There are various types of brain tumors, each with distinct symptoms, treatment approaches, and outcomes.
Dr. Sabareesh Natarajan, a board-certified specialist in neurological surgery and neurointervention, offers a comprehensive range of treatments for different brain tumor types. These include microsurgery, skull base access, vascular management, and radiation therapy. His extensive training allows him to recommend the most suitable treatment plan for each patient.
Patients benefit from having a single provider oversee their entire treatment process. Most cases are reviewed in a multidisciplinary tumor board comprising medical oncologists, radiation oncologists, geneticists, and other neurosurgeons. Dr. Natarajan collaborates closely with this team to ensure patients receive the most advanced and effective treatments available.
Learn more about brain tumor types and treatment options below. If you have questions or wish to schedule an appointment, please call our office at (619)-984-6969.
Metastatic Brain Tumors
Metastatic brain tumors develop when cancer from other parts of the body spreads to the brain. Common primary cancers include lung, breast, and skin cancers such as melanoma. These can present as multiple tumors or just a single one.
In the past, patients diagnosed with metastatic brain tumors typically had limited survival. Today, advances in treatment mean some patients live ten or more years after their cancer spreads.
Treatments for Metastatic Brain Tumors
Dr. Natarajan offers treatment options including radiation, surgery, or a combination. Surgery is generally preferred for tumors larger than 2.5 cm, while smaller tumors are treated with focused radiation.
Radiation
Radiation is performed on an outpatient basis. Dr. Natarajan designs a 3D plan using AI-enhanced imaging with our radiation oncologist. Multiple X-ray beams are directed through various pathways to converge on the tumor, delivering a high dose of radiation while sparing the rest of the brain from excess exposure.
Surgical Procedures
Traditionally, brain tumor surgery involved keeping the patient awake to monitor brain function and minimize damage. However, thanks to advancements in operating room technology, this is less common.
Dr. Natarajan employs diffusion tensor imaging (DTI), which maps each individual fiber tract of the brain relative to the tumor. This allows for safer removal of the tumor while preserving critical brain functions. The patient is under general anesthesia, and instead of shaving, the hair is parted for access, maintaining a normal appearance post-surgery. He uses computerized navigation, robotic guidance, minimally invasive ports, high-resolution microscopes, ultrasound, Gleolan dye to distinguish tumor from healthy tissue, and neuromonitoring to ensure precision.
The procedure lasts approximately 4-6 hours. Most patients wake up, walk, and eat within a few hours. Many can go home the next day, and all are typically discharged within 48 hours.
Gliomas and Glioblastomas
Gliomas are tumors that originate from the brain and its supporting cells. These tumors are classified on a spectrum: low grade, intermediate grade, or high grade. It is essential to remove low and intermediate-grade tumors completely and precisely to prevent them from progressing to a higher grade over time.
Dr. Natarajan employs advanced techniques such as computerized navigation, robotic guidance, minimally invasive port access, high-resolution microscopes and ultrasound, Gleolan (a dye that differentiates tumor tissue from healthy brain), and neuromonitoring to ensure accurate tumor removal while preserving brain function.
Although the outlook for high-grade glioblastomas remains challenging, treatment can still significantly extend the patient’s life compared to no intervention. Untreated high-grade glioblastomas typically result in survival of just a few months, whereas treatment can enable patients to live approximately two years post-diagnosis. This additional time allows patients to spend meaningful moments with loved ones—seeing children marry, enjoying family, meeting grandchildren—and to leave a lasting legacy.
Treatment for Gliomas and Glioblastomas
Dr. Natarajan offers both radiation therapy and surgery.
Surgery
Usually, he recommends removing the tumor surgically first. Several advanced technologies facilitate safe removal.
He uses diffusion tensor imaging (DTI) to visualize individual brain fiber tracts, helping him operate without damaging critical areas. Motor mapping with electrical probes may be used during resection to ensure motor functions remain intact. High magnification microscopy with Gleolan, a dye administered intravenously, makes the tumor fluoresce pink, making it easier to identify.
The procedure is performed under general anesthesia, so the patient remains unconscious. Instead of shaving, the hair is parted to access the tumor, maintaining a normal appearance post-surgery.
Radiation & Chemotherapy
After surgery, patients typically undergo chemotherapy in pill form, followed by a 10-day radiation course over two weeks.
Radiation therapy is outpatient-based. It involves detailed 3D planning to target the tumor precisely. Dr. Natarajan then directs multiple X-ray beams through various angles converging on the tumor, delivering a high dose of radiation specifically to that area.
Meningiomas
Meningiomas are tumors that develop from the dura, the covering of the brain. They are common, often found during brain scans, and most are benign (non-cancerous). Treatment depends on the tumor’s size, growth, and whether it causes swelling or other symptoms.
Regular Check-Ins
If the tumor is small and asymptomatic, Dr. Natarajan usually recommends regular monitoring. Surgery is only advised if necessary.
Surgery
Dr. Natarajan performs surgery under general anesthesia. Instead of shaving, he parts the hair to access the tumor. He uses diffusion tensor imaging (DTI) to visualize brain fiber tracts and a CT angiogram to identify and protect blood vessels around the tumor. These advanced imaging techniques enable him to remove the meningioma safely, preserving vital brain functions and blood flow.
If the tumor has many blood vessels, he performs embolization, a minimally invasive, catheter-based procedure that injects glue into the vessels supplying the tumor. This reduces bleeding and softens the tumor, making removal easier and faster.
The surgery lasts approximately 4 to 6 hours. Most patients can walk shortly after surgery and usually go home the next day. All patients typically leave the hospital within 48 hours and can resume work and normal activities within 2-4 weeks.
Pituitary Tumors
Pituitary tumors are skull base tumors originating from the pituitary gland, situated between the eyes, behind the nose at the top of the throat. This gland secretes hormones that regulate various body functions. Tumors here can produce excess hormones, leading to different health issues.
Common problems caused by pituitary tumors include:
- Acromegaly: An overproduction of growth hormone, causing increased height and larger hands and feet.
- Cushing syndrome: Elevated cortisol levels, the stress hormone, which can result in weight gain, thin and fragile skin, and a hump on the back of the neck.
- Prolactinoma: Excess prolactin, the hormone involved in milk production, which can cause men to develop breasts and produce milk.
Many tumors do not produce excess hormones but may compress the pituitary gland, reducing its function. Due to their proximity to the optic nerves, they can also cause blurred vision or blindness.
Treatments for Pituitary Tumors
Treatment varies based on the tumor type and symptoms, with Dr. Natarajan recommending the most suitable approach.
Medication
For prolactinoma, cabergoline is commonly prescribed to reduce prolactin and often shrink the tumor. If this isn’t effective, surgery might be considered.
Surgery
For acromegaly and Cushing syndrome, surgery is usually the first option if symptoms are severe. It may also be necessary for vision problems, after consultation with an ophthalmologist.
Dr. Natarajan typically performs the operation through the nose with an ENT surgeon, using a camera and endoscopic tools to remove the tumor while preserving the pituitary gland. In some cases where the tumor extends toward the brain and presses on the optic nerves, a craniotomy may be needed to relieve pressure and improve vision.
The surgery usually lasts 4-6 hours, and most patients can go home the following day.
Brain Tumor Treatment in the San Diego Bay Area
As a board-certified neurosurgeon and neurointerventional specialist with expertise in radiation treatments for the brain, Dr. Sabareesh Natarajan can address all types of brain tumors using a comprehensive range of treatment options. This enables him to make personalized treatment decisions suited to each patient’s specific needs.
With four offices in the San Diego Bay area, we are ready to provide expert care. To schedule an appointment, please call our office at (619)-984-6969 or complete our appointment request form.
