When it comes to brain tumor care, different types of doctors often work together to create a patient’s overall treatment plan, which may combine different types of treatment. 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
- Side effects that could occur
- What the patient prefers 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
There are five types of standard treatment options for brain tumors, which include surgery, radiation therapy, chemotherapy, targeted therapy, and active surveillance.
Surgery is usually 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 doctor will use the patient’s own bone to cover the opening in the skull. After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left.
Several advancements have been made regarding brain surgery, which include:
- 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.
- Making tumor cells more visible by administering a fluorescent dye, called 5 aminolevulinic acid, by mouth the morning before surgery.
Surgery also provides an opportunity for biopsy, which is needed for diagnosis. For cancerous tumors that cannot be cured, removing it can still be beneficial for 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. Certain ways of giving external radiation therapy can help keep radiation from damaging nearby healthy tissue. These types of radiation therapy include the following:
- 3-dimensional conformal radiation therapy (3D-CRT)
- Intensity modulated radiation therapy (IMRT)
- Stereotactic radiosurgery, a non-surgical 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 cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. 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 placed directly 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. Because of its precision in the way it attacks cancer cells, targeted therapy may cause less harm to normal cells than chemotherapy or radiation therapy do.
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 is closely watching a patient’s condition but not giving any treatment unless there are changes in test results that show the condition is getting worse. It 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. This method of treatment may be used for very slow-growing tumors that do not cause symptoms.
At Affiliated Oncologists, we are here to answer any questions you have about your individual situation. Once a treatment plan is in place, your cancer care team will 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. For more information on clinical trials, visit US Oncology Clinical Trials, ClinicalTrials.Gov, or the National Cancer Institute. You may also contact us directly to learn more about the clinical trials available at Affiliated Oncologists.