Care and Treatment for Brain Tumors
When it comes to brain tumor care, a team consisting of different types of doctors work together to design a treatment plan for the patient. The treatment plan often includes a combination of treatments. This team of medical professionals is called a multidisciplinary team.
Brain cancer treatment options and recommendations depend on several factors, including:
- The size, type, and grade of the tumor
- Whether or not the tumor is pressing on other vital parts of the brain
- Potential side effects
- The preferences of the patient as well as their overall health
Your multidisciplinary team will take all these factors into consideration before you are presented with a recommended treatment plan and start date.
Brain Tumor Treatment Options
The most common treatment options for brain tumors include surgery, radiation therapy, chemotherapy, targeted therapy, and active surveillance.
Surgery is typically the first step in brain tumor treatment, especially if the entire tumor can be removed. Surgical procedures involving the brain require a craniotomy, which is the removal of part of the skull. Once the tumor is removed, the opening in the skull will be covered with the patient’s own bone.
Several advancements have been made regarding brain surgery, which includes:
- Cortical mapping, which allows doctors to identify areas of the brain that control the senses, language, and motor skills.
- Enhancing imaging devices, such as Image-Guided Surgery (IGS), which help surgeons plan and perform surgery more accurately.
- 5 aminolevulinic acid, a fluorescent dye, which gets absorbed by tumor cells, making them more visible during surgery.
In addition to removing or reducing the size of the brain tumor, surgery provides an opportunity for biopsy, which is needed for diagnosis. For cancerous tumors that cannot be cured, removing it can still benefit the patient in that it can relieve symptoms caused by pressure on the brain.
In some cases, the location of the tumor makes it impossible to perform surgery (inoperable). If the tumor is inoperable, other treatment options will be recommended.
Radiation therapy (also called radiotherapy) is a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. It is typically given after surgery and sometimes in combination with chemotherapy.
The most common type of radiation treatment is called external-beam radiation therapy, which is given from a machine outside the body. It can be directed at the tumor in a variety of ways, including:
- 3-dimensional conformal radiation therapy
- Intensity-modulated radiation therapy (IMRT)
- Stereotactic radiotherapy, a technique that precisely focuses beams of radiation to destroy certain types of tumors often resulting in a greater amount of spared normal tissue.
Chemotherapy (chemo) is a group of medicines used to treat cancer. These drugs are usually given into a vein (IV) or taken orally (by mouth). Many chemo drugs, however, aren't able to cross the blood-brain barrier and enter the fluid that surrounds the brain and spinal cord. Because of this, your oncologist may suggest another alternative, called intrathecal chemotherapy. In intrathecal chemotherapy, an anticancer drug is injected into the fluid-filled space to kill cancer cells there.
While receiving active treatment, patients are monitored every 2 to 3 months with a brain MRI. The grade of the tumor typically determines how often MRI scans are needed after treatment.
Targeted therapies are drugs or other substances that target the specific genes, proteins, or tissue of a tumor. They differ from chemotherapy in that they can identify cancerous cells and attack them while leaving the normal, healthy cells alone.
Anti-angiogenesis therapy is commonly used for brain tumors because it “starves” the tumor of nutrients that cause it to grow and spread. Other targeted therapies for brain cancer are being researched.
Active surveillance includes closely watching a patient’s brain tumor(s) but not giving any treatment unless there are changes in test results that show the condition is getting worse. Active surveillance may be used to avoid or delay the need for treatments such as radiation therapy or surgery, which can cause side effects or other problems. During active surveillance, certain exams and tests are done on a regular schedule. Active surveillance may be used for very slow-growing brain and spinal tumors that do not cause symptoms.
The Compass Oncology care team is here to answer any questions you have about your individual situation. Once a treatment plan is in place, our staff is here to help you or your loved one through every step of cancer treatment.
Many clinical trials evaluating new therapies, such as proton therapy and biological therapy, as well as potential drugs to treat brain tumors, are ongoing. If you would like more information, you may speak with your Compass oncologist regarding the available clinical trials, or you can visit our available cancer clinical trials page.