Glioblastoma and Other Primary Brain Cancers

Primary brain tumors are those that begin in the brain. These can be non-cancerous (benign) or cancerous (malignant). Sometimes cancerous tumors can spread to the brain from another part of the body -- these are called secondary or metastatic brain tumors and often require a different treatment approach.

Types of Primary Brain Tumors We Treat 
We treat all types of primary brain tumors, including these most common types:

• Glioblastomas
• Astrocytomas
• Embryonal tumors
• Ependymal tumors / Ependymomas
• Lymphomas
• Meningiomas
• Nerve sheath tumors
• Oligodendrogliomas
• Pituitary tumors

We conduct a series of comprehensive tests to properly diagnose your primary brain tumor and develop a customized treatment plan. Most tests can be performed on the same day.

Neurological Exam
This exam assesses your speech, hearing, balance, strength, sensation, coordination, reflexes, vision, swallowing, and ability to think and remember.

Head or Brain CT, MRI, PET, Angiography
These tests create images that help detect and diagnose your type of brain tumor.

Biopsy
A small sample of the tumor may be removed to refine your diagnosis and determine its grade (which indicates how quickly it’s growing).

Surgery
A neurosurgeon may be able to remove your brain tumor by performing a craniotomy surgery. During this procedure, a small portion of bone is removed to create a temporary opening in the skull. After the neurosurgeon removes the tumor, the bone segment is replaced. 

Our surgeons are experienced in removing primary brain tumors and can often operate on people who were told their tumor was inoperable. They may also be able to remove additional portions of tumors in people who underwent surgery at another hospital.

Radiation Therapy
Image-guided radiation therapy targets a cancerous tumor while preserving your healthy brain tissue. Our radiation oncologists use MRI, CT, and other imaging scans to find the precise location of the tumor and focus X-rays directly on it. Stereotactic radiosurgery uses 3D imaging to target and deliver a focused, high-dose of radiation to a well-defined tumor in a short amount of time.

Chemotherapy
Oral drugs or injections can kill additional cancer cells -- especially for aggressive tumors -- after surgery and radiation therapy. Chemotherapy may also be combined with targeted therapies to battle malignant brain tumors.

Immunotherapies 
New immunotherapies -- including viruses, immunotoxins, vaccines, and others -- that target and kill tumor cells and/or generate an immune response against brain tumors were co-developed at Duke. As a Duke patient, you may be eligible to participate in clinical trials evaluating innovative therapies like these to treat brain tumors.

Focused Ultrasound
Focused ultrasound uses MRI guidance to target your brain tumor with thousands of sound beams. This opens up the blood-brain barrier (which separates circulating blood from the brain itself), making it easier to deliver treatment to the tumor and monitor it without having to do a biopsy. Focused ultrasound does not require any incisions or general anesthesia, so recovery from this outpatient procedure is minimal.

Laser Interstitial Thermal Therapy (LITT)
Some people may be eligible for LITT -- a minimally invasive surgical technique that requires a very small incision in the skull. Compared to a traditional craniotomy, this reduces bleeding, recovery time, and risk.

Supportive Care
We care about your overall health and quality of life while undergoing treatment for a brain tumor. Our team helps manage medications, control seizures, evaluate and manage mood-related issues, and address side effects from chemotherapy and radiation therapy.

Experience with All Types of Brain Tumors
Our brain tumor specialists treat thousands of people each year, many of which are new patients. We treat all types of brain tumors, including malignant brain tumors, meningiomas, and other benign brain tumors. We take a personalized approach to each person’s care.

Recognized for Excellence
Our brain cancer specialists will work with you to determine which tests you need and decide on next steps for your care. Our nationally ranked cancer center has been designated as a Comprehensive Cancer Center by the National Cancer Institute. This recognizes Duke’s high care standards and continuing research to prevent, diagnose, and treat cancer.

Qualified Care Team
Our board-certified brain tumor specialists -- medical, radiation, and surgical oncologists; experts in neurosurgery, neurology, and neuro-oncology; radiologists; pathologists; geneticists; specially trained nurse practitioners and physician assistants; neuropsychologists; nutritionists; and social workers -- meet regularly to discuss each person’s case. We share knowledge and coordinate advanced surgical, medical, and follow-up care.

One Point of Contact
A dedicated nurse coordinator will be your main contact throughout your treatment and recovery. They can address any questions or concerns about your initial evaluation, surgical procedures, financial obligations, emotional needs, and dietary requirements.

Support for You and Your Family
Our comprehensive cancer support services range from helping you minimize the side effects of treatment to coping with the emotional and psychological effects of diagnosis and treatment.

Research Leaders
The Preston Robert Tisch Brain Tumor Center's robust research program is dedicated to improving outcomes for brain tumors. We helped develop multiple “vaccines” for people with brain tumors, including a genetically engineered poliovirus that fights cancer. We also played a pivotal role in introducing the drug bevacizumab to treat brain tumors. We continue to explore ways to selectively target tumors, tame fast-growing and drug-resistant tumors, and design new therapies to destroy cancer. Our researchers are also studying ways to manipulate the genes and proteins that fuel tumor growth.

Latest OR Technology
The use of intra-operative MRI (iMRI) in the operating room gives neurosurgeons access to MRI images while the patient is still in surgery. This helps confirm removal of all or as much of the tumor as possible. It also reduces the time and number of procedures required.

Remote, Written Second Opinions 
Get a written second opinion from a Duke Health specialist from the comfort of your home. A second opinion can confirm a diagnosis, offer a different diagnosis, provide information about the most advanced treatments available, and lend confidence to your treatment decisions. Learn more about our remote second opinion platform and process.