Brain Tumor Treatment
Surgery Remains Therapy of Choice
Brain Tumor treatment is normally prescribed through a team approach of multidisciplinary specialists. Neurosurgeon, Oncologists (cancer specialists), Neurologist (nervous system specialists), radiation oncologists and neuropathologist (specialists in the cause and development of the disease of the brain and spinal cord) comprise the team. Their treatment decisions follow a thorough evaluation of the respective situation, including taking into account:
- Results of diagnostic tests
- Tumor size, position and growth pattern
- Medical condition and health history
- Patient's and family's wishes
Other Surgery Factors
Surgery is the standard therapy of choice for accessible brain tumors or tumor that can be resected without causing neurologic damage. The objective is to remove as much of the tumor as possible (called debunking the tumor), while not damaging healthy tissue.
The surgery also allows the team of specialists to perform microscopic analysis of the tumor tissue (biopsy) and to view where the tumor is situated and the nature of its growth. Also, the surgery creates an entry point for radiation and chemotherapy drugs, if necessary.
Brain tumors only partially removed still help in the relief of symptoms by reducing pressure on the brain and decreasing the size of the tumor to be subsequently treated by radiation or chemotherapy.
The tumor size and location play a role in surgery options. Besides the conventional surgery, laser microsurgery and ultrasound aspiration are minimally invasive procedures. Laser microsurgery employs high temperature to vaporize tumor cells. Ultrasound aspiration breaks up the tumor into small pieces with the use of ultrasound waves. The small pieces are subsequently removed in a vacuum-like fashion.
- Removal of low-grade astrocytomas generally allow the patient functional survival for several years (five-year survival rate over 90 percent by some reports)
- High-grade astrocytomas usually recur after the initial surgery and therapy
- If a tumor cannot be removed by surgery, the physician may only request a biopsy
Prior to surgery a brain tumor patient often receives:
- Steroids to reduce brain tissue swelling
- Preventive medication to control seizures
- Radiation to reduce tumor size
Radiation is a leading component of treatment and can occur alone or combined with surgery and/or chemotherapy. Three delivery options exist for radiation therapy:
- External delivery
- Traditional form
- Directs radiation at the tumor and the area surrounding it
- Treatment occurs five days a week, while length of time depends on the tumor type
- Internal delivery
- Also known as brachytherapy
- Places radioactive pellets directly in the brain
- Pellets release a measured dosage of radiation daily
- Patients are frequently hospitalized when the pellets are most active
- Stereotactic radiosurgery
- Patient is fitted with a frame to stabilize the head
- Imaging technique finds the exact location of tumor cells
- Instrument precisely targets a concentrated radiation dose to the tumor and spares surrounding normal tissue
Other Radiation Factors
Radiation results in long-term effects. For this reason, radiation treatment in children is postponed or eliminated and replaced by utilizing chemotherapy
For metastatic brain tumor patients, radiation is the leading treatment
Several drugs may be administered during radiation to protect brain cells from the radiation effect or to increase the effectiveness of the radiation
Possible side effects include fatigue, skin irritation, change in brain function and inflammation inside the mouth and throat
Chemotherapy's Goal Is to Kill Cells With Drugs
Chemotherapy employs the use of drugs to stop or control the growth of cancer cells. The goal of chemotherapy is to kill as many of the tumor cells as possible and to put remaining tumor cells into a non-dividing, sleeping state for as long as possible.
It can be prescribed in combination with surgery and radiation — the most common approach involving a brain tumor — as the initial treatment or it is used alone to treat recurring tumors. Depending on the type and tumor stage, it is taken in pill form or by injection.
Other chemotherapy delivery forms:
- Interstitial chemotherapy — performed during surgery when a chemotherapy-soaked, biodegradable wafer is placed into the tumor resection cavity in a controlled-release fashion
- Intraaterial chemotherapy — uses catheter tubes for high-dose delivery of chemotherapy in the brain's arteries
- Electrochemotherapy — uses electric voltage to carry chemotherapy agents into the brain
- Intrathecal chemotherapy — delivers medication directly into the spinal fluid
Other Chemotherapy Factors
In pediatric brain tumors, chemotherapy is used to eliminate or postpone radiation
- Chemotherapy is helpful in controlling high-grade gliomas , but it is not possible to cure most of these tumors
- Chemotherapy has several side effects including vomiting and nausea, hair loss, drop in white blood cell count and infections
The BTTC is currently conducting state-of-the-art clinical trials in a collaborative and collegial environment to investigate new treatments for malignant brain tumors .
Learn more about the research and clinical trials
Treatment is designed to provide the patient with comfort and maintain as much neurologic function as possible. The patient's physician may prescribe:
- Analgesics for pain relief
- Steroids to reduce intercranial pressure and reduce swelling; however, long-term use of steroids can create toxic effects
- Anticonvulsant drugs to control seizures