Brain Tumors

OU Health provides comprehensive and multidisciplinary care for all brain tumor patients in Oklahoma, including cases at the highest levels of complexity. Our Oklahoma City care team integrates fellowship-trained neurosurgeons, neuro-oncologists, and ear, nose and throat (ENT) physicians to deliver individualized care and patient-centered treatment plans.

Types of Brain Tumors

The World Health Organization (WHO) recognizes more than 120 different types of tumors that can affect the central nervous system. These tumors are grouped using three main factors to help doctors better understand each type and choose the most effective treatment.

First, tumors are classified by where they start. Some are primary tumors, which begin in the brain or spine. Others are metastatic tumors, meaning they have spread to the brain or spine from another part of the body.

Second, tumors are described as benign or malignant. Benign tumors tend to grow more slowly and are often less immediately harmful. Malignant tumors are cancerous, can grow more quickly, and may have a greater impact on both life expectancy and quality of life.

Finally, tumors are sorted by their location within the central nervous system. Some grow within the brain or spinal cord (intra-axial tumors), while others develop outside these areas (extra-axial tumors) but may still put pressure on nearby structures. This location can affect how the tumor causes symptoms and how it is treated. The most common tumor types include:

• Brain metastases – These are the most common tumors affecting the brain and spinal cord. They occur when cancer from another part of the body such as the lung, breast, skin (melanoma), kidney, or colon spreads to the central nervous system. While some cancers are more likely to spread this way, many types can do so.
• Gliomas (including glioblastoma) – These are the most common tumors that begin in the brain itself. Gliomas include a range of tumor types some slower-growing, but many that are more aggressive. Surgery is often the first step in treatment, followed by radiation therapy and/or chemotherapy based on the specific diagnosis and results of surgery.
• Meningiomas – These are the most common noncancerous (benign) brain and spinal tumors. They form in the lining around the brain and spinal cord and may cause symptoms by pressing on nearby tissue. Meningiomas are more common in women and with increasing age. Small tumors that aren’t causing symptoms may simply be monitored over time with imaging. Larger or symptomatic tumors may be treated with surgery or, in some cases, a highly targeted form of radiation called stereotactic radiosurgery (Gamma Knife®).
• Pituitary adenomas – These benign tumors develop in the pituitary gland, located at the base of the brain. Many are found incidentally or because they affect vision, often causing “tunnel vision.” Some can affect hormone levels, leading to symptoms related to too much or too little hormone production. A subtype called prolactinomas often responds well to medication. Other pituitary tumors may be monitored or treated with surgery, most commonly using a minimally invasive approach through the nose. Care typically involves a team that includes neurosurgery, ear, nose and throat (ENT) specialists, and endocrinology.
• Vestibular schwannomas – These benign tumors grow on the nerve responsible for hearing and balance. They are located near the brainstem and can affect hearing, balance, or facial nerve function. Small tumors without symptoms may be monitored, while larger or growing tumors often require treatment, such as surgery or targeted radiation. Care is provided by a coordinated team that may include neurosurgery, ENT specialists, and radiation oncology.

What Are Common Brain Tumor Symptoms?

Brain tumors can affect the body in many different ways. Symptoms may happen when a tumor grows into nearby areas, presses on healthy tissue, or causes swelling in the brain or spine. Because of this, symptoms can vary widely. While many neurological symptoms can have other causes, some of the most common signs of a brain tumor include:

• Headaches, especially in the morning, or worsened with activities that use a lot of energy
• Nausea, especially together with a headache, which is relieved by vomiting
• Seizures, staring spells, or unexplained fainting episodes
• Cognitive changes including short-term memory loss or personality changes
• Weakness in the arms or legs
• Sensory changes in the arms or legs
• Facial pain, numbness, weakness, or stroke-like symptoms
• Difficulty with speech, or with understanding language
• Hearing or vision loss, especially unilateral
• Drowsiness, lethargy, or excessive daytime sleepiness
• Hormonal imbalance or dysregulation

Brain tumors can vary widely in how they affect each person, we take a team-based approach to diagnosis and care. This means specialists from different areas work together to fully understand your condition and create a care plan that’s right for you.

OU Health specializes in comprehensive care for all brain tumor patients, incorporating neurosurgery and neurology with a range of other specialists from otolaryngology, radiation oncology, medical oncology, endocrinology, ophthalmology, or physical therapy and rehabilitation, among many others.

Grading Brain Tumors

In addition to providing guidelines for diagnosing brain tumors, the WHO also specifies criteria for tumor grading, which provide insight regarding the aggressiveness of the disease which in turn often informs treatment recommendations. For all central nervous system tumors, the WHO grading system is a scale that goes from one to four and is typically written using the Roman numerals I, II, III, and IV, with higher grades indicating more aggressive tumors.

Low-grade tumors

Grade I and II tumors are classified as low grade, which means they typically grow more slowly and tend to have a better long-term outlook. In some cases, these tumors can be successfully treated with surgery. Even after treatment, regular follow-up with imaging is important especially for Grade II tumors, which have a higher chance of coming back over time. It’s also important to know that some low-grade tumors, particularly certain gliomas, can become more aggressive years after diagnosis.

High-grade tumors

Grade III and IV tumors are classified as high grade. These tumors are more aggressive, grow more quickly, and are considered cancerous. Treatment is often more complex and usually involves a combination of surgery, radiation therapy, and chemotherapy. While treatment can help control the disease, these tumors are more likely to return, and they can have a greater impact on both life expectancy and quality of life.

Why Diagnosis and Tumor Grading Matter

A tumor’s diagnosis and grade can only be determined by looking at cells from the tumor under a microscope, which is the role of a pathologist. This is why most patients need at least a biopsy, even if surgery is not part of the treatment plan.

Knowing the exact type and grade of a tumor helps your care team recommend the best treatment options and gives you and your loved ones a clearer understanding of what to expect moving forward.

Treatments for Brain Tumors

OU Health offers the full suite with state-of-the-art treatment options for all patients with central nervous system tumors. Individualization of treatment plans for every patient is a core value for our multidisciplinary care team, and recommendations will be established and refined during your initial consultations.

Although every tumor is different, the most common treatment strategies for patients with brain and spine tumors include neurosurgical resection, stereotactic radiosurgery, chemotherapy, or a combined approach. In some cases, closely monitoring the tumor may be the safest and most appropriate first step. Your care team may recommend a biopsy to better understand the tumor before deciding on treatment.

Along with the diagnosis, several other factors help guide a personalized treatment plan, including:

• Age
• Personal values, comfort with risk, and goals for care
• Overall health, including other major medical conditions
• Tumor size and observed or how it is growing now or may grow over time
• Tumor location and whether it is affecting nearby areas
• Any symptoms you’re experiencing from the tumor or related swelling
• Prior treatment history, especially if you’ve had cancer or other major health conditions before

Clinical Trials for Advanced Treatment

Although most initial treatment plans are built around a personalized standard-of-care protocol, OU Health also offers a wide variety of clinical trials that may qualify to participate in at some point during your clinical care. The Stephenson Cancer Center is the only National Cancer Institute (NCI)-certified treatment center in the state of Oklahoma, and a member of the NCI’s National Clinical Trials Network (NCTN). This provides early access to advanced therapies including novel drugs, devices, protocols, or other treatments before they are widely available.

Our program offers access to many national clinical trials for patients with brain and spinal cord tumors. At key points throughout you and your care team carefully reviews whether a clinical trial may be a good option for you so we can help ensure you have access to every possible treatment opportunity.

Your Expert Brain Tumor Team

At OU Health, you will receive care from a team of highly specialized experts who are national and international leaders in their field, working collaboratively to achieve the best possible outcomes for Oklahomans with central nervous system tumors. We pride ourselves on efficient diagnosis and treatment for brain tumors, integrated care models, and outcomes that meet or exceed national standards. Your care team will work tirelessly with a single shared goal to ensure that every patient receives the best possible care, as safely, effectively, and efficiently as possible.