evaluation process governed by the American Board of Medical Specialties. Before board certification is granted, a neurosurgeon must: • Validate appropriate education and training • Demonstrate professional skills, judgment and knowledge – which includes opinions by his/her colleagues • Pass both written and oral examinations in their specialty Board certification is considered the “gold standard.” It is a way for patients to assess the neurosurgeons they seek for treatment. You can ensure that your neurosurgeon is board certified by calling the American Board of Medical Specialties at 866-275-2267, by visiting their website (www.abms.org) or by calling the Physician Referral Service at the hospital where the doctor is on staff. WHAT ARE THE POTENTIAL BENEFITS OF BRAIN TUMOR SURGERY? The benefits of brain tumor surgery may: • Establishes an accurate diagnosis. Every time tissue is taken from a tumor, whether through biopsy or removal, a pathologist will diagnose the tissue. Appropriate treatment planning requires an accurate diagnosis. • Relieves pressure on the brain. This includes both general intracranial pressure and local pressure near the brain tumor. • Can eliminate or improve many of the symptoms associated with the presence of a brain tumor. For 26 AMERICAN BRAIN TUMOR ASSOCIATION instance, difficulty with thought processes might be improved or resolved after brain tumor surgery. • Improves the effectiveness of additional therapies by reducing the number of cells to be treated. • Tissue removed during surgery may be tested for genomic changes which may help guide treatment. • Tissue may be used in clinical trials for vaccines. Ask your doctor to help you balance the potential benefits and risks of surgery. WHAT ARE THE COMMON RISKS OF BRAIN TUMOR SURGERY? Brain tumor surgery poses both general and specific risks. The general risks apply to anyone going through surgery for any reason and are not limited to brain tumor surgery. These include: • Infection • Bleeding • Blood clots • Pneumonia • Blood pressure instability Risks specific to brain tumor surgery depend greatly on the particular location of the tumor. Particular areas of the brain control functions such as vision, hearing, smell, movement of the arms and legs, coordination, memory, language skills, and other vital functions. The process of operating on the brain always includes some risk that nerves or blood vessels serving these areas will be damaged. This could result in partial or complete loss of sensation, vision, movement, hearing or other functions. When a tumor is located deep within the brain it increases the risk and range of possible complications. Additional risks, while generally rare, are also possible. These brain surgery risks include: • Seizures SURGERY www.abta.org 27 • Weakness • Balance/coordination difficulties • Memory or cognitive problems • Spinal fluid leakage • Meningitis (infection causing inflammation of membranes covering the brain and spinal cord) • Brain swelling • Stroke • Hydrocephalus (excessive fluid in the brain) • Coma • Death WHAT IS INFORMED CONSENT? Prior to surgery you may be provided with an informed consent document. Its purpose is to provide important details regarding the procedure and to obtain your voluntary consent to proceed. Most informed consent documents cover the following: • Nature of the procedure • Risks of the procedure • Benefits of the procedure • Alternatives available • Consent to store extra tissue for research purposes (if the institution has a a tissue bank) It is very important that you read the informed consent document carefully, and understand all that it says before you sign it. This might involve asking numerous questions about items that are not clear. It can also be very helpful to have a family member or friend present to read the document and ask additional questions. It is important to understand all the risks, benefits and alternatives after a discussion of these with your surgeons before agreeing to proceed with the procedure. 28 AMERICAN BRAIN TUMOR ASSOCIATION WHEN WILL MY PATHOLOGY REPORT BE BACK? HOW WILL I GET THOSE RESULTS? At the time of your surgery, the neurosurgeon sends a piece of the tumor tissue to the hospital pathologist. The pathologist examines the tissue, determines the diagnosis, writes a report and sends the report to the neurosurgeon. It usually takes several days for this process to be completed. In complex cases or when the tissue is sent to a pathologist at another hospital for diagnosis, it may take a week or more for your neurosurgeon to receive the final report. Additional tests for molecular changes in the chromosomes of the tumor cells may take even longer. Once the neurosurgeon receives the report, you will typically be contacted to discuss the results. HOW LONG WILL IT TAKE FOR ME TO RECOVER FROM SURGERY? Any type of surgery is a trauma to your body. Because we each heal at our own pace, some people will recover faster than others. While there is no “normal” recovery period that applies to all people, your recovery time will depend on: • The procedure used to remove your brain tumor • The part of your brain where the tumor was located • The areas of your brain affected by the surgery • Your age and overall general health Ask your neurosurgeon what you can expect as a reasonable recovery