Brain; Women's Health

What women need to know about common benign brain tumors

Brain; Women's Health

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Severe headaches upon waking can be a symptom of a brain tumor.

Benign brain tumors are mysterious health occurrences that we can’t fully explain. Doctors sometimes discover these growths by happenstance: An imaging specialist might find a tumor while reviewing a patient’s images after a car accident, for example.

What’s more curious is that women are at increased risk compared to men for developing two types of benign brain tumors: meningiomas and pituitary adenomas. But we aren’t sure why that is the case, either.

One theory about why women develop more benign brain tumors is that women have higher levels of estrogen than men. When we test meningiomas, some have estrogen receptors, which means that the tumors can be fueled by estrogen. This could explain why some meningiomas grow during pregnancy when hormone levels are higher than normal.

While many unknowns remain, we have plenty of facts about benign brain tumors:

  • Women are more than twice as likely as men to develop meningiomas
  • Women are more likely to develop pituitary adenomas than men, but the difference is less dramatic
  • Lifestyle choices do not appear to affect a woman’s risk for either type of tumor
  • The majority of benign brain tumors do not appear to be genetic
  • The only known external risk factor is significant radiation exposure
  • Benign brain tumors – large and small – require medical care 

It’s important for women to realize that “not cancerous” does not mean “no treatment needed.” All known brain tumors should be evaluated by a neurosurgeon, and some may need to be removed. The recommended treatment will depend upon the patient’s symptoms, the size and location of the tumor, and the balance of risks vs. benefits of having surgery.

Common symptoms of benign brain tumors

Women with meningiomas often have headaches first thing in the morning. Some patients report that these headaches wake them from sleep. Meningiomas can also cause seizures. Any adult who has a new onset of severe headaches should see their primary care physician. A new onset seizure also warrants a trip to the emergency department.

Pituitary adenomas can cause changes in the pituitary gland, which can affect a woman’s menstrual cycle. These tumors also can cause loss of peripheral vision or blurry vision. Pituitary tumors also can cause changes in weight, energy levels, thirst, urination, and shoe size.

When a patient is referred to us, we discuss the severity of the symptoms and the impact on the patient’s daily life. We start the diagnostic process by ordering an MRI to verify the location of the tumor and then order a series of laboratory tests to better define the tumor. If the tumor is determined to be cancerous, we consult with the UT Southwestern neuro-oncology team to outline next steps. If the tumor is determined to be benign, we will discuss surgical and nonsurgical treatment options.

Treatment options for benign brain tumors

Nonsurgical treatments

If the tumor is small and not causing any symptoms or posing an immediate threat, we do not have to do surgery. We can monitor the tumor over time to ensure that it doesn’t grow or start to cause issues. This process is called active monitoring. It can continue for many years if the tumor remains stable in size and the patient does not develop new or worsening symptoms.

Surgical treatments

Large tumors or those that are putting pressure on critical areas of the brain – such as those that control motor function, speech, or vision – will have to be surgically removed. Today, surgeons have smaller tools and more precise techniques than ever before, resulting in faster recovery times.

We remove different tumor types in different ways:

  • Meningiomas: The surgeon will open the skull and remove the tumor, carefully avoiding healthy tissue and nerves. Then we close up the incision, and the surgery is complete.
  • Pituitary adenomas: We remove these tumors through the nose in a collaborative surgery. An otolaryngologist will chart a path through the nose, then the neurosurgeon will remove the tumor. There is no external incision made in this type of surgery.

If a benign tumor is in a part of the brain that is surgically inaccessible, we can treat it with focused radiation, such as Gamma Knife or CyberKnife. Similarly, if removing the tumor would do more harm than leaving it in, we might remove part of it and treat the remainder with radiation.
Approximately 5 percent of completely removed benign meningiomas will return within five years of surgery. We are currently researching the biology of these tumors, as well as new radiation approaches to treat this subset of patients with fewer radiation side effects. Preliminary research is encouraging, and we will continue to pursue the most effective and safest treatments.
Women who are diagnosed with benign brain tumors should discuss all of their options with a doctor before deciding on treatment. While today’s surgical techniques offer minimal incisions and quick recovery, not all patients will need surgery. However, all women with benign brain tumors require care from a neurosurgeon with specific expertise in these conditions.
To find out whether you or a loved one might benefit from a neurosurgical consultation, call 214-645-8300 or request an appointment online.