Brain Tumors: Surgery

Surgery is a common treatment for many types of brain tumors. Surgery is often the first treatment. For some slow-growing tumors, it may be the only treatment needed. But for other brain tumors, surgery might be followed by other treatments. These may include radiation therapy or chemotherapy.

When may surgery be done?

Surgery may be done in some cases, such as:

• To try to remove the tumor fully, if possible

• To help relieve symptoms

• To remove a small piece of the tumor (biopsy) to see what type of tumor it is

• To place a small tube called a shunt into the area around the brain

A shunt helps the cerebrospinal fluid (CSF) flow out of the skull. This helps keep the pressure inside the skull at a normal level.

Types of surgery

There are several types of surgery for a brain tumor. The type of surgery done will depend on:

• What type of tumor it appears to be, based on imaging tests like MRI

• The size and location of the tumor

• Whether the tumor is causing pressure on vital areas of the brain

• Whether the neurosurgeon thinks the tumor can be removed fully   

In most cases, the neurosurgeon will need to remove a small piece of the skull to get to the brain tumor. This surgery is called a craniotomy. The piece of skull is replaced at the end of the surgery and held in place with small titanium plates and screws. You may be asleep through most of the surgery. You may need to be awake for part of the surgery if the surgeon needs to check the function of a part of the brain.

Brain tumors can be removed through surgery in several ways, such as:

• The surgeon may cut the tumor out with a scalpel or special surgical scissors.

• If the tumor is very soft, the surgeon might use a vacuum device to remove it.

• A special tool can be used to liquefy the tumor, after which it can be vacuumed out. 

• A laser may be used to kill cancer cells if a tumor is hard to reach with regular surgery.

The neurosurgeon will try to take out the whole tumor if possible. If the surgeon can’t remove all of the tumor without harming the brain, he or she will take out as much as possible. This is called debulking surgery. Reducing the size of a tumor through surgery can help lower the pressure on the brain and relieve some symptoms.