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Listener Questions

Program: The ABC's for Primary Brain Tumors
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Andrew Schorr:

Welcome back. We've been getting some e mail questions from our listeners, and I want to pose some to Dr. Raizer. And then I'll also get some comments from Darren before he has to fly home. And I'm sure his family is listening and waiting, come on home, Daddy. Anyway here's a question I've often wondered about, Dr. Raizer. Angela from Denver writes in, well, what's the difference between a benign brain tumor and a malignant one?

Dr. Raizer:

So there are certain tumors like meningiomas which people have and they sort of grow off the covering of the brain, which the vast majority of them, probably 85 percent or so, are truly benign in that if you cut them out they often never come back. Now, occasionally they are in spots where you can't get them all out, and they certainly can cause neurologic problems in patients. But then we also have low grade tumors, which sometimes surgeons say they're benign, but they're not truly benign because most low grades over time eventually start to change, become more aggressive. So again it depends on what the cell type you're looking at is. There are some benign tumors in the brain that grow in the brain and most of those are in the pediatric patients, but really only the benign ones in adults are meningiomas that we typically see. Most of the other ones might be sort of low grade tumors, but even those we have to follow because they do change over time.

Andrew Schorr:

Now, some people have cancers, they're told it's inoperable. Does that mean they should give up hope?

Dr. Raizer:

Again, first of all, inoperable to one person is not necessarily inoperable to another person. So again this goes back to getting second opinions from people that do this all day long. So if a surgeon says, well, I can't operate on that, that doesn't mean there isn't another surgeon who is well versed in operating on tumors in that certain location. So I would also get a second opinion, and I've seen many patients where a surgeon says, well, that's not really operable and we actually operate on them.

And there's also patients where it truly is inoperable but sometimes after radiation therapy the tumor changes a little bit, and it actually then becomes operable because it sort of changes in its shape, allows the surgeon to now get into it and sort of clean it out. So it is kind of a moving target. But again I would always get a second opinion especially from people who do a lot of these surgeries because they're often much more comfortable in doing these procedures. And also we tend to be I think more aggressive because I think again somebody in the communities because certain of the tumors like the glioblastomas are very aggressive that some people often figure, well, they're bad tumors, and they're not as aggressive as they probably should be, and we know that the more you get out the better patients do.

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