What's the treatment for brain cancer?
Treatment of brain cancers depends on the diagnosis. Treatment involves any combination of surgery, radiation, and chemotherapy. Some tumors require several different surgical procedures, and some can be treated with radiation alone. Initial treatment of a brain tumor may include steroid medications to reduce swelling and inflammation of brain tissue.
Anticonvulsant medications may help prevent or control seizures. If the tumor has resulted in a buildup of fluid in the brain (hydrocephalus), the doctor may surgically insert a shunt. A shunt is a long, thin tube that's placed in the brain and then threaded under the skin to another part of the body, usually the abdomen. The tube allows excess fluid to be removed from the brain. These measures aren't often needed for benign, primary brain tumors.
Surgery is the mainstay of brain tumor treatment. It involves removing as much of the tumor as possible while trying to minimize damage to healthy tissue. Some tumors can be removed completely, while others can be removed only partially or not all. If a tumor is slow-growing doctors may not operate immediately but take a watch-and-wait approach. To remove a tumor from the brain, the surgeon makes an opening in the skull, called a craniotomy, and removes as much of the tumor as possible without damaging normal brain tissue. If a tumor, or a part of it, can't be removed that way, the surgeon may insert a needle through a small hole in the skull to collect cells from the tumor. This procedure is called a biopsy.
Radiation therapy uses x-rays to kill cancer cells from the outside and shrink tumors (external-beam radiation therapy). Radiation therapy (also called radiotherapy) is the use of high-energy rays to kills tumor cells and stop them from growing and multiplying. Radiation from an external source focused precisely on the tumor is called external beam radiation. This is similar to a diagnostic x-ray except that treatments last longer and that many treatments are given over a period of a few weeks. Radiation may also be given by placing radioactive material directly within the tumor, called interstitial radiotherapy or brachytherapy. Radiation therapists use several different approaches to treat primary brain tumors, but external-beam radiation is the most common. Local radiation therapy techniques, including external focal, brachytherapy, and stereotactic radiosurgery, may be administered to selected patients.
Chemotherapy uses drugs to kill cancer cells. Unlike other organs, the brain is protected by the 'blood-brain barrier'. Only some chemotherapy drugs can cross this system of thin membranes. Chemotherapy is not generally the initial treatment for brain cancer. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. These chemotherapy drugs kill cancer cells but can also damage normal cells. Careful attention is given to avoid or reduce the side effects of chemotherapy. These side effects depend on the type and dose of drugs given and the length of time they are taken. Drugs used in cancer chemotherapy specifically attack cells that are rapidly dividing. These drugs are useful because cancer cells spend more of their time dividing and reproducing than normal cells do.
Although the three options (surgery, radiation, and chemotherapy) are available for both adults and children, the approach for children differs from adults. Generally, in children with common brain tumors, therapy consisting of surgery, radiation, and a "tried and true" combination of the drugs vincristine, CCNU, and prednisone still yields the best chances of survival. In children under six, however, physicians try to use chemotherapy alone, if possible, and avoid radiation to prevent harm to the developing brain.