UBNS specializes in treating brain tumors in both children and adults. As with all tumors, early diagnosis and treatment is of the utmost importance.
Brain tumors compress and invade crucial brain structures as they grow, giving rise to progressive neurological disturbances. A brain tumor should be suspected whenever a patient presents with slowly evolving neurological signs and symptoms, particularly those itemized below:
- Intense headaches, often accompanied by nausea and vomiting or worse in the morning
- Seizures of recent onset, generalized or focal
- Personality changes, mental sluggishness or memory loss
- Visual complaints, such as blurred or double vision, or an enlarged blind spot
- Hearing loss
- Lack of coordination or localized physical weakness
- “Stroke-like” symptoms—particularly in the elderly
- Increasing head size (in children)
Sometimes, tumors may not become noticeable until after they bleed or when they reach a large size, often depending on their rate of growth.
Tumors that arise in the pituitary gland are very commonly benign in character. Nevertheless, they may cause serious neurological symptoms by compressing nerves that are critical for vision. In addition, invasion of local structures around the pituitary gland can make complete removal difficult or impossible.
Pituitary tumors can also affect the patient’s general physical well-being by altering the balance of hormones in the body. This can occur as a result of excessive production of certain hormones by the tumor itself or by compression of the normal gland by the tumor with resulting underproduction of pituitary hormones. This, in turn, can lead to overproduction or deficiencies in the production of hormones by the thyroid and adrenal glands, and by the ovaries and testes.
Some symptoms of a pituitary tumor include:
- Memory problems
- Diminished peripheral vision
- Severe fatigue
- Excessive thirst combined with frequent urination
- Weight gain or loss
- Milk production from the breasts when not pregnant
- Loss of normal menstrual periods
- Loss of sex drive
- High or low blood pressure
- Progressive coarsening of facial features
- Excessive sweating
- Steady increase in glove or shoe size
Pituitary tumors are best diagnosed using a MRI scan and specific blood tests of pituitary hormone levels.
Although medication can be used to treat certain pituitary tumors, surgery is frequently required. The typical pituitary tumor is removed by way of a “transphenoidal” operation. In this minimally invasive procedure, surgery is performed through one nostril using a microscope and without the need for any externally visible incisions. Certain other pituitary tumors may be treated with Gamma Knife radiosurgery or with conventional radiation therapy.
Gamma Knife Surgery
Gamma Knife stereotactic radiosurgery is a technique that utilizes 201 separate beams of gamma radiation energy, all precisely directed at a single point. The Gamma Knife is used to treat benign and malignant brain tumors, as well as other brain disorders. Gamma Knife radiosurgery combines modern methods in neuroradiology (MRI, CT and cerebral angiography) with sophisticated computer technology to localize and target brain lesions with gamma rays. The precise targeting of Gamma Knife radiation in a single large dose makes it as effective as conventional surgery for certain brain conditions, but with potentially fewer serious risks.
The Gamma Knife Center at Roswell Park is a major community-based resource for the application of state-of-the-art radiosurgery in Western New York. Treatment is provided by our neurosurgeons as well as radiation oncologists and neuroradiologists working together as part of UBNS’ multidisciplinary brain tumor team.
Brain tumor treatment is highly individualized. Although not appropriate for everyone, many patients benefit from having stereotactic radiosurgery as part of their overall treatment plan. The main tumor types that are potentially treatable with Gamma Knife stereotactic radiosurgery include:
- Metastatic brain tumor
- Pituitary tumors
- Skull Base Tumors
Skull Base Surgery
Skull base surgery is a specialized surgical technique that can be employed to treat benign and malignant tumors and cerebral aneurysms, repair fractures of the skull base, and to remove deep-seated infections of the skull base bone.
The base of the skull contains numerous critical structures because of its location between the brain and the rest of the body. Vital blood vessels and nerves pass through holes in the skull base, and damage to these can lead to blindness, deafness, loss of the ability to speak and swallow, paralysis, and death.
The basic concept of skull base surgery is to approach the offending tissue from underneath or from the side by removing specific areas of skull base bone. Thus, the tissue can be exposed and with little or no brain retraction. Skull base procedures are adaptable to the particular situation, and may be designed to traverse the bone containing the ear, low on the temple beneath the brain, around the eye, through the nose or paranasal sinuses (transsphenoidal approach), or from the neck. Fundamentally, these are minimally-invasive techniques designed to maximize the efficacy of the surgery while preserving neurological function to the greatest extent possible.