What You Need to Know About Brain Tumors

Kowalska Agnes Kowalska, MD
Neurologist, Neuro-oncologist
Co-Director, Neuro-Oncology Center
Stony Brook University Cancer Center
Gutman Frederick Gutman, MD
Co-Director, Neuro-Oncology Center
Stony Brook University Cancer Center

The Stony Brook Neuro-Oncology Center is led by Dr. Agnes Kowalska, one of the few neurologists in the country who is board certified in both neurology and neuro-oncology, and Dr. Frederick Gutman, a neurosurgeon with expertise in treating the broad range of brain tumors.

What is a brain tumor?
Dr. Kowalska:
A brain tumor is an abnormal growth of tissue in the brain. When the tumor originates in the brain, it is called a primary brain tumor. When it comes from another part of the body and travels to the brain, it is called a metastatic or secondary tumor. Brain tumors can be either benign (noncancerous) or malignant (cancerous), depending on their cell growth.

What causes brain tumors?
Dr. Gutman:
The majority of brain tumors are the result of gene abnormalities that cause uncontrolled cell growth. Patients with certain genetic conditions also have an increased risk of developing tumors of the central nervous system. There have also been some reports of people in the same family developing brain tumors who do not have any of these genetic syndromes.

What are the symptoms?
Dr. Kowalska:
Symptoms vary depending on the size and location of the tumor. Many symptoms are related to an increase in pressure in and around the brain. The most common symptoms include:
• Headache
• Seizure
• Nausea
• Vomiting (usually in the morning)
• Personality changes
• Irritability
• Drowsiness
• Depression
• Decrease in heart rate and breathing and, eventually, coma if not treated

How is a brain tumor diagnosed?
Dr. Kowalska:
In addition to a complete medical history and physical examination, a computed tomography scan (also called a CT or CAT scan)or magnetic resonance imaging (MRI) may be performed to evaluate your specific case. At Stony Brook, you may be a candidate for a simultaneous positron emission tomography (PET/MRI). Simultaneous PET/MRI can more accurately localize the tumor, which is ideal for surgical planning. And with PET/MRI, patients are exposed to much lower levels of radiation than with PET/CT. At Stony Brook, you may also undergo a scan and a biopsy where a cell sample is removed for analysis. And you may also see physicians from multiple specialties, including neurosurgery, neurology and radiation oncology. Together, they will map out a treatment plan tailored to your needs and best outcomes.

What is the treatment for brain tumors?
Dr. Gutman:
A treatment plan may include a combination of medication, surgery, radiation and chemotherapy. Radiation uses a form of targeted energy to destroy cancer cells. At Stony Brook, we offer stereotactic radiosurgery, which delivers a specialized, highly precise type of radiation to brain tumors during a noninvasive procedure. It is delivered using the latest Varian Edge radiosurgery system. It has high success rates with both benign and cancerous tumors and in patients with more than one tumor or condition. Minimally invasive procedures like these are based on image guidance and tiny incisions, and are often preferred to open surgeries, as they reduce pain, recovery time and the risk of infection and complication. At Stony Brook, we offer both approaches.

What’s the Stony Brook difference?
Dr. Kowalska:
The Neuro-Oncology Center at Stony Brook Medicine provides complete care for primary and metastatic brain tumors. Our collaborative approach involves experts from neurology, neurosurgery, pathology, medical oncology, radiation oncology and neuroradiology. And our chemotherapy suite offers the most advanced therapies. 
As an academic medical center, we also value research highly, as it contributes to advancements in the field and gives patients access to the most novel treatment options. For patients with malignant brain tumors, we offer clinical trials that are not offered anywhere else on Long Island. For information about our active brain tumor clinical trials, visit: bioinfo.osa.sunysb.edu/octs/listActiveTrialMedArea.jsp

To schedule an appointment with Dr. Kowalska in Neurology, call (631) 444-2599. To schedule an appointment with Dr. Gutman in Neurosurgery, call (631) 444-1213 (option1).

For more information about our Neuro-Oncology Center, visit neuro.stonybrookmedicine.edu.