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Treatments and drugs
By Mayo Clinic staff
Treatment for a brain tumor depends on the type, size and location of the tumor, as well as your overall health and your preferences. Your doctor can tailor treatment to fit your particular situation.
Surgery
If the brain tumor is located in a place that makes it accessible for an operation, your surgeon will work to remove as much of your brain tumor as possible. In some cases, tumors are small and easy to separate from surrounding brain tissue, which makes complete surgical removal possible. In other cases, tumors can't be separated from surrounding tissue or they're located near sensitive areas in your brain, making surgery risky. In these situations your doctor may try to remove as much of the tumor as is safe. Even removing a portion of the brain tumor may help reduce your signs and symptoms. In some cases only a small biopsy is taken to confirm the diagnosis.
Surgery to remove a brain tumor carries risks, such as infection and bleeding. Other risks may depend on the part of your brain where your tumor is located. For instance, surgery on a tumor near nerves that connect to your eyes may carry a risk of vision loss.
Radiation therapy
Radiation therapy uses high-energy beams, such as X-rays or protons, to kill tumor cells. Radiation therapy can come from a machine outside your body (external beam radiation), or, in very rare cases, radiation can be placed inside your body close to your brain tumor (brachytherapy).
External beam radiation can focus just on the area of your brain where the tumor is located, or it can be applied to your entire brain (whole brain radiation). Whole brain radiation is most often used to treat cancer that has spread to the brain from some other part of the body.
Side effects of radiation therapy depend on the type and dose of radiation you receive. In general it can cause fatigue, headaches and scalp irritation.
Radiosurgery
Stereotactic radiosurgery is not a form of surgery in the traditional sense. Instead, radiosurgery uses multiple beams of radiation to give a highly focused form of radiation treatment to kill the tumor cells in a very small area. Each beam of radiation isn't particularly powerful, but the point where all the beams meet — at the brain tumor — receives a very large dose of radiation to kill the tumor cells.
Radiosurgery is typically done in one treatment, and in most cases you can go home the same day. Side effects may include fatigue, headache and nausea.
Chemotherapy
Chemotherapy uses drugs to kill tumor cells. Chemotherapy drugs can be taken orally in pill form or injected into a vein (intravenously). The chemotherapy drug used most often to treat brain tumors is temozolomide (Temodar), which is taken as a pill. Many other chemotherapy drugs are available and may be used depending on the type of cancer.
Another type of chemotherapy can be placed during surgery. When removing all or part of the brain tumor, your surgeon may place one or more disk-shaped wafers in the space left by the tumor. These wafers slowly release a chemotherapy drug over the next several days.
Chemotherapy side effects depend on the type and dose of drugs you receive. Chemotherapy can cause nausea, vomiting and hair loss.
Targeted drug therapy
Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die.
One targeted drug therapy used to treat a type of brain cancer called glioblastoma is bevacizumab (Avastin). This drug, given through a vein (intravenously), stops the formation of new blood vessels, cutting off blood supply to a tumor and killing the tumor cells.
The targeted drug everolimus (Afinitor) is used to treat a benign brain tumor that occurs in people with a genetic disorder called tuberous sclerosis. Everolimus blocks an enzyme in the body that plays a role in growth of cancer cells.
Rehabilitation after treatment
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. Your doctor may refer you to services that can help, such as:
- Physical therapy can help you regain lost motor skills or muscle strength.
- Occupational therapy can help you get back to your normal daily activities, including work, after a brain tumor or other illness.
- Speech therapy with specialists in speech difficulties (speech pathologists) can help if you have difficulty speaking.
- Tutoring for school-age children can help kids cope with changes in their memory and thinking after a brain tumor.
- What you need to know about brain tumors. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/brain. Accessed April 18, 2012.
- Adult brain tumors treatment (PDQ): Health professional version. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/adultbrain/healthprofessional. Accessed April 18, 2012.
- Bradley WG, et al. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa.: Butterworth-Heinemann Elsevier; 2008. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-7506-7525-3..X5001-8--TOP&isbn=978-0-7506-7525-3&uniqId=230100505-57. Accessed April 18, 2012.
- Childhood brain and spinal cord tumors treatment overview (PDQ): Health professional version. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/childbrain/healthprofessional. Accessed April 18, 2012.
- Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-4/0/1709/0.html. Accessed April 18, 2012.
- Armstrong TS, et al. Use of complementary and alternative medical therapy by patients with primary brain tumors. Current Neurology and Neuroscience Reports. 2008;8:264.
- Avastin (prescribing information). South San Francisco, Calif.: Genentech Inc.; 2011. http://www.avastin.com/patient/index.html. Accessed April 19, 2012.
- Afinitor (prescribing information). East Hanover, N.J.: Novartis; 2012. http://www.afinitor.com/sega-tuberous-sclerosis/hcp/prescribing-information.jsp?site=PC018122&irmasrc=ONCWB0042&source=01030. Accessed April 19, 2012.
- Temodar (prescribing information). Whitehouse Station, N.J.: Merck & Co. Inc.; 2012. http://www.temodar.com/temodar/index.do. Accessed April 23, 2012.
- Moynihan TJ (expert opinion). Mayo Clinic, Rochester, Minn. April 23, 2012.
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