Brain Tumor

A "brain tumor" can mean many different things. Tumors that arise in the brain (primary) and tumors that spread to the brain from cancer elsewhere (metastatic) are managed very differently. Among primary tumors, meningiomas, gliomas, pituitary tumors, and many others each have their own behavior and treatment path.

What matters most is not the word "tumor" — it is the type, the location, and what the tumor is doing. Some are slow-growing and may never need treatment. Some are aggressive and need immediate action. Most fall somewhere in between, where the right move is a deliberate plan made with you.

Diagnosis starts with imaging — a contrast-enhanced MRI is the standard. Depending on what we see, additional imaging (MR spectroscopy, perfusion, or specialized sequences) may help characterize the lesion before any decision is made.

For symptomatic or progressive lesions, the next step is often a biopsy or surgical resection to confirm the pathology — knowing exactly what we are treating is essential before committing to a long treatment course.

Treatment is multidisciplinary. I work closely with medical oncology, radiation oncology, and pathology — and where appropriate, with referral centers — to assemble the right plan for your specific tumor.

Surgery is considered when a tissue diagnosis is needed, when mass effect is causing symptoms, when the tumor is in a resectable location, or when a maximal safe resection has been shown to improve outcomes for that tumor type.

The phrase that matters is 'maximal safe resection' — taking as much tumor as we can without injuring the functional brain around it. For tumors near speech, motor, or visual areas, we use awake mapping, intraoperative imaging, and stereotactic navigation to push that boundary as far as it can safely go.