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Surgery, performed by a neurosurgeon, is the primary treatment for brain tumors. The goal is to remove as much of the tumor without causing severe damage to the surrounding brain tissue. Many benign tumors are treated by surgery alone, however most malignant brain tumors require additional treatment with chemotherapy or immunotherapy or enrollment in a clinical research trial.

The exact location of the tumor inside the brain, in relation to blood vessels and vital brain tissue, must be evaluated prior to surgery. This evaluation can be achieved by using a variety of tests including:

• CT scan
• MRI scan
• PET scan
• Angiography (making x-ray pictures of blood vessels)
• Intra-operative electocorticography (also known as brain mapping which helps the neurosurgeon identify the tumor margins)

Brain mapping, evoked potentials, functional MRI and intra-operative ultrasound imaging can improve the safety and effectiveness of the surgery.

During neurosurgery, the neurosurgeon may use a high-powered microscope to magnify the view of the surgical field. Endoscopic neurosurgery involves endoscopes - long, narrow, flexible tubes - that provide light and visual access to the tumor area. Stereotactic surgery relies on computers to create a three-dimensional image called steretaxy of the cancerous area. This technique is particularly helpful in reaching a tumor located deep within the brain or areas of the brain that are considered difficult to reach. Stereotactic surgery images help plan surgical procedures and radiation therapy. All these techniques and procedures are available at Carolinas Medical Center and Blumenthal Cancer Center.

CMC also offers a revolutionary new technology with the Novalis shaped-beam device, which is the most advanced approach to stereotactic radiosurgery and radiotherapy available today. CMC is the only hospital in the state of North Carolina to offer this leading-edge technology.

Brain tumor clinical research has developed rapidly at the Blumenthal Cancer Center. The center is currently involved in multiple Phase I, II, III protocols by both industry and large cooperative groups such as RTOG and SWOG.