There are many options for brain tumor treatment. The choice of treatment is based on many different factors, including the size and location of the tumor and especially the type of tumor.
Treatment of a complicated disease such as a brain tumor requires a complex treatment that is made possible only through the collaboration of a multidisciplinary care team:
- Neurosurgeon: A surgeon who is trained to treat various disorders of the nervous system. When seeking a neurosurgeon, look for one who subspecializes in the treatment of the specific brain tumor that you or your loved one has.
- Neuro-oncologist: Can be a medical oncologist or a neurologist who subspecializes in the medical treatment of brain tumors. Your neuro-oncologist will guide the chemotherapy treatment of your particular tumor after the diagnosis has been made.
- Radiation Oncologist: A specialist trained in radiation treatment of people who have received the diagnosis of tumor.
- Endocrinologist: These are specialists in diagnosis and treatment of the diseases of the endocrine system, a complex system of organs that secretes and controls the body’s hormones. Endocrinologists are involved in the care of people with brain tumors that affect the endocrine organs, such as the pituitary gland.
- Other specialists that you may see during your journey or just hear about their involvement in your care include neuro-radiologists, neuro-pathologists, neuropsychologists, rehabilitation specialists, speech therapists, physical and occupational therapists, social workers and more.
Treatments are often combined for the best results.
Brain Tumor Surgery
Surgery is the most common way to treat a brain tumor, either by removing all or part of the tumor, or just taking a small sample of the tumor to help make the correct diagnosis. For certain tumors, surgery is the only treatment option.
During surgery, your doctor can physically remove all or most of the tumor, depending on its size and location. Depending on the location of the tumor, the neurosurgeons can use different techniques that make it possible to remove the majority of the tumor and limit injury to the important surrounding areas of the brain such as speech and motor areas. One such technique is called Awake Craniotomy, during which the individual is kept awake and the surgeon, a speech specialist and the operating room team communicate with the individual and test the speech and other functions of the brain while the surgeon removes the brain tumor. If cancer is present, additional treatment may be needed.
Surgery for brain tumors can accomplish a few different goals:
- Make the correct diagnosis, since by removing the tumor, the tissue can be evaluated under the microscope.
- Reduce the size of the tumor. The surgery can help treat the tumor completely, or make the other treatment options, such as chemotherapy and radiation, easier by reducing the size of the tumor.
- Improve the symptoms by releasing the pressure that the tumor causes in the brain.
Radiation & Chemotherapy
Chemotherapy uses special drugs to stop the growth of cancer cells. These drugs are given by mouth or by injection. Although used most often for cancerous tumors, slower growing tumors or benign tumors are also sometimes treated with chemo. Some treatment protocols for certain type of tumors are standardized, but some are not. Your physician may suggest you enroll in a clinical trial after he or she has exhausted all standard treatment protocols.
In radiation therapy, high-energy radiation is used to kill cancer cells. Radiation therapy may be scheduled on its own, or may be done to shrink a tumor enough that surgery can be safely performed. More often though, the radiation therapy is done after the surgery has been performed, to reduce the chances of tumor recurrence.
Other Brain Tumor Treatments
Laser Interstitial Thermal Therapy (LITT) refers to the treatment of brain tumors with laser technology, using light energy to destroy the tumor. The location of the tumor and its response to other treatment options determine which brain tumors can be considered for laser ablation. During this treatment, the neurosurgeon will introduce a laser probe into the tumor. As the laser is delivered, the temperature will rise and destroy the unwanted tissue only. Depending on the size, location, shape and type of the tumor, your specialized physician will be able to determine if your tumor can be treated with this technology.
Optune™, formerly known as Novocure TTF100, is a new and unique form of treatment for brain tumors. The treatment uses alternating electrical fields that are delivered through electrode arrays. These arrays are placed on the individual’s head, and the electrical fields kill the dividing cells of the brain tumor. The FDA has approved this approach for treatment of certain tumors.
In some cases, your doctor may feel that waiting and performing active surveillance with serial MRIs is the best approach for the time being. Your condition is closely monitored until symptoms appear or change, at which time a more informed decision about treatment can be made.