Treatment for a brain tumor depends on several things like your age, general health, and the size, location, and type of tumor.
You and your loved ones will have many questions about brain cancer, the treatment, side effects, and the long-term outlook. Your health care team is the best source of this information. Don't hesitate to ask.
Brain Cancer Treatment Overview
Treatment of brain cancer is usually complex. Most treatment plans involve several doctors. Your team might include:
- Neurosurgeons (specialists in the brain and nervous system)
- Oncologists (cancer specialists)
- Radiation oncologists (doctors who practice radiation therapy)
- Your primary doctor
Your team may also include a dietitian, a social worker, a physical therapist, and other specialists.
The most widely used treatments are surgery, radiation therapy, and chemotherapy. In most cases, more than one of these is used.
The treatment you get will depend on:
- The type of tumor
- The size and location of the tumor
- Your age and overall health
- The risks of a particular treatment
- Other medical problems you have
- The treatment you most prefer
Brain Cancer Surgery
Many people with a brain tumor undergo surgery. During the operation, the surgeon will confirm that you have a tumor and then try to remove all of it. If the surgeon can’t remove the tumor, they’ll take a sample to identify its type.
In some cases, mostly in benign tumors, removing the tumor will cure your symptoms.
You may get several treatments and procedures before surgery. For example:
- You may take a steroid drug, like dexamethasone (Decadron), to relieve swelling.
- You may get an anticonvulsant drug to relieve or prevent seizures.
- If cerebrospinal fluid is collecting around your brain, your doctor may put in a thin, plastic tube called a shunt to drain the fluid. One end of the shunt goes in the space where fluid collects. The other is threaded under your skin to another part of your body. The fluid drains from your brain to a place where you can get rid of it easily.
Common types of surgery include:
- Craniotomy. This is the surgery most often used to remove a brain tumor. The surgeon starts by cutting through your scalp. They’ll remove a piece of skull to expose your brain. Then they’ll remove the entire tumor or as much as possible. The surgeon places the piece of skull back into position and sews the scalp together.
- Neuroendoscopy. The surgeon makes a small hole in the skull or goes through the nose or mouth, depending on the location of the tumor. They’ll use small tools to remove the tumor. One of these has a tiny camera that sends images back to a monitor next to the operating table. The surgeon uses these images to find and remove the tumor.
If a new tumor appears, you may need a second surgery.
Radiation Therapy for Brain Cancer
Radiation therapy (also called radiotherapy) uses high-energy rays to kill tumor cells, stopping them from growing and spreading.
- Radiation therapy may be used for people who cannot have surgery. It’s also used after surgery to kill any tumor cells that may remain.
- Radiation therapy is a local therapy. This means that it usually does not harm cells elsewhere in the body or even elsewhere in the brain.
Radiation can be given in the following ways:
- External radiation uses a high-energy beam of radiation targeted at the tumor. The beam travels through the skin, the skull, healthy brain tissue, and other tissues to get to the tumor. The treatments are usually given 5 days. Each treatment takes only a few minutes.
- Internal or implant radiation uses a tiny radioactive capsule that is placed inside the tumor. The radiation from the capsule destroys the tumor. The radioactivity of the capsule decreases a little bit each day and is carefully calculated to run out when the optimal dose has been given. You need to stay in the hospital for several days while receiving this treatment.
- Stereotactic radiosurgery destroys a brain tumor without opening the skull. A single large dose of high-energy radiation beams is trained on the tumor from different angles. The radiation destroys the tumor. Stereotactic radiosurgery has fewer complications than regular surgery and a shorter recovery time.
The side effects of radiation include:
- Skin redness
- Hair loss
- Weight gain
- Memory problems
Chemotherapy for Brain Cancer
Chemotherapy is the use of powerful medicines to kill tumor cells.
- You may get a single medicine or a combination of them.
- Chemotherapy is given by mouth or through an IV. Some medications are given through the shunt put in place to drain excess fluid from your brain.
- Chemotherapy is usually given in cycles. A cycle is a short period of intensive treatment followed by a period of rest and recovery. Each cycle lasts a few weeks.
- You’ll probably get two to four cycles. Then there’s a break in the treatment to see how your tumor has responded to the therapy.
The side effects of chemotherapy include:
- Nausea and vomiting
- Mouth sores
- Loss of appetite
- Hair loss
- Weight loss
- Easy bruising and bleeding
- Increased risk of infections due to a weakened immune system
Some of these side effects can be relieved or improved by medication.
Brain Cancer Clinical Trials
Researchers use clinical trials to test the effects of new medications on a group of volunteers with brain cancer. They follow strict rules and create carefully controlled conditions to figure out how well the drug treats brain cancer, how safe it is, and if there are any side effects.
If you join a clinical trial, you might get a new therapy that may be more effective than existing therapies or have fewer side effects. The disadvantage is that the new therapy has not been proven to work or may not work in everyone.
To find out more about clinical trials, ask your oncologist. Or check these sites for information and services to help you find a clinical trial that’s right for you.
- TrialCheck. Lets you search for cancer trials based on disease and location.
- National Cancer Institute. Lists more than 12,000 cancer clinical trials, along with descriptions, eligibility criteria, and instructions on what to do when you find one you think is right for you.
- ClinicalTrials.gov. Offers up-to-date information on clinical trials in the U.S. and around the world.
- CenterWatch. Lists industry-sponsored clinical trials.
Brain Cancer Treatment Follow-up Care
Brain tumor surgery usually requires at least a few days of recovery in the hospital. The time could be longer depending on your age, overall health, and the type of treatment. You may need chemotherapy or radiation therapy after surgery. That could also affect how much time you spend in the hospital.
You may get painless tests, like computed tomography (CT) and MRI, during recovery. Both of these provide doctors with images of the brain to help them see if there have been any changes.
Depending on your condition, you may need a stay in a rehabilitation center.
A team of doctors and nurses will care for you. Together, they’ll come up with a post-surgery treatment and recovery plan. Some of the specialists you may see include:
- A neurologist to evaluate and treat conditions of the nervous system
- A physical therapist to help with walking and other large-muscle activities
- An occupational therapist to help with smaller muscle function, such as using eating utensils, buttoning a shirt, brushing teeth, and similar activities
- A speech therapist to help improve talking and communication skills
- An ophthalmologist to check your vision
- An audiologist to check your hearing
- A psychiatrist or psychologist to evaluate any changes in your memory, intelligence, and other mental skills
After you get home, you should call 911 if you have trouble breathing or have a seizure -- especially if it’s different from previous seizures or if you never had one.
Other symptoms that should prompt a call to the doctor include:
- Memory problems
- Major mood changes
- Trouble with bowel movements and urination
- Frequent headaches
- Weakness or tingling in the arms or legs
- Fever above 100.5 F
Call the doctor anytime you have questions about your health during recovery.
Brain Cancer Survival Rate
Survival rates in brain cancer vary widely. The major things that influence survival are the type of cancer, its location, whether it started in your brain or spread there from somewhere else in your body, whether it can be surgically removed or reduced in size, your age, and other medical problems.
Support Groups and Counseling
Living with cancer presents many new challenges, both for you and for your family and friends. You will probably have many concerns about how the cancer will affect you and your ability to "live a normal life," such as caring for your family and home, working, and continuing the friendships and activities you enjoy.
For most people with cancer, talking about their feelings and concerns helps.
- Your friends and family members can be very supportive. They may be hesitant to offer support until they see how you are coping. Don't wait for them to bring it up. If you want to talk about concerns, let them know.
- Some people don't want to "burden" their loved ones or prefer talking about their concerns with a more neutral professional. A social worker, counselor, or member of the clergy may be helpful if you want to discuss feelings and concerns about having cancer. Your oncologist should be able to recommend someone.
- Many people with cancer are helped profoundly by talking to other people who have cancer. Sharing concerns with others who have been through the same experience can be remarkably reassuring. Support groups of people with cancer may be available through the medical center where you are receiving treatment. The American Cancer Society also has information about support groups all over the U.S.
Home Care for Brain Cancer
When you have brain cancer, your health care team will discuss details about home care with you and your family members. This could include:
- Physical therapists. They can help if you have trouble walking or moving.
- Occupational therapists. Can teach you how to use equipment to help with daily activities.
- Speech therapists. Can help with problems related to speaking and swallowing.
- Home health aides. They’re specially trained to help with personal care tasks like bathing, dressing, and eating.
- Nurses. Can give medicines, provide wound care, and keep an eye on your side effects.
- Home hospice care. Provides pain and symptom relief, as well as emotional and spiritual support for you and your family, at home rather than in the hospital. It may include a doctor, nurses, a pharmacist, aides, a social worker, a spiritual caregiver, and counselors.
- Advance directives. These legal documents provide a way for you to express your wishes for treatment and choose the person you want to make decisions on your behalf if you can’t. Types of advance directives include a living will and durable power of attorney for health care. For example, you may not want to be put on a ventilator (breathing machine) if you stop breathing. You have the right to make these decisions for yourself as long as you’re mentally competent.