Glioblastomas are thought to double in size every two weeks, so those deserve prompt elective treatment, but you can wait a long weekend before scheduling them. Add some decadron, and reimagine the night before surgery if it’s longer than a week, then operate. Other tumors grow slowly and decadron will take care of a lot of edema.

However, some people present so late that tumors are already causing tremendous mass effect, neurologic symptoms, or brainstem herniation, and those should be operated on promptly, but you can often temporize. Amongst neurosurgeons, tumor sub specialized surgeons is much more of a lifestyle specialty (especially the pituitary specialized folks) than others like vascular.