What's the treatment for brain tumors?
The approach for treating brain tumors is to reduce the tumor as much as possible using surgery, radiation treatment (also called radiotherapy), chemotherapy, or investigative procedures. Such treatments are used alone or, more commonly, in combinations. With some very slow-growing cancers, such as those that occur in the midbrain or optic nerve pathway,
patients may be closely observed and not treated until the tumor shows signs of growth. The intensity, combination, and sequence of these treatments depends on the glioma subtype, its size and location, and patient age, health status, and medical history.
Treatment of a brain tumor depends on its location and type. When possible, the tumor is removed surgically. Some brain tumors can be removed with little or no damage to the brain. However, many grow in an area that makes removal difficult or impossible without destroying essential structures. Surgery sometimes causes brain damage that can lead to partial paralysis, changes in sensation, weakness, and impaired intellect. Nevertheless, removing a tumor - whether cancerous or noncancerous - is essential if its growth threatens important brain structures. Even when a cure is impossible, surgery may be useful to reduce the tumor's size, relieve symptoms, and help doctors determine whether other treatments, such as radiation therapy or chemotherapy, are warranted.
Radiation therapy, which uses high-powered rays to kill cancer cells, is often used after surgery to help rid the area of any remaining cancer cells or to destroy parts of the tumor that could not be removed by surgery. External radiotherapy, generally delivered on an outpatient basis, directs radiation to the tumor and the area around it. Implant radiation therapy involves placing tiny pieces of radioactive material in the brain. Left in place permanently, or for a short time, these radioactive pellets release measured doses of radiation each day. Patients are usually hospitalized during the several days the pellets are most active. Stereoactic radiosurgery involves fitting the patient with a frame to stabilize the head, using imaging techniques to determine the exact location of tumor cells, and using a sophisticated instrument called a gamma knife to administer radiation precisely to that point.
Chemotherapy may involve one or a combination of anticancer drugs, usually taken orally or by injection. One or more cancer-killing drugs may be taken by mouth or injected into a blood vessel, muscle, or the cerebrospinal fluid. Chemotherapy may be used with radiation and surgery as part of a patient's initial treatment, or used alone to treat tumors that recur in the same place or in another part of the body. When a young child has a brain tumor, chemotherapy is often used to eliminate or delay the need for radiation. In general, however, chemotherapy is usually administered in brain cancer as salvage therapy for recurrent or slowly progressing cancers in patients who have previously been treated.