When we hear the term „brain cancer,“ it’s commonly used in popular literature. However, in the field of neurosurgery, we no longer use the term „brain cancer“ and rarely find it in medical literature. Instead, we prefer the more precise term „brain tumor,“ specifying whether the tumor is benign or malignant. This distinction is especially important because even benign brain tumors can cause severe neurological impairments depending on their location. In this article, we will focus on the treatment of „brain tumors“ and clarify key concepts related to their diagnosis and management.

Understanding Brain Tumors: Primary vs. Secondary Tumors

Before we delve into the details of brain tumor treatment, it’s important to understand the difference between primary brain tumors and secondary (metastatic) tumors from other cancers.

Primary Brain Tumors

Primary brain tumors originate within the brain itself or in the structures surrounding the brain. These include:

• Gliomas
• Medulloblastomas
• Ependymomas
• Meningiomas
• Acoustic Neuromas (Schwannomas)

These tumors form directly in the brain tissue or in extracerebral structures, affecting the brain’s function.

Secondary Brain Tumors (Metastases from Other Cancers)

Secondary brain tumors, also known as metastases, are far more common than primary brain tumors. They occur when cancer from other parts of the body spreads to the brain. Metastatic brain involvement is ten times more frequent than primary brain tumors. These tumors can affect various brain structures, including cranial nerves and the meninges.

The Complexity of Brain Tumors: Benign vs. Malignant

While the term „benign brain tumors“ suggests non-cancerous growths, it’s important to understand that benign tumors in the brain can still pose significant risks. Even though these tumors are not malignant, their location can make them difficult or impossible to remove without damaging vital brain tissue. This can lead to serious disabilities, such as:

• Vision loss
• Hearing impairment
• Coordination issues
• Paralysis

Some benign tumors can also grow within the confined space of the skull, leading to increased pressure on the brain, neurological dysfunction, or even death, despite being benign in nature.

Causes of Neurological Deficits in Brain Tumors

Neurological deficits in brain tumor patients can result from various factors, including:

• Tumor infiltration into brain tissue and destruction
• Direct compression of surrounding brain tissues
• Increased intracranial pressure (due to the tumor occupying space within the skull)
• Bleeding inside or outside the tumor
• Brain edema (swelling)
• Obstruction of venous sinuses of the dura mater
• Impaired cerebrospinal fluid (CSF) drainage or absorption
• Disruption of arterial blood flow

The prognosis of brain tumor patients is influenced by many factors. In many cases, the location and the impact of the tumor are more important than whether the tumor is classified as benign or malignant. Tumors that develop blood vessels (common in malignant tumors) can lead to bleeding or clotting, while benign tumors tend to grow more slowly without causing obvious clinical symptoms until they reach significant size.

Clinical Presentation of Brain Tumors

Both primary and metastatic brain tumors can cause similar symptoms. These symptoms are often related to increased intracranial pressure, including:

• Headaches
• Changes in mental state or behavior
• Focal neurological symptoms (such as weakness, numbness, or difficulty speaking)

These symptoms can also occur in other neurological conditions, so accurate diagnosis is essential.

Diagnosis of Brain Tumors

To diagnose brain tumors, advanced imaging techniques such as MRI (Magnetic Resonance Imaging) with gadolinium contrast or CT (Computed Tomography) scans with contrast enhancement are typically used. These imaging tools help to visualize the tumor’s size, location, and effect on surrounding tissues. It’s important to note that symptoms of brain tumors can overlap with those of other intracranial conditions, including:

• Abscesses
• Aneurysms
• Arteriovenous malformations
• Intracerebral hemorrhages or hematomas
• Parasites cysts
• Ischemic strokes

Treatment of Brain Tumors in Germany

The treatment of brain tumors often begins with surgical removal of the tumor. However, surgery is not always an option, especially if the tumor is located in a critical area of the brain or is too close to vital structures. In such cases, surgical removal can be too risky and may result in significant neurological damage.

A multidisciplinary approach is often required, combining surgery with other treatments such as:

• Radiation therapy: Modern radiation techniques, including proton therapy, allow precise targeting of the tumor while minimizing damage to healthy brain tissue. This is particularly important for brain tumors, where protecting surrounding healthy structures is crucial.
• Chemotherapy: For malignant tumors, chemotherapy may be necessary to help shrink or eliminate the tumor. Chemotherapy is typically used in conjunction with radiation therapy to improve outcomes.

Pediatric Neurosurgery: A Special Focus

Pediatric neurosurgery holds a unique place within the field, integrating pediatric care, pediatric intensive care, pediatric anesthesia, and neurosurgery. Treating brain tumors in children requires specialized knowledge and careful management to ensure the best possible outcomes.

Successful Collaboration with Leading Neurosurgical Centers in Germany

For many years, we have successfully collaborated with one of Germany’s leading neurosurgical centers, the Nuremberg Clinic, renowned for its expertise in brain tumor treatments. This collaboration has allowed us to provide world-class care to our patients, combining advanced medical techniques with personalized care.

Conclusion: Brain Tumor Treatment in Germany

If you or a loved one is facing a brain tumor diagnosis, Germany offers cutting-edge medical expertise and world-class treatment options. With a focus on precision, safety, and a holistic approach to care, Germany’s leading neurosurgical centers are well-equipped to provide the best possible outcomes for both benign and malignant brain tumors.

We are here to help guide you through your treatment journey and are happy to assist in providing more information or arranging consultations with trusted medical professionals.