What You Need to Know About Brain Tumors

KowalskaAgnes Kowalska, MD
Neurologist, Neuro-Oncologist
Co-Director, Neuro-Oncology Center
MikellChuck Mikell, MD
Co-Director, Neuro-Oncology Center

Our 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. Charles Mikell, 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 a tumor originates in the brain, it’s called a primary  brain tumor. When it comes from another part of the body and travels to the brain, it’s 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. Mikell: The majority of brain tumors are the result of gene abnormalities that cause uncontrolled cell growth. People 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 don’t 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 (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. Mikell: At Stony Brook, we can often treat tumors declared inoperable or untreatable by other centers. We have a number of tools, including laser ablation, awake surgery, radiation and chemotherapy. We have high success rates with both benign and cancerous tumors and in patients with more than one tumor or condition. We also offer minimally invasive procedures with tiny incisions, such as laser ablation and endoscopic surgery, which can be better than open surgeries, as they reduce pain, recovery time and the risk of infection and complication. At Stony Brook, we offer flexible approaches for the best outcomes.

What’s the Stony Brook difference?
Dr. Kowalska: Our Neuro-Oncology Center 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 health center, we also value research highly. It contributes to advancements in the field and gives patients access to the most novel treatment options.
For people 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: bit.ly/sbclinicaltrials.

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

For more information, call (631) 4954-2323 or visit neuro.stonybrookmedicine.edu/centers/neuro-onco.