Brain & CNS
Virginia Cancer Specialists offers specialized care and clinical resources for brain and central nervous system tumors, including diagnosis, treatment options, radiation therapy, clinical trials, and supportive services.
Disease Information
Use the sections below to review diagnosis, staging, and treatment information for each condition in one place.
What are brain tumors?
There are two major categories of brain tumors, primary brain tumors, which start in the brain, rarely spread outside the nervous system, and are more common in children and older adults, and metastatic brain tumors, which develop in other parts of the body (for example, breast, lung, skin), spread to the brain, and occur more often in adults than in children.
Tumors may either be benign or malignant. Benign tumors are noncancerous, but can still be dangerous as they can cause damage within the brain. Malignant tumors are cancerous and are more likely to spread.
Metastatic Tumors
- Gliomas are the most common class of primary brain tumor.
- Astrocytomas are the most common type of glioma.
- Ependymomas develop in the hollow cavities.
- Oligodendrogliomas originate in the cells.
Non-Glial Brain Tumors
- Craniopharyngiomas develop in the pituitary gland.
- Meningiomas occur in the membranes.
- Pineal tumors are found near the center.
There are many types of brain tumors that are named based on the type of brain cells they originated from. Most primary brain tumors begin from glial cells in the brain and are called gliomas. One type of glioma is an astrocytoma, which can be any grade. Grade I-II astrocytomas are often called a low grade glioma. A grade III astrocytoma is sometimes called an anaplastic astrocytoma, while a grade IV may be called a glioblastoma.
Meningiomas are tumors that arise from the brain’s meninges and can be grade I-III, though are usually grade I and tend to grow slowly. Oligodenrogliomas come from the cells that surround and protect nerves. These can be Grade II–III.
How are brain tumors classified?
Brain tumors are classified in two main ways: by grade (how the tumor cells look and behave) and by type (the kind of cells the tumor originated from).
Classification of Brain Tumors by Grade (Grades I–IV)
Brain tumors are assigned a grade from I to IV based on how abnormal the tumor cells appear under a microscope and how quickly the tumor is likely to grow. The grade helps guide treatment decisions.
- Grade I tumors are often considered benign and tend to grow slowly. The tumor cells closely resemble normal brain cells.
- Grade II tumors are malignant. The cells look less like normal brain cells than Grade I tumors and may grow more quickly.
- Grade III tumors are malignant and referred to as anaplastic. The cells look very different from normal brain cells and tend to grow rapidly.
- Grade IV tumors have the most abnormal appearance, grow the fastest, and are usually the most aggressive.
Grades I–II are considered low-grade tumors, while Grades III–IV are considered high-grade tumors.
Classification by Origin: Primary vs. Metastatic Brain Tumors
There are two major categories of brain tumors based on where they begin:
- Primary brain tumors start in the brain or central nervous system and rarely spread outside of it.
- Metastatic brain tumors begin in another part of the body—such as the breast, lung, or skin—and spread to the brain.
Metastatic brain tumors are the most common type of brain tumor and occur about 10 times more frequently than primary brain tumors.
Types of Primary Brain Tumors
Gliomas (Most Common Primary Brain Tumors)
Gliomas arise from glial cells, which support and protect neurons in the brain. Common types include:
- AstrocytomasThe most common type of glioma. Astrocytomas can be Grade I–IV and may develop anywhere in the central nervous system.
The most common type of glioma. Astrocytomas can be Grade I–IV and may develop anywhere in the central nervous system.
- Grade I–II astrocytomas are often referred to as low-grade gliomas.
- Grade III astrocytomas are sometimes called anaplastic astrocytomas.
- Grade IV astrocytomas are known as glioblastoma multiforme (GBM), the most aggressive form.
- EpendymomasDevelop in the fluid-filled cavities of the brain or in the spinal cord. They are often slow growing and may be benign.
Develop in the fluid-filled cavities of the brain or in the spinal cord. They are often slow growing and may be benign.
- OligodendrogliomasOriginate from cells that support the nerve fibers in the brain. These tumors are typically Grade II–III.
Originate from cells that support the nerve fibers in the brain. These tumors are typically Grade II–III.
Non-Glial Brain Tumors (Less Common)
Although less common, there are many other types of brain tumors, including:
- MeningiomasArise from the meninges (the membranes that protect the brain and spinal cord). Most are Grade I, slow growing, and benign, though malignant meningiomas do occur.
Arise from the meninges (the membranes that protect the brain and spinal cord). Most are Grade I, slow growing, and benign, though malignant meningiomas do occur.
- CraniopharyngiomasDevelop near the pituitary gland and most often affect children and adolescents.
Develop near the pituitary gland and most often affect children and adolescents.
- Pineal TumorsLocated near the center of the brain and can be difficult to completely remove with surgery.
Located near the center of the brain and can be difficult to completely remove with surgery.
What Causes Brain Tumors?
At this time we still don’t know what causes most brain tumors. There are some rare cases of brain tumors running in families though the vast majority of brain tumors are not related to family genetics. There continues to be ongoing research into areas such as cell phone use, head injury, and chemical use to evaluate for a link, though so far there have not been any consistent results that show a cause.
What are the risk factors of a brain tumor?
Radiation exposure: Exposure to radiation, most often from some type of radiation therapy, increases the risk. Currently, radiation exposure is the only known environmental
factor proven to cause brain tumors.
Family history: There is an increased risk when immediate family members have well-defined
disorders, such as Neurofibromatosis type 1, Neurofibromatosis type 2, tuberous sclerosis, Von
Hippel-Lindau disease, or Li-Fraumeni syndrome.
Weakened immune systems: Patients with impaired immune systems have an increased risk of developing lymphomas of the brain or spinal cord.
Screening for Brain and Spinal Cord Tumors
There are no widely recommended tests used to screen for brain cancer or spinal cord tumors. Most brain tumors are found once a person starts having symptoms. People who have a higher risk for brain tumors should obtain frequent physical exams and other tests beginning at a young age.
What are the symptoms of a brain tumor?
The symptoms of a brain tumor can vary from person to person and vary widely depending on the type, size, and location of the tumor. Patients experiencing any of these symptoms should consult a physician:
- Headaches, especially headaches that get worse over time
- Nausea and/or vomiting
- Visual changes or blurred vision
- Balance problems
- Personality or behavior changes
- Seizures
- Weakness or changes in mood or memory
- Drowsiness or even coma
Treatment Options for Brain Tumors
Treatment depends on the tumor’s type, grade, size, and location, as well as the patient’s age and overall health. Common treatment options include:
- Surgery, often the first step, to remove all or part of the tumor
- Radiation therapy
- Chemotherapy, given alone or in combination with radiation, either orally or intravenously
Patients are typically monitored closely with regular brain MRIs and follow-up visits with their care team, which may include neurosurgeons, radiation oncologists, and medical oncologists.
Advances in research and clinical trials continue to improve treatment options, helping patients live longer and with a better quality of life.
Explore clinical trials and research available through Virginia Cancer Specialists.
Brain Tumor Profiling and Personalized Treatment
While examining tumor tissue under a microscope remains the standard for diagnosis, doctors now routinely study a tumor’s molecular and genetic profile. Identifying specific DNA changes—known as driver mutations—can help predict tumor behavior, guide treatment decisions, and improve outcomes.
Even among patients with the same type of brain tumor, outcomes and responses to treatment can vary significantly based on these molecular differences. It is increasingly clear that specific characteristics of cancer cells and cancer patients can have a profound impact on prognosis and treatment outcome. This approach allows for more personalized, targeted therapies, offering the potential for improved outcomes despite added complexity in care.
Targeted therapies are based on the type of tumor and its profile. Although factoring these characteristics into treatment decisions makes cancer care more complex, it also offers the promise of improved outcomes. Targeted therapies for each tumor lead to better outcomes through personalized medicine.
Explore clinical trials and research available through Virginia Cancer Specialists.
Brain Tumors and Neuro-Oncology
Virginia Cancer Specialists’ highly-experienced team of neuro-oncologists and radiation oncologists focus on personalized treatment plans to provide the best possible outcome for each patient and their families. Each member of our team is experienced in caring for people with brain tumors, having had years of specialized training. Using advanced technologies, leading-edge medical services and treatment options, Virginia Cancer Specialists offers the most advanced, patient-friendly treatment and cancer care. Because of our participation in innovative clinical trial research programs we are able to offer new treatment options for patients that they wouldn’t normally have access to, right in their own community.
What is neuro-oncology?
It is the medical terminology for the specialty treating malignancies of the brain and spinal cord. Neuro-oncologists treat patients with primary brain tumors and metastasis to the brain or spinal fluid, as well as neurological complications of cancer. Such complications can include seizures, cerebral edema, stroke, and peripheral nerve disorders.
Treating Brain Tumors at Virginia Cancer Specialists
Treatment for brain tumors is determined by many factors, including tumor type; grade; size and location in the brain; whether it’s newly diagnosed or a recurrence; the tumor’s specific genetic makeup; and your overall health. The potential benefits of a singular or combination of treatments or participation in a clinical trial must be carefully balanced with the potential risks.
Treatment options may include surgery, radiation therapy, and chemotherapy. Surgery is usually the first treatment, and may involve removing all or part of the tumor. Depending on the grade and type of tumor, location as well as the patient’s age and overall health, this may be followed by additional treatment. This may include both radiation and chemotherapy. Radiation and chemotherapy are often given in combination following surgery for a period of several weeks. This may be followed by chemotherapy alone for a period of time. Depending on the type of chemotherapy, this may be given as either oral medication or intravenously.
While being treated, patients will typically have regular monitoring with frequent MRIs of the brain as well as regular follow up with their doctors including surgeons, radiation and medical oncologists. We continue to learn more and more through research and clinical trials into the various types of brain tumors. This research has led to improved treatments that are helping patients to live longer and with a better quality of life than ever before.
Neurosurgery to Treat Brain Tumors
Surgery is an important treatment for most brain tumors. This is especially true if located within the membranes covering the brain or in an area where removal would not damage the surrounding areas. Even if the entire tumor cannot be removed, surgery can relieve some symptoms caused by the tumor. Many benign tumors are treated only by surgery.
Most malignant tumors also require treatment after surgery such as radiation therapy, chemotherapy, electrical field therapy, or targeted drug therapy.
Cancer Treatment Options
Most treatment plans combine several of these approaches. Your Virginia Cancer Specialists care team builds a plan around your specific diagnosis — explore each option below, or browse all treatments & services.
Chemotherapy
Chemotherapy uses powerful medicines to destroy cancer cells or slow their growth, and it remains one of the most widely used and effective cancer treatments. It can be given on its own or alongside surgery, radiation, or other therapies.
- Given by IV infusion or as pills, in planned cycles with recovery time between
- Delivered in our offices by our medical oncology team, close to home
- Often used to shrink a tumor before surgery or lower the risk of recurrence after
Radiation Therapy
Radiation therapy uses precisely targeted, high-energy X-rays to destroy cancer cells while sparing nearby healthy tissue. Virginia Cancer Specialists offers advanced, state-of-the-art radiation for a wide range of cancers and select benign conditions.
- Painless outpatient treatments that usually take only minutes a day
- Planned and delivered with image guidance by our APEx-accredited radiation oncology team
- Can be the main treatment, or support surgery and chemotherapy
Surgery to Treat Cancer
Surgery is one of the oldest and most effective treatments for cancer. For many cancers, removing the tumor offers the best chance for a positive outcome, often combined with other therapies before or after the operation.
- Used to diagnose, stage, and treat cancer, and to relieve symptoms
- Minimally invasive and robotic-assisted techniques when appropriate
- Coordinated with your medical and radiation oncologists as one care plan
Immunotherapy
Immunotherapy helps your body’s own immune system recognize, target, and destroy cancer cells. Over the past decade it has transformed treatment for many types of cancer.
- Works with your immune system rather than attacking cells directly
- Usually given by IV infusion in our offices
- May be used alone or with chemotherapy, radiation, or targeted therapy
Targeted Therapy
Targeted therapy focuses on the specific genes, proteins, and other molecular features that help cancer cells grow and survive. By attacking what makes a cancer unique, it can be highly effective with fewer effects on healthy cells.
- Guided by biomarker and genomic testing of your cancer
- Taken as pills or given by infusion
- Often paired with chemotherapy, hormone therapy, or immunotherapy
Hormone Therapy
Hormone therapy treats cancers that use the body’s natural hormones to grow — most commonly breast and prostate cancers — by lowering hormone levels or blocking their effects.
- Usually pills or injections rather than infusions
- Can lower the risk of recurrence after surgery or radiation
- Managed by your medical oncology team, sometimes over months or years
Specialized Programs
CAR T-Cell Therapy Program — one of the most advanced treatments for certain blood cancers: your own immune cells, re-engineered to fight the disease.
Scalp Cooling — cold-cap therapy that can significantly reduce hair loss during many types of chemotherapy.
Clinical Trials & Research — access to tomorrow’s treatments today through the Virginia Cancer Specialists Research Institute.
Physicians
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Locations
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Fairfax
Monday through Friday 8:30 a.m. to 5:00 p.m
571.350.8400
703.280.9596
8613 Route 29
The Supportive Cancer Care Team works in close partnership with each patient’s primary oncology team to ensure patients receive coordinated, comprehensive, seamless support that complements their current medical treatment. Patients have easy access to a team of compassionate experts – palliative care physicians, pain management specialists, social workers, nutritionists, nurse navigators, clinical coordinators, research coordinators, financial counselors, and many others who provide guidance, education, and emotional support every step of the way.
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Goals of Supportive Cancer Care
Virginia Cancer Specialists’ Supportive Cancer Care Program has 3 key goals:
Hallmarks of Our Supportive Cancer Care Program
While the primary goal is to improve quality of life for the patient and family throughout the treatment process, there are various ways in which this can be accomplished:
- Focusing on symptom management, including treating pain, insomnia, anxiety, respiratory and gastrointestinal problems
- Fostering open and honest communication
- Understanding the patient’s hopes and expectations
- Facing the realities of treatment and how it affects one’s life, including finances, employment, and more
- Providing support to caregivers and family
Patient Stories
Read patient stories and gain insight into their experiences, as well as the support they received from our dedicated care team.
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