prognosis of the patient

Surgery to the brain requires the removal of part of the skull, which is known as a craniotomy. After the surgeon removes the brain tumor, the patient's bone will cover the opening in the skull. There have been plenty of innovative advances in surgery for brain tumors, including cortical mapping, enhanced imaging, and fluorescent dyes.

Curiously, for a brain tumor near the speech center, surgery will usually be performed while the patient is awake for part of the procedure. Typically, they are awakened once the surface of the brain is exposed. Subsequently, special electrical stimulation techniques are used to find the specific region of the brain that controls speech. This approach helps avoid causing damage while resecting the tumor.

Regrettably, surgery cannot be performed in some cases because the tumor is located in a place the surgeon cannot reach or is close to a vital structure. These brain tumors are known as inoperable or unresectable. If the tumor is inoperable, the doctor will recommend other treatment options, such as radiation therapy to keep the tumor as small as possible and prevent it from growing.