Treatment of Brain Tumor

Brain Tumor Treatment

People with brain tumors have several treatment options. These include: Many people get a combination of treatments. The choice of treatment depends mainly on the following:
  • The type and grade of brain tumor
  • Its location in the brain
  • Its size
  • Your age and general health

Surgery

Surgery is the usual first treatment for most brain tumors. Surgery to open the skull is called a craniotomy. The surgeon makes an incision in your scalp and uses a special type of saw to remove a piece of bone from the skull. Sometimes surgery isn’t possible. If the tumor is in the brain stem or certain other areas, the surgeon may not be able to remove the tumor without harming normal brain tissue. People who can’t have surgery may receive radiation therapy or other treatment. Brain surgery may harm normal tissue. Brain damage can be a serious problem. It can cause problems with thinking, seeing, or speaking. It can also cause personality changes or seizures. Most of these problems lessen or disappear with time. But sometimes damage to the brain is permanent. You may need physical therapy, speech therapy, or occupational therapy.

Radiation Therapy

Radiation therapy kills brain tumor cells with high-energy x-rays, gamma rays, or protons. Radiation therapy usually follows surgery. The radiation kills tumor cells that may remain in the area. Sometimes, people who can’t have surgery have radiation therapy instead. External radiation therapy: A large machine outside the body aims beams of radiation at the head. Because cancer cells may invade normal tissue around a tumor, the radiation may be aimed at the tumor and nearby brain tissue, or at the entire brain. Some people need radiation aimed at the spinal cord also. The treatment schedule depends on your age, and the type and size of the tumor. Fractionated external beam therapy is the most common method of radiation therapy used for people with brain tumors. Giving the total dose of radiation over several weeks helps to protect healthy tissue in the area of the tumor. There are some other ways of delivering external beam radiation therapy:
  • Intensity-modulated radiation therapy or 3-dimensional conformal radiation therapy: These types of treatment use computers to more closely target the brain tumor to lessen the damage to healthy tissue.
  • Proton beam radiation therapy: The source of radiation is protons rather than x-rays. The doctor aims the proton beam at the tumor. The dose of radiation to normal tissue from a proton beam is less than the dose from an x-ray beam.
  • Stereotactic radiation therapy: Narrow beams of x-rays or gamma rays are directed at the tumor from different angles. For this procedure, you wear a rigid head frame. The therapy may be given during a single visit (stereotactic radiosurgery) or over several visits.
Internal radiation therapy (implant radiation therapy or brachytherapy): Internal radiation isn’t commonly used for treating brain tumors and is under study. The radiation comes from radioactive material usually contained in very small implants called seeds. The seeds are placed inside the brain and give off radiation for months. They don’t need to be removed once the radiation is gone.

Chemotherapy

Chemotherapy, the use of drugs to kill cancer cells, is sometimes used to treat brain tumors. Drugs may be given in the following ways: By mouth or vein (intravenous): Chemotherapy may be given during and after radiation therapy. The drugs enter the bloodstream and travel throughout the body. They may be given in an outpatient part of the hospital, at the doctor’s office, or at home. Rarely, you may need to stay in the hospital. The side effects of chemotherapy depend mainly on which drugs are given and how much. Common side effects include nausea and vomiting, loss of appetite, headache, fever and chills, and weakness. In wafers that are put into the brain: For some adults with high-grade glioma, the surgeon implants several wafers into the brain. Each wafer is about the size of a dime. Over several weeks, the wafers dissolve, releasing the drug into the brain. The drug kills cancer cells. It may help prevent the tumor from returning in the brain after surgery to remove the tumor.

Optune

Optune is not a radiation therapy or a chemotherapy, but a new FDA approved treatment for some forms of Glioblastoma. It is a medical device that is attached to the scalp and delivers Tumor Treating Fields (TTFields) to cancerous cells, stopping their ability to multiply and resulting in cell death. To learn more about this new brain tumor treatment, visit our page about Optune.

Nutrition

It’s important for you to take care of yourself by eating well. You need the right amount of calories to maintain a good weight. You also need enough protein to keep up your strength. Eating well may help you feel better and have more energy.

Follow-up Care

You’ll need regular checkups after treatment for a brain tumor. For example, for certain types of brain tumors, checkups may be every 3 months. Checkups help ensure that any changes in your health are noted and treated if needed. If you have any health problems between checkups, you should contact your doctor. Your doctor will check for return of the tumor. Also, checkups help detect health problems that can result from cancer treatment. Checkups may include careful physical and neurologic exams, as well as MRI or CT scans. If you have a shunt, your doctor checks to see that it’s working well. Contact us to request an appointment with one of the physicians at Diablo Valley Oncology to discuss the treatment options available to treat your brain tumor or to obtain a second opinion.