treatments
Once a diagnosis is made, your physician will discuss the many different ways to help treat and manage your specific type of tumor. You may be referred to one or more of the following:
Surgery
Surgery is often the first option considered and the preferred first step for treatment. The purpose of surgery is to do the following:
- Remove as much of the tumor as possible
- Retrieve tissue for a biopsy and determine tumor type
- Reduce the size of the tumor to alleviate pressure caused by the tumor and to reduce the amount of tumor treated by chemotherapy and/or radiation
- Provide a way for chemotherapy to be administered directly to the tumor
- Help reduce the symptoms caused by the tumor
An “awake” surgery is sometimes necessary for patients with tumors in locations close to speech or motor areas. Patients receive sedation for the majority of the surgery, but are allowed to regain consciousness with adequate pain control and sedation to allow for neurological testing during the tumor removal.
During your visit, your physician will discuss all pros and cons, risk and benefits, and potential side effects of surgery.
For some patients surgery isn’t an option due to the following:
- Tumor location. Depending on the location of the tumor, surgery may cause damage to parts of the brain that control speech, movement, hearing, or vision.
- General health of the patient. Patients with a history of heart, lung, and other medical conditions may not be candidates for surgery.
- Tumor type. Small, benign tumors that don’t increase in size, do not cause any symptoms, and are considered stable may not require surgery.
Chemotherapy
During your appointment, the neuro-oncologist will determine if you are a candidate for chemotherapy.
Chemotherapy is the use of pharmaceutical medications to treat or manage malignant, high grade, low grade, and benign tumors. The goal of chemotherapy is to slow, stop, or kill rapid, uncontrollable cell growth. Chemotherapy drugs that slow or stop tumor cells are called cytostatic. Chemotherapy drugs that kill the tumor cells are called cytotoxic.
Chemotherapy works in one of two ways:
- Cell-cycle-specific chemotherapy works by interrupting one of the steps necessary for a cell to divide.
- Non-cell-cycle-specific chemotherapy is effective during any part of cell division.
These drugs are sometimes used together to provide a wider range of treatment.
Chemotherapy is given in different ways:
- Systemic chemotherapy is given through the body orally or intravenously.
- Local chemotherapy is delivered through doses within or around a tumor. To provide this type of delivery, the surgeon places a “wafer” directly onto the tumor or places a catheter in spaces in the brain so the chemotherapy can be injected directly into the spaces. This allows the chemotherapy to have direct contact with the tumor.
The most typical side effects of chemotherapy, though they do not always occur, include the following:
- Intestinal upset (diarrhea)
- Mouth sores
- Fatigue
- Nausea
- Vomiting
- Lowered white cell count
Inform your neuro-oncologist of any side effects; there are many options for managing side effects.
During chemotherapy, a series of MRIs will be performed to track the treatment’s effectiveness.
Radiation Therapy
The purpose of radiation is to kill the cell directly or halt the cell from progressing. Radiation affects both tumor cells and healthy cells, but the healthy cells have a faster recovery rate. As radiation treatment continues, the tumor cells die and the tumor reduces in size.
Some patients, depending on the tumor type, will receive radiation and chemotherapy at the same time. This is called concurrent therapy.
Radiation treatment is an outpatient procedure and requires little preparation on the patient’s part. On a patient’s first visit, a mask of the patient’s face is made to insure that the radiation is delivered precisely each treatment. After the mask is made, a technician takes the patient to a treatment room. The patient lies on a table, the mask is secured, and the technician leaves. The patient is monitored on close-circuit television and can communicate with the technician.
Radiation treatment is painless and quick. During treatment some people experience an unusual smell or see flashes of light even with closed eyes. The patient will hear noises made by the machine and will experience periodic pauses as the technician readjusts the machine or the patient. The typical treatment schedule is five times a week for six weeks. Your radiation-oncologist will discuss the best treatment plan for you.
The main types of radiation treatments for patients with brain, spine, and skull base tumors are whole brain radiation, stereotactic radiosurgery, and stereotactic radiotherapy.
- Whole Brain Radiation: This process delivers radiation to a patient’s entire brain. The indications for whole brain radiation are dependent upon the size of the tumor, the location of the tumor, the number of lesions in the brain, and the type of brain tumor.
- Stereotactic Radiosurgery: This technique delivers a high dose of radiation to a small, well-defined area. The goal is to kill cancerous tissue within a targeted area while sparing surrounding normal tissue. Stereotactic radiosurgery treats both primary brain tumors and those that have metastasized to the brain from another site. As with any treatment, it has advantages and disadvantages. The main limitation is determined by the size of the tumor (the larger the tumor the less likely it can be treated). The advantage is that it provides the ability to treat tumors almost anywhere in the brain and spare nearby critical tissue. This technique is done on an outpatient basis and offers a good option for people who may be poor candidates for surgery.
- Stereotatic Radiotherapy: This is the same concept as stereotactic radiosurgery, but it is repeated several times using a smaller dose of radiation.
Learn more about Novalis®, a non-surgical way to treat brain cancers, on the Huntsman Cancer Institute Technology webpage.
Potential side effects of radiation include the following:
- Fatigue
- Hair Loss
- Skin Change
- Edema (brain swelling)
If you are experiencing any of these side effects discuss them with the radiation-oncologist. They will help you manage the side effect.
|
