Surgery is typically the first treatment for brain tumors. It can help improve symptoms, aid in diagnosis, and improve a person’s outlook.
According to the American Cancer Society (ACS), an
This article explores how surgery helps treat brain cancer, its types, procedures, and risks.
Surgery is usually the
During surgery, a surgeon attempts to remove all, or as much, of the brain tumor as possible without damaging healthy brain tissue.
Removing or reducing the size of the brain tumor can help relieve symptoms caused by the pressure created by the tumor pressing on the brain.
Surgery may also help treat cancers, including brain cancer, in
- confirm a cancer diagnosis through biopsy and help doctors learn more about the type of cancer
- investigate the tumor’s size and spread to help with staging and treatment decisions
- treat low-grade or early-stage cancers
- “debulk” or reduce the size of the tumor, if removing it entirely is not possible to help make other cancer treatments more effective
- prevent cancer
- repair tissues damaged by the tumor removal
- insert a tube for drug delivery
There are a few different types of surgery that may be used for brain cancer. The surgery used may depend on the type, location, and size of the tumor.
Craniotomy involves the removal of part of the skull to have an opening where a doctor can operate on the brain and remove all or most of the tumor. After removing the tumor, the surgeon returns the bone and secures it with small metal brackets and stitches.
A person undergoes a craniotomy under general anesthesia, meaning they will be asleep and not feel anything.
A surgeon may use a scalpel, special scissors, or ultrasound to break up the tumor with a suction device to remove it, known as ultrasonic aspiration.
Aside from these, they may use different tools to aid in the removal of the tumor, including:
- A fluorescent dye — a person will take by mouth — highlights tumor cells and doctors use this with a special microscope to differentiate healthy cells from tumor cells.
- Cortical mapping helps doctors identify brain areas used for vital functions, such as motor skills, language, and sensation. Intraoperative language mapping is an example of this.
- Enhanced imaging devices, including image-guided surgery (IGS), help surgeons get an accurate map of the tumor’s location.
This is similar to a craniotomy, but a person stays awake during the surgery. A surgeon may suggest this procedure if the tumor is near the parts of the brain that controls essential brain functions, such as speech, senses, or movement.
A person will have a general anesthetic at the start of the operation, which a doctor reduces so that the person wakes up. The surgeon may also ask a person to do tasks during the surgery to check the functioning of different body parts.
Neuroendoscopy, or keyhole brain surgery, aims to remove all or part of tumors in the ventricles, the fluid-filled spaces in the brain.
A surgeon uses an endoscope, a long tube with a camera attached to an eyepiece, and a monitor.
The procedure involves making a small hole — called a burr hole — into the skull, where the surgeon inserts the endoscope. The surgeon uses small forceps at the end of the endoscope to remove the brain tumor.
Laser interstitial thermal therapy
Laser interstitial thermal therapy (LITT) is an
Endoscopic transsphenoidal surgery
This is a type of surgery for tumors at the base of the brain. This involves a surgeon inserting an endoscope through the nose and skull into the lower part of the brain.
A person may experience immediate side effects related to the surgery, which may include:
- lack of coordination and balance
- personality and behavior changes, including agitation
- speech problem
It is also possible to have long-term issues after brain surgery. This depends on which area of the brain may have damage. Long-term issues may include:
- difficulty walking
- speech problems
- memory and concentration difficulties
- behavior changes
Complications related to surgical intervention may
- fluid buildup in the brain (postoperative hydrocephalus)
- new neurological deficits
- lack of seizure control
- injuries to brain structures near the tumor, such as blood vessels and nerves
- brain swelling
Risk factors for surgical complications
A person’s overall health, age, and tumor position can influence surgical outcomes.
Younger patients who receive an early diagnosis and only have focal partial seizures typically have a
The following non-medical factors may affect surgical outcomes, according to a
- socioeconomic status
- type of hospital
- preoperative psychological status
- preoperative cognitive status
After surgery, a person goes to the recovery room, where the medical team monitors their status. A person may need to go to the intensive care unit (ICU) or neuro-critical care unit for immediate nursing care and observation.
A person may:
- receive frequent neurological checks
- have vital sign monitors, including a blood pressure cuff, oximeter, and ECG
- have a bandage on their head and dressing over the wound
- have several tubes in place, including a urinary catheter, a drain in the wound site, an intravenous (IV) line into an artery, and an intracranial pressure monitor
Medical staff typically remove surgical clips or stitches between 5–14 days after surgery.
The length of stay in the hospital after brain cancer surgery depends on the following:
- the type of surgery performed
- a person’s age and overall health
- location of the tumor in the brain
- presence of complications
A person’s medical team continues to check the person’s status to check for tumor recurrence. They will also help manage side effects and complications and monitor their health.
Follow-up care may include routine monitoring with physical exams and medical tests. A person may also need certain rehabilitation therapies to help them improve, including:
- speech therapy
- occupational therapy
- physical therapy
- neuropsychological testing
It is important for an individual to speak with their doctor about concerns they may have and follow all follow-up care instructions.
Many factors play a role in the effectiveness of surgery for brain cancer. An individual should discuss these factors with a doctor.
Brain cancer surgery is the initial treatment for many types of brain tumors. It can effectively remove the tumor, reduce intracranial pressure, and improve seizure control. It also carries certain risks, such as bleeding, fluid buildup in the brain, and new neurological problems.
Factors, such as age, overall health status, type of tumor, and location, may influence surgery outcomes. Follow-up care after surgery and rehabilitation therapies are also crucial for recovery and long-term health.