Most often, the first step in brain or spinal cord tumor treatment is for the neurosurgeon to remove as much of the tumor as is safe without affecting normal brain function. Surgery alone or combined with radiation therapy may control or cure many types of tumors, including some low-grade astrocytomas, ependymomas, craniopharyngiomas, gangliogliomas, and meningiomas.

Tumors that tend to spread widely into nearby brain or spinal cord tissue, such as anaplastic astrocytomas or glioblastomas, typically cannot be cured by surgery. But surgery is often done first to reduce the amount of tumor that needs to be treated by radiation or chemotherapy which might help these treatments work better. This could help prolong the person’s life, even if all of the tumor can’t be removed. Surgery can also be done to help relieve some of the symptoms caused by brain tumors, particularly those caused by a buildup of pressure within the skull. These can include headaches, nausea, vomiting, and blurred vision.

Surgery may also make seizures easier to control with medicines. Surgery to remove the tumor may not be a good option in some situations, such as if the tumor is deep within the brain, if it's in a part of the brain that can’t be removed, such as the brain stem, or if a person can’t have a major operation for other health reasons. Surgery is not very effective against some types of brain tumors, such as lymphomas, although it may be used to get a biopsy sample for diagnosis.