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May is Brain Cancer Awareness Month.

Brain tumors are among the most feared and most complex types of cancers that exist. And with that notoriety come many myths.

Cancers that originate in the brain, or primary brain cancers, are relatively rare. More commonly, it’s metastatic, or secondary cancers, that spread to the brain from another part of the body and impacts a patient’s life.

There is ongoing research to determine the exact causes of brain cancer and its risk factors. Researchers have learned that genetic mutations in healthy brain cells can lead to uncontrolled and abnormal cell growth, which results in tumors. There are also promising clinical trials relating to immunotherapy that give doctors, researchers and patients hope.

While there is still much we don’t know about brain cancers, there are many things we do know, despite the persistence of the myths around them.

Here are some of the more popular myths and what members of the Neuro-Oncology Department at Moffitt Cancer Center have to say about them.

MYTH: Radiation is going to make me very sick.

Michael Yu, MD, radiation oncologist: Side effects depend on the radiation dose, site receiving radiation and treatment techniques. In general, most patients with brain tumors tolerate radiation well and can continue their usual lifestyle and routine activities.

MYTH: Discovery of brain metastasis is always an emergency that requires immediate surgery.

Arnold Etame, MD, PhD, neurosurgeon: Metastatic brain tumors arise from cancer cells outside the brain with lung, breast and melanoma representing the most common primary cancer sites. Metastatic brain tumors can present with neurological symptoms such as headaches and seizures, or without any symptoms as is the case on screening MRIs. Symptoms are usually related to brain irritation from edema that is usually responsive to steroid treatment. Hence, surgery is rarely an emergency unless there is significant brain compression or tumor-associated hemorrhage with worsening neurological symptoms. Otherwise, surgery can be performed electively in a non-emergent fashion. Furthermore, the overwhelming majority of patients with brain metastases are primarily treated with focused radiation therapy (radiosurgery, which does not require an incision) and not surgery.

MYTH: A headache likely means you have a brain tumor.

Michael Vogelbaum, MD, PhD, Chief of Neurosurgery: The vast majority of headaches have nothing to do with a brain tumor. Context matters. If someone with a known history of cancer has new persistent headaches or a neurological change, there should be some type of brain imaging done.

MYTH: If you are diagnosed with brain cancer, there’s very little hope for you.

Peter Forsyth, MD, Chair of the Department of Neuro-Oncology: There are new technologies that evaluate both the tumor micro-environment, as well as the tumor itself and how the two interact. It’s also through research that we’re going to be able to understand all this and I’m confident that we can. We are developing new treatments all of the time.  The patients and families have been fantastic. They are hopeful, supportive, loving and appreciative. It’s really humbling to be involved in that enterprise and I’m sure we are going to cure them.