BRAIN TUMOR

Treatment

Treatment for a brain tumor — along with survival odds — depends on the type, size and location of the tumor, as well as your age and overall health. Treatment is also tailored to fit each person's diagnosis.

Because brain tumors can be complex to treat, a team of doctors often treats them. This team may include:

• A neurosurgeon (a brain surgeon)

• An oncologist (a doctor who specializes in treating cancer)

• A radiologist (a doctor who specializes in reading medical images)

• A radiation oncologist (a doctor who specializes in radiation therapy)

• A neurologist (a doctor who specializes in the nervous system)

Initial treatment of a brain tumor may include steroid medications to reduce swelling and inflammation of brain tissue. Anticonvulsant medications may be prescribed to help prevent or control seizures. If the tumor has resulted in a buildup of fluid in the brain (hydrocephalus), a shunt may be surgically inserted. 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 from the brain to drain into the stomach. These measures aren't very often needed for benign, primary brain tumors.

The main treatment methods for brain tumors include:

• Surgery. This 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; and 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.

• Radiation. High-energy radiation can be used to destroy tumor cells in the brain.

• Chemotherapy. These drugs, taken by mouth or intravenously, can help kill cancerous tumor cells. Although chemotherapy is highly effective in treating some cancers, it's less successful in treating brain tumors.

Many brain tumors are treated with a combination of therapies. Because a tumor may recur if any tumor cells are left behind, the goal is to remove as much, if not all, of the tumor as possible through surgery. Radiation therapy and chemotherapy are used to treat tumors that can't be cured by surgery alone. Brain tumor treatments do carry side effects, such as hair loss and nausea. Ask your doctor about possible side effects and how best to cope with them.

Once treated, a brain tumor may remain in remission for many years, or may never recur. When a brain tumor is in remission, it means that the tumor cells have stopped growing or multiplying.

As part of follow-up for brain tumor treatment, you're usually monitored on a regular basis for tumor recurrence with MRI or CT scans. You may be asked to return to your doctor for a scan every 3 to 6 months or annually, depending on the type of tumor you had.

New and experimental treatments

In addition to current brain tumor treatments, new technology is evolving and helping to make the treatment of brain tumors more precise. One of the most important advances is stereotactic localization. This technique utilizes a MRI scan to map a tumor's exact location within the brain.

New techniques utilizing lasers and ultrasound also make actual removal of the tumor more precise, reducing the risk that cancer cells will be left behind and that healthy tissue will be harmed.

Some of the most intriguing new methods in brain tumor treatment involve the use of radiation. A treatment that precisely focuses radiation beams to the tumor is called stereotactic radiosurgery. No scalpels are involved. Gamma knife stereotactic radiosurgery delivers radiation beams in the exact size and shape of the tumor, with the aid of brain imaging techniques.

New ways to deliver cancer-fighting drugs to brain tumors are also being studied. For instance, biodegradable wafers containing cancer-fighting drugs are being implanted in some tumors during surgery. In addition, gene therapy, drugs that cut off a tumor's blood supply and agents that may be able to interrupt tumor growth or seek out and kill brain cancer cells are all under investigation.

Many of these newer treatments for brain tumors are being tested in clinical research trials. If you have a brain tumor, particularly a malignant brain tumor, participating in a clinical trial can help you have access to the newest experimental treatments and take part in helping to define the role of these new treatments.

Decisions about brain tumors can be complex. Before starting any treatment, you may want to get a second opinion. To find brain tumor specialists, ask your doctor for recommendations. You can also try calling local hospitals, cancer centers, medical schools or medical societies for recommendations. The ABTA provides lists of brain tumor specialists. You may not be able to get a consensus on treatment for your tumor, but the more information you gather, the more prepared you and your family are to make decisions.

Rehabilitation

Because brain tumors can develop in parts of the brain that control motor skills, speech, vision and thinking, rehabilitation may be a necessary part of recovery. The brain can sometimes heal itself after trauma from a brain tumor — but this can take time and patience.

Cognitive rehabilitation helps people with brain tumors cope with or regain lost cognitive abilities. Physical therapy can help them regain lost motor skills or muscle strength. Vocational therapy — helping people get back to work after a brain tumor or other illness — may also be beneficial. Speech pathologists (specialists in speech difficulties) are just one of many types of therapists that can help a person with a brain tumor recover as fully as possible.

School-age children with brain tumors may especially benefit from tutoring as a part of their overall treatment plan. A brain tumor can cause changes in the brain that affect thinking and learning. The earlier these problems can be identified, the earlier they can be addressed with strategies that maximize the benefit to the child.