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Brain Tumor Treatment Options
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BRAIN TUMOR TREATMENT OPTIONS Improved Outlook with Personalized Treatment
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t’s difficult to think of a health condition more ominous than a brain tumor. But while these tumors are challenging to treat, the outlook isn’t necessarily bleak. As advancements in brain Dr. Tsz Lau surgery techniques and other therapies continue to evolve, there are more options for removing brain tumors, slowing tumor growth and preventing recurrence.
UNDERSTANDING BRAIN TUMORS
“No one knows what causes brain tumors; however, certain risk factors have emerged, such as having a family history of brain tumors and exposure to a type of radiation called ionizing radiation,” said Dr. Tsz Lau, board-certified neurosurgeon with Houston Methodist Neuroscience & Spine Center at Sugar Land. Like other tumors, brain tumors are either benign (noncancerous) or malignant (cancerous). Benign brain tumors tend to grow slowly and usually don’t invade surrounding tissues. But because they can place pressure on sensitive areas of the brain and cause serious health problems, they may require treatment as well. Malignant brain tumors have cancer cells and are considered life-threatening because they grow and invade healthy brain tissue. They may be either a primary tumor, which started in the brain or a secondary tumor, which spread to the brain. Most brain tumors are secondary, or metastatic, meaning that cancer cells migrated to the brain from cancer elsewhere in the body.
WARNING SIGNS
A range of symptoms may suggest a brain tumor, and symptoms vary depending on the location and size of a tumor. General signs and symptoms may include: Difficulty with balance or walking Gradual loss of sensation or movement in an arm or a leg Headaches that become more frequent and more severe Personality or behavior changes Seizures Speech difficulties Vision problems These symptoms, however, are not sure signs of a brain tumor and may suggest other neurological disorders.
PATH TO DIAGNOSIS
Doctors perform a neurological exam to check for alertness, balance, coordination and reflexes as well as vision, speech and hearing. Depending on the results, the patient may undergo one or more tests using computed tomography (CT), MRI, positron emission tomography (PET) or other types of brain scans. The only way to confirm a brain tumor diagnosis is with a biopsy, in which a sample of tissue is examined under a microscope.
TREATMENT OPTIONS
Treatment for brain tumors is based on individual factors, such as age, overall health and medical history as well as characteristics of the tumor (type, location and size) and how likely the tumor is to spread or recur. Specialists in neurosurgery, medical oncology and radiation oncology all work together to
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create a customized treatment approach to combat brain tumors. “Therapies may include surgery, radiation, chemotherapy or a combination of these treatments,” said Lau. “If a brain tumor can’t be removed through surgery because of its size or nearness to critical areas of the brain, other types of treatment can be used to shrink it or slow down tumor growth.”
Schedule an Appointment
At Houston Methodist Neuroscience & Spine Center our specialists work together to diagnose, treat and manage a range of brain tumors and other neurological conditions. To schedule an appointment with Dr. Tsz Lau or another specialist with Houston Methodist Neuroscience & Spine Center at Sugar Land, visit houstonmethodist.org/neuro-sl or call 281.205.4662 for an appointment.
Advanced treatments and therapies for brain tumors may include: S urgery using intraoperative MRI performed to detect and remove as much of the tumor as possible. R adiation therapy uses X-rays, gamma rays or protons to destroy tumor tissue. C hemotherapy is taken by mouth, by injection or intravenously to attack cancer cells.
B rachytherapy surgically places radiotherapy “seeds” after removing the tumor. I ntraoperative chemotherapy involves surgically implanting biodegradable devices in the brain to release anticancer drugs. T argeted therapy uses drugs that specifically target the molecules or pathways involved in cell growth.
T umor-treating fields, using a wearable device, produces electric fields to disrupt cell growth. Experts continue to explore new surgical techniques to remove tumors, new ways to target tumor destruction and new avenues to deliver anticancer drugs. “While it’s true that treating brain tumors requires aggressive action, the prognosis is often hopeful,” said Lau.
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4 BENEFITS OF BARIATRIC SURGERY A re you ready to transform your life and lose weight? If you have weight-related health problems and are unable to lose pounds with diet and exercise alone, bariatric surgery may be an option. The goal of weight loss surgery is to reduce the size of the stomach, so you feel fuller faster and eat less.
Dr. Nabil Tariq
JOIN US FOR A BARIATRIC ORIENTATION WEBINAR Dates/Times: Jan. 25, 6 p.m. March 4, 12 p.m. Feb. 8, 6 p.m. March 22, 6 p.m. Feb. 25, 12 p.m. Location: Online Webinar
LOSE WEIGHT TO LIVE HEALTHIER
Dr. Nabil Tariq, board-certified bariatric surgeon with Houston Methodist Center for Weight Loss & Bariatric Surgery at Sugar Land, identifies the following four ways surgical weight loss can help you get on a path to better health and well-being: how you eat. Bariatric surgery changes the 1 Changing anatomy of the gastrointestinal tract, restricting the amount of food you can eat or changing the route food takes through your body. “Weight loss surgery is a tool to help you lose weight, but it’s up to you to maintain a healthy diet and exercise plan for long-term success,” Tariq said. “Participating in an after-care program with support through nutrition, exercise and counseling can help you stay on track.” appetite. Some types of bariatric surgery involve 2 Controlling removing a portion of the stomach where hormones that stimulate appetite are produced. As a result, bariatric surgery may reduce the production of hormones that drive appetite and desire to eat. It’s important to recognize the changes to your body and emotions, so you can build a healthy relationship with food. Reducing health risks. If you have health problems 3 associated with being overweight, the benefits of weight loss surgery aren’t just measured in pounds. Instead, success may be measured by improvement of health numbers, such as blood pressure, cholesterol and blood glucose levels. Losing excess weight can help your health in many ways: Blood pressure and cholesterol – numbers can return to normal or near normal. Cardiovascular health – reduced risk of death from heart attack and stroke. Diabetes management – reduced need for insulin and related medications. Joint pain – taking pressure off joints improves mobility and may allow reduced need for pain medications. Sleep apnea – some people no longer use a CPAP machine at bedtime.
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Join us for a webinar to learn more about our bariatric surgery program at Houston Methodist Center for Weight Loss & Bariatric Surgery at Sugar Land. Visit houstonmethodist.org/sugar-land-bariatric or call 281.205.4514 for more information and to register.
Improving quality of life. Surgical weight loss can give you a new outlook on life. Losing weight may improve self-esteem and boost confidence in social interactions. “Feeling good about losing weight can also improve emotional health,” Tariq said. “You may have increased energy levels, and the ability to engage in more physical activity, which helps fuel weight loss even more.”
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PROVIDING COMPREHENSIVE CARE ON YOUR WEIGHT LOSS JOURNEY
Taking control of your weight can empower you to do things that once seemed impossible. The team at Houston Methodist Center for Weight Loss & Bariatric Surgery at Sugar Land, including bariatric surgeons, doctors, dietitians, mental health professionals and endocrinologists, specializes in helping people achieve a healthier weight — and keep it off.
Take the Next Step To learn more about your options, including non-surgical weight management, visit houstonmethodist.org/weight-management or call 832.667.LOSE (5673).
Should You See a Physical Medicine and Rehabilitation Specialist?
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he road to recovery from a stroke, brain injury or orthopedic injury can be difficult to navigate — and it’s different for everyone. The goal of physiatry, or physical medicine and rehabilitation (PM&R), is to guide you through recovery and help restore function so you can live your best life.
Dr. Joseph Elias
RESTORING FUNCTION
Dr. Joseph Elias, PM&R specialist with Houston Methodist Physical Medicine & Rehabilitation Associates at Sugar Land, focuses on diagnosing and treating disability related to musculoskeletal and neurological disorders. Patients may be referred to a PM&R specialist for spine pain, joint pain, stroke, spinal cord injury, brain injury, cerebral palsy and other conditions. PM&R doctors, also called physiatrists, help restore function and get you back to your activities at work and home. “We use nonsurgical treatments and therapies to help reduce pain, improve mobility, increase range of motion, and regain strength in your daily life,” Elias explained.
A TEAM APPROACH
A physical exam is one of the most important tools in physiatry, and in some cases, imaging, such as an X-ray or MRI, may also be needed. “When a nerve injury is suspected, we may perform an EMG/NCS (electromyogram/nerve conduction study) test to confirm where the nerve injury is and how severe it is,” Elias added. It’s important to understand the underlying causes of symptoms so they can be addressed by your physiatrist and other specialists. Depending on your situation, you may see other specialists in interventional spine management, neurology, orthopedic surgery or neurosurgery. “Communication with all doctors, therapists and team members involved in your care is the key to success,” Elias said.
PM&R TREATMENTS
Your physiatrist can create a treatment plan that addresses your unique concerns. “Sometimes you may be hurting so badly that you need some acute pain relief before you can tolerate physical therapy (PT) or occupational therapy (OT). In cases like this, we may prescribe nonnarcotic oral or topical medications or perform an injection, such as a steroid injection or a trigger point injection, before starting therapy,” Elias added.
PM&R provides a range of treatments that promote rehabilitation and recovery, including: Electromyography/nerve conduction studies (EMG/NCS) Neurological injuries ■ Cerebral palsy ■ Spinal cord injury ■ Multiple sclerosis ■ Stroke and brain injury Spasticity management ■ Botulinum toxin (Botox®) injections Spine and musculoskeletal injuries ■ Back and neck ■ Shoulder, hip and knee ■ Carpal tunnel syndrome Ultrasound-guided peripheral joint injections
SUPPORTING YOU
Sometimes the most meaningful progress is measured by performing everyday tasks. “For example, your goal might be having the ability to reach into your upper cabinets after a shoulder injury or being able to pick up your grandchild after a back injury. If you’ve had a stroke or other neurological injury, your goal might be to cook a meal for yourself or return to work in a wheelchair,” Elias said. Experiencing a musculoskeletal or neurological injury can be life changing. “After getting home from the hospital, you may need extra support to help you get back to real life. Having access to PM&R on an outpatient basis provides a link to the care you need to improve function and access equipment to help with mobility and everyday tasks,” Elias said.
Learn More
To schedule an appointment with Dr. Joseph Elias, visit houstonmethodist.org/spg or call 281.729.0076 for more information.
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Team Up With Your Doctor for Better Health W hen it comes to your health, your primary care doctor is your quarterback. They have a big-picture view and understanding of Dr. Harika your overall health, and Medi they can help you make the right moves to stay healthy. “A strong relationship with your primary care doctor is key for your health,” said Dr. Harika Medi, family medicine physician with Houston Methodist Primary Care Group. Building a relationship and partnership with your primary care doctor can help you tackle health problems and stay healthy through the ups and downs of life.
IT’S A TEAM EFFORT
Here are some ways to make the most of your health visits and build a winning relationship with your doctor. Find a primary care doctor. Look for a doctor who speaks your preferred language and offers
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convenient appointments in a location near you. Above all, you should choose a doctor you trust who listens and makes you feel comfortable. Schedule an annual exam. It’s important to schedule an annual checkup even when you feel healthy. Annual checkups, make it possible to prevent and detect problems early. “Your doctor may review your plan for managing chronic conditions and recommend screening tests to help you stay healthy,” Medi said. Identify communication barriers. Resources are available if you or a loved one struggles with hearing, understanding or remembering what is said in your health visits. Bringing a loved one along to your appointment may help you better understand the information shared by your doctor while providing emotional support, if needed. Contact the doctor’s office to let them know if you need help with communication or would like to have a family member or friend join you for your appointment.
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Put Your Health First
Prioritize your health by making an appointment with a primary care doctor. Convenient appointments are available at a location near you. Schedule an appointment with a doctor at Houston Methodist Primary Care Group by visiting houstonmethodist.org/pcg/southwest or calling 832.416.1678.
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A CHECKLIST FOR YOUR NEXT CHECKUP
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Share your health history. Managing your health is easier when you build a relationship with a primary care doctor who knows you and your health history. Your doctor may recommend health screening tests based on your age, personal or family health history, and other factors. “For example, if you have a family history of heart disease, stroke, diabetes or cancer, your doctor may emphasize ways to prevent disease and recommend screening tests to help detect disease early,” Medi said. Be open and honest. There’s no reason to hold back information because you’re worried or embarrassed. Your primary care doctor is there to support you in improving your health, not to pass judgment on your decisions. The doctor-patient relationship is ironclad in its confidentiality, with many ethical, professional and legal standards that protect it. Having open and honest conversations about your health helps the doctor better serve your health care needs.
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Talk about mental health. Your primary care doctor can help with mental health concerns, including screening and treatment for depression and anxiety. Your doctor can also connect you with referrals to therapy, counseling or specialized care. Ask about vaccines. Your primary care doctor can be a great resource to help you understand which vaccines are recommended for you and when to get them. It’s important to have these conversations with your doctor so you can make informed decisions based on the latest medical guidance. Set goals for your health. If you want to lose weight, quit smoking or make other healthy changes, your doctor can help you get started. Your chances of success improve when you have medical support for making big changes to your health.
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Going to the doctor for a yearly checkup is an important part of your health routine. Here’s a checklist to help you prepare for your next visit: Ask about screenings or vaccinations. When scheduling your appointment, find out whether you’re due for any shots or tests. Knowing in advance helps so that you’re mentally and physically prepared — especially if there are any special instructions to follow, such as fasting before a cholesterol test. Review your family medical history. Your doctor may ask about any new diseases or conditions that have occurred in your close relatives since your last visit. If needed, write down notes about your family health history to share with your doctor. Write down a list of questions. When you’re in the doctor’s office, it can be hard to remember everything. Having a list of questions prepared ahead of time can help you make sure you get answers to all your questions. Bring a list of medications. Your doctor’s office will ask about the current medications you’re taking, including all prescription and over-thecounter medications as well as herbs, vitamins and other dietary supplements.
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On Track to Delivering a Healthy Baby F or many expecting mothers, the final trimester leading up to delivery is the most challenging part of the pregnancy. During this time, your body changes shape to Dr. Brandi accommodate your fastComptongrowing baby. You may Joseph continue to gain weight and feel increasingly uncomfortable; your feet may swell; backache or soreness may intensify; and you may feel exhausted during the day and have difficulty sleeping at night. As much as possible, try to rest and continue to take good care of yourself as your due date approaches.
FOCUS ON YOU
When you’re busy with all the details — choosing a crib, decorating the baby’s room, attending baby showers, installing a car seat — it’s easy to forget about your health. Ask for help from your partner, family and friends so you can avoid getting overly tired and stressed. Do your best to continue eating well and getting some light exercise, with your health care provider’s permission. Continue your prenatal visits as scheduled. “The final weeks of pregnancy are especially important for continuing prenatal care,” said Dr. Brandi Compton-Joseph, board-certified obstetrician-gynecologist at Houston
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OUR CHILDBIRTH CENTER We offer a range of classes for expecting parents on prenatal care, labor and delivery, breastfeeding, care of infants and more. Call 281.333.8899 or visit houstonmethodist.org/events for current class listings.
Methodist Sugar Land Hospital. “Starting at 36 weeks, we recommend a prenatal visit every week.” Your health provider will continue checking the baby’s heart rate and watching your health closely. He or she may check your cervix to watch for dilation or softening in preparation for birth. Know your options for labor and delivery. Your health care provider can walk through your options for pain management and different scenarios for delivery, including the possibility of cesarean section for high-risk situations. If you haven’t already, you and your partner may want to take a childbirth preparation class to learn more about what to expect during labor and delivery. Write down your preferences. “Your birth experience will most likely turn out differently than you expect, but it can still be helpful to write down a birth plan,” said Compton-Joseph. “Your plan may include preferences for pain management, expectations for bonding with baby immediately after delivery and plans for breastfeeding or bottle feeding.”
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Ready to Start Your Family?
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When in doubt, call your health provider. It may not be easy to identify when true labor starts because many women experience early contractions (called Braxton-Hicks contractions or false labor). Call your doctor or clinic if you experience contractions that persist or grow stronger. If you suspect your baby is moving less than normal (less than 10 movements within two hours) or if you experience vaginal bleeding, call your health care provider right away to rule out any serious problems.
CARE YOU CAN TRUST
No one can predict how your birth experience will unfold. That’s why it’s important to surround yourself with support so you feel confident and ready for anything. At Houston Methodist Childbirth Center at Sugar Land, our health professionals are here to help you be well prepared.
When you choose the Houston Methodist Childbirth Center at Sugar Land for the birth of your baby, you can trust that we will listen to your needs and offer a range of solutions to help you move through labor — so you can focus on welcoming your little miracle into the world. To learn more about what we have to offer or to schedule an appointment with an obstetrician-gynecologist, visit houstonmethodist.org/childbirth-sl or call 281.205.4514.
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STAY IN THE RACE Avoid Injury From Walking and Running
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unning and walking not only can make you feel good, but are also good for you. Starting with even 10 minutes a day may reduce your risk of cardiovascular Dr. David disease. Injuries, however, Braunreiter are common. Many factors can contribute to chronic (overuse) and acute (sprains and strains) injuries, including shoe condition and overtraining. Here are some common injuries and ways to prevent them.
ACHILLES TENDINITIS What it may feel like
The Achilles tendon connects your heel bone to your calf muscle. It helps you walk, run and jump. Achilles tendinitis can cause pain above the heel in the lower leg after activity. It may feel worse in the morning.
How to prevent it
“Stretching is essential before working out, especially when it comes to the Achilles tendon. Switch up your exercises, increase the length and intensity of your workouts slowly and rest when you have symptoms of pain or swelling,” said Dr. David Braunreiter, board-certified primary care sports medicine specialist at Houston Methodist Orthopedics & Sports Medicine at Sugar Land.
RUNNER’S KNEE
Runner’s knee, or patellofemoral pain syndrome, may occur when your kneecap is out of alignment, or due to overuse or injury.
What it may feel like
Pain typically builds gradually beneath or around the kneecap. Squatting or using stairs can make it feel worse. Your knee may also feel stiff after sitting for long periods of time.
How to prevent it
“The best way to prevent runner’s knee is to do strengthening exercises for your hip abductors, hip extensors and quadriceps,” said Braunreiter.
SHIN SPLINTS
Shin splints are common in new runners and walkers and also in those returning to activity after extended time off.
What it may feel like
Shin splints can feel like sharp, dull or throbbing pain along the length of the shin while running or walking.
How to prevent it
Wear appropriate shoes for your foot type and training intensity. Replace your shoes every 300 miles. Increase your mileage gradually. Stretch your calf muscles. Strengthen your hip abductors and extensors.
Drop In for Orthopedic Care
When you need care for a running or walking injury, come in for a same-day evaluation and treatment at the Houston Methodist Orthopedic Injury Clinic at Sugar Land. No appointment required. Visit houstonmethodist.org/osm-injury-sl or call 281.609.7547 to get started. We accept patients ages 5 and up. Major insurance plans are accepted. Chronic conditions, concussions, spine injuries, motor vehicle accidents and workers’ compensation injuries are not treated at the injury clinic. Please call 281.201.0396 to schedule an appointment with the appropriate physician for those conditions.
Modify your training schedule and avoid hills.
SPRAINS AND STRAINS
“A sprain is a stretch or tear in a ligament, the band of connective tissue that joins bones. A strain is a twist, pull or tear of a muscle or tendon, the cord of tissue connecting muscle to bone,” Braunreiter explained.
What it may feel like
Signs of a sprain or strain include tenderness and pain, bruising, swelling and muscle tightness or spasm. Loss of strength may also occur.
How to prevent it
Take time to warm up and cool down and build up the muscles around ankles and knees with proper strength and balance exercises.
7 BEGINNER TIPS TO GET YOU RACE READY Signing up for a 5K race is a great way to stay motivated and have fun when starting a new walking or running regimen. If you can run, jog or walk for 30 to 40 minutes, you can complete a 5K. Here are tips to help you get race ready and avoid injury. 1. S tay hydrated at all times and especially on race days. 2. Wear comfortable, supportive footwear. 3. Always warm up and cool down. 4. Stretch before and after every run. 5. Make sure you can walk for 30 minutes at a time before trying to run. Then run slowly at first. 6. Make a schedule for yourself and stick to it. 7. Know your limits — progress at your own pace.
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STRESS AND YOUR STOMACH Tension Takes a Bite Out of Your Digestive System
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tress, worry and anxiety can take a toll on your stomach: Just think back to how you felt the last time you went on a job interview, got pulled over for speeding or awaited the results of a medical test. Those nervous butterflies in your belly were hard to ignore. “The enteric nervous system, a collection Dr. Anam Omer of neurons in the gastrointestinal tract, makes up your gut’s brain,” said Dr. Anam Omer, gastroenterologist with Houston Methodist Gastroenterology Associates at Sugar Land. “The entire system is very sensitive to moods — and stress can be a major contributor to many digestive problems.” Here’s a look at common conditions and how they’re affected by stress: I rritable bowel syndrome (IBS) is an intestinal disorder that’s marked by cramping, gas, bloating and a change in bowel habits. Stress doesn’t cause the condition, but some IBS sufferers find that it brings on flare-ups. Experts think that this may be because the colon is partly controlled by the body’s autonomic nervous system, which responds to stress. H eartburn occurs when the lower esophageal sphincter muscle relaxes and opens up. This can cause stomach acid to back up into the esophagus. According to the National Heartburn Alliance, stress can cause problems with the way food makes its way through your digestive system, causing food to move upward instead of down. Research shows that heartburn sufferers who recently experienced a life-changing event were more likely to develop severe symptoms. I ndigestion — or feelings of bloating or nausea, belching, gas and diarrhea — is often caused by eating too much or eating too fast, consuming high-fat foods or eating during stressful situations. “It can also be a sign of gastroesophageal reflux disease (GERD) or ulcers,” Omer said. “Indigestion tends to get worse during stressful times and improve in times of relaxation. Stress can worsen underlying health conditions and trigger unhealthy eating and smoking, both of which are known to worsen indigestion.”
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JOIN US FOR A DIGESTIVE HEALTH WEBINAR Date: March 31, 2022 | Time: 6 p.m. Location: Virtual Webinar Join us for a digestive health webinar with specialists from Houston Methodist Gastroenterology Associates to learn more about how stress may be affecting your digestive system and what you can do. Registration is required. Visit join.houstonmethodist.org/digestive-sl or call 281.205.4514 for more information and to register.
EASE ANXIETY AND BELLYACHES You can’t always avoid stress, but you can manage it and help ease your stomach woes. Some key strategies include: E xercise. Regular activity helps reduce stress, control weight, regulate bowel function, and improve your overall well-being. Just make sure to exercise before eating or wait at least one hour after a meal. B iofeedback. This mind-over-matter technique helps you learn to control certain body functions that may have fallen into an abnormal pattern, including bowel function, and bring them back to normal. Biofeedback also helps reduce muscle tension and slow heart rate, promoting a relaxed state. R elaxation and breathing techniques. Try yoga or meditation, taking slow, rhythmic breaths to lessen stress and, in turn, cramps and pain.
Help for Your Digestive System
To schedule an appointment with Dr. Anam Omer or another one of our specialists with Houston Methodist Gastroenterology Associates at Sugar Land, call 281.801.9303.
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Houston Methodist offers safe, quick access to high-quality care — so you can feel better now. Sniffles got you down? Whether you’re suffering from the flu, a cold, a skin rash or even pink eye, we are here for you with a variety of ways to get care quickly, including:
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