Neuro-Oncology University of Washington Medical Center

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Treatment Strategies: Surgery Resection, the surgical removal of brain tumors, is recommended to relieve the pressure from the tumor and to provide tumor tissue, so a pathological diagnosis can be made. The tumor tissue can be analyzed under a microscope to determine what type of tumor it is. Further treatment recommendation will depend upon the type of the tumor and whether the tumor was completely removed or if any tumor cells remain after surgery. It is best to remove as much tumor as safely possible. This minimizes the number of remaining tumor cells, and maximizes the effectiveness of subsequent treatment. In some instances, tumors may be "inoperable" because of their location. In these cases, a small biopsy of these tumors may be done using x-ray guidance, (stereotactic biopsy). This procedure enables the physician to obtain a sample of the tumor tissue so that a diagnosis of the type of tumor and recommendation for further treatment can be made. In a some cases, even a biopsy of the tumor may be dangerous. In these instances, subsequent treatment is prescribed based on the appearance of the tumor on the scan and the most likely tumor type found in that area of the brain. Brain mapping is a technique that can be used during surgery to identify precisely where functions such as language and motor skills are located in the brain. Brain mapping has demonstrated that the anatomical areas for different functions of the brain are not located in the same places. By knowing exactly what areas of the brain are responsible for which functions in each individual, the surgeon can remove as much tumor as is safely possible. Methods have also been developed which assist the surgeon to more accurately localize the tumor and it's boundaries during surgery. These techniques include ultrasound, and more recently Stealth and the ISG wand. Your physician or nurse can describe these procedures in more detail and answer any questions you may have. Surgery: What to Expect Many patients who have a craniotomy, the surgical opening of the skull, for tumor removal can expect to be in the hospital for approximately 5 to 7 days. Prior to your surgery, you will meet with various physicians who will interview and examine you. You will need to have lab work done and possibly a new scan. You may need to receive high doses of anticonvulsant or steroid medications, and these may be administered intravenously. Following your surgery, you can expect to spend a period of time, perhaps 1 to 3 days in the intensive care unit where the nurses will be able to watch you closely. The rest of your hospital stay will be spent on the nursing unit while you progressively recuperate from your surgery. Again, the time you spend on any hospital units will vary depending on your situation. If the symptoms you had before surgery persist after surgery, for example weakness on one side or language problems, or if post surgical brain swelling (edema) has caused some temporary deficits, you can expect to spend additional time in the rehabilitation unit. Many patients are surprised at how little discomfort they experience from these surgeries and how quickly they recover.  Top of Page   |  Next Page