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Treatments and drugs
By Mayo Clinic staffTreatment 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 are 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 signs and symptoms you experience. 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 beams of high-energy particles, such as X-rays, 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 sometimes used after surgery to kill tumor cells that might have been left behind. Whole brain radiation may also be an option if you have several brain tumors that can't be removed through surgery. Whole brain radiation is often used in situations where cancer has metastasized to the brain.
Side effects of radiation therapy will 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 may be an option if your brain tumor can't be removed with traditional surgery. 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 or injected into a vein (intravenously) so that they travel throughout your body. Chemotherapy drugs can also be administered into your spinal column, so treatment affects only your central nervous system.
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 void 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. Systemic 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. Many targeted drug therapies are very new and still undergoing careful study in clinical trials.
One targeted drug therapy used to treat brain tumors 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.
Clinical trials
Clinical trials are studies of the latest treatments, such as new drugs or new ways of using existing drugs and new surgical techniques. A clinical trial may offer you a chance at the latest treatment advances. But clinical trials can't guarantee a cure. And, in some cases, side effects of new treatments may not be fully known.
Talk to your doctor about clinical trials. Together you can discuss the benefits and risks and decide if a trial is appropriate for you.
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. The brain can sometimes heal itself after trauma from or treatment of a brain tumor — but this can take time and patience.
- Cognitive rehabilitation can help you cope with or regain lost cognitive abilities.
- Physical therapy can help you regain lost motor skills or muscle strength.
- Vocational therapy can help you get back to work after a brain tumor or other illness.
- Specialists in speech difficulties (speech pathologists) are just one of many types of therapists who can help you recover.
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 are identified, the earlier they can be addressed with strategies that provide the most benefits to the child.
