Why Would I Be Referred to a Neuro-Oncologist?

Hearing that you need to see a neuro-oncologist can feel overwhelming. You may wonder what it means, what will happen next and why this specialist is part of your care team. Let me explain why your doctor might refer you to a neuro-oncologist and what to expect.

What Does a Neuro-Oncologist Do?

A neuro-oncologist is a doctor who treats tumors involving the brain, spine and nervous system. You might be referred to one if your imaging or symptoms suggest the presence of a mass in these areas. These masses can range from benign (non-cancerous) growths to malignant (cancerous) tumors. My goal is to provide compassionate, clear guidance to help you understand the next steps, whether you’re dealing with a benign meningioma or a complex glioblastoma (GBM).

Common Reasons for Referral

Here are some scenarios where seeing a neuro-oncologist is necessary:

• Benign Tumors: Not all brain or spinal tumors are cancerous. A common example is meningioma—a non-cancerous tumor that develops in the membranes surrounding the brain. Even though these tumors aren’t malignant, they can grow and press against your brain, causing symptoms that may need treatment.
• Malignant Tumors: Conditions like glioblastoma (GBM) require prompt attention. These aggressive tumors often involve a multidisciplinary approach, including surgery, radiation and chemotherapy.
• Uncertain Findings: If imaging reveals a mass but it’s unclear whether it’s benign or malignant, a neuro-oncologist evaluates the best diagnostic and treatment options.
• Management After Surgery: If you’ve already undergone surgery to remove a tumor, follow-up care may include radiation or chemotherapy overseen by a neuro-oncologist.
• Recurrent Tumors: If a tumor returns after treatment, neuro-oncologists determine the next steps to manage it effectively.

Treatment Approaches

The treatment plan depends on the type, size and location of the tumor. Here’s an overview:

Benign Tumors

• Surgery: The most common treatment to remove the tumor and relieve symptoms. Advanced tools help surgeons achieve precise removal while protecting important brain functions.
• Radiotherapy: Used when surgery isn’t possible or to target small areas of remaining tumor. Options like stereotactic radiosurgery (e.g., Gamma Knife) deliver radiation directly to the tumor.
• Medications:
  • Hormonal Therapy: For pituitary tumors that affect hormone levels.
  • Symptom Relief: Medications like anticonvulsants for seizures or steroids to reduce swelling.

Regular check-ups and imaging help monitor tumors for changes or regrowth.

Malignant Tumors

• Standard Treatments:
  • Surgery: Removing as much of the tumor as possible to ease symptoms and improve treatment outcomes.
  • Radiotherapy: Often combined with chemotherapy to slow tumor growth and target any remaining cancer cells.
  • Chemotherapy:
    • Temozolomide (TMZ): A widely used drug for treating malignant brain tumors.
    • Lomustine: Another option, though it requires careful monitoring for side effects.
  • Combination Treatments: Using multiple therapies together—like chemotherapy with radiation or targeted drugs with immunotherapy—can improve effectiveness and reduce resistance.

For tumors that can’t be surgically removed, treatments like targeted radiation or oral cancer medications are considered. Every decision is personalized to your specific case, ensuring you receive care that balances treatment effectiveness with your quality of life.

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Frequently Asked Questions

What happens during my first appointment? 

I’ll review your imaging and medical history, discuss symptoms and outline potential next steps. This may include additional diagnostic tests or consultations with other specialists.

Will I need surgery? 

Not every case requires surgery. If surgery is needed, I’ll explain the risks, benefits and alternatives tailored to your condition.

How long will the treatment take?

Treatment duration varies depending on the tumor type and the combination of therapies needed. Some treatments may span weeks, while others are ongoing.

Can a benign tumor become cancerous? 

While most benign tumors remain non-cancerous, certain rare cases can progress. Regular monitoring ensures we address any changes early.

What are the risks of not treating a tumor? 

Left untreated, even benign tumors can grow and cause complications by pressing on critical structures. Malignant tumors may spread or worsen. We’ll discuss the risks and benefits of treatment options in detail.

Why Would I Be Referred to a Neuro-Oncologist?

If you’ve been referred to a neuro-oncologist, know that you’re not alone. Let’s work together to create a treatment plan that fits your needs and ensures optimal outcomes.