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Health care tips  Details of Brain Tumor  Brain Tumor Treatments

Treatments Of Brain Tumor

Surgery

Surgery is the initial therapy for nearly all patients with brain tumors and can cure most benign tumors, including meningiomas. The goal of surgery is to remove as much of the tumor as possible while minimizing injure to healthy tissue.

Some tumors can be removed completely; others can be removed only partly or not at all. Partial removal helps relieve symptoms by reducing pressure on the brain and reducing the size of the tumor to be treated by radiation or chemotherapy.

After the tumor has been removed, immediately evaluate the tissue and report results directly to the surgeon in the operating room. Direct, face-to-face contact with the pathologist during the surgery allows the surgeon to verify that the tumor has been fully removed and may reduce the need for an other operation.

If a tumor cannot be surgically removed, the doctor may do only a biopsy. A small piece of the tumor is removed so a pathologist can examine it under a microscope to determine its cell makeup. The finding helps determine the proper treatment.

Patients diagnosed with brain tumors often can be scheduled for surgery the next day, if preferred. Surgeons provide patients with information to help them decide which treatment is best for them.

The surgery is performed with the patient awake during segments of the operation. The patient's responses to questions allow the surgeon and attending team to more accurately identify critical brain regions and minimize damage during tumor removal.

Lasers are sometimes used to get rid of tumors. In some cases, tumors can be removed using minimally invasive techniques. Innovative techniques such as gene therapy also are available under research Protocols.


Radiation Therapy

Radiation therapy (in North America), or radiotherapy (in the UK and Australia) also called radiation oncology, and sometimes abbreviated to XRT, is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). Radiotherapy may be used for curative or adjuvant cancer treatment. It is used as palliative treatment (where cure is not possible and the aim is for local disease control or symptomatic relief) or as therapeutic treatment (where the therapy has survival benefit and it can be curative). Total body irradiation (TBI) is a radiotherapy technique used to prepare the body to receive a bone marrow transplant. Radiotherapy has several applications in non-malignant conditions, such as the treatment of trigeminal neuralgia, severe thyroid eye disease, pterygium, pigmented villonodular synovitis, prevention of keloid scar growth, and prevention of heterotopic ossification. The use of radiotherapy in non-malignant conditions is limited partly by worries about the risk of radiation-induced cancers.

Radiotherapy is an necessary component of treatment for many patients with brain tumors. It can cure some patients and prolongs survival for most. Radiation is often the primary treatment for patients with metastatic brain tumors.

It is used in precise treatment intent (curative, adjuvant, neoadjuvant, therapeutic, or palliative) will depend on the tumour type, location, and stage, as well as the general health of the patient.

Radiation therapy is commonly applied to the cancerous tumour. The radiation fields may also include the draining lymph nodes if they are clinically or radiologically involved with tumour, or if there is thought to be a risk of subclinical malignant spread. It is necessary to include a margin of normal tissue around the tumour to allow for uncertainties in daily set-up and internal tumor motion. These uncertainties can be caused by internal movement (for example, respiration and bladder filling) and movement of external skin marks relative to the tumour position.

External-Beam Radiation

External beam radiation therapy is a form of radiotherapy generally used at Cancer Treatment Centers of America (CTCA). External beam radiation therapy may be used along with surgery, chemotherapy, and a variety of other treatment options to help you to fight against brain cancer.

External beam radiation therapy uses a high-energy x-ray machine to direct beams of radiation from outside the body on cancerous tissue within the body. The procedure lasts a few minutes at a time, and is usually planned for five days a week over the course of six to eight weeks.

As developments are made in computer hardware and software, radiation treatment, planning and delivery have changed radically and will continue to progress. Recent advances allow radiation therapists to more correctly target brain tumors with higher doses of radiation, while helping to minimize damage to nearby healthy brain tissue.

Brain cancer treatment as some of the advantages of external beam radiation therapy includes the following:

  • It is an outpatient procedure
  • Radiation does not carry the risks or complications that accompany major brain cancer surgery, such as surgical bleeding, post-operative pain, or the risk of stroke, heart attack or blood clot
  • The radiation process itself causes no pain
Fractionated Stereotactic Radiotherapy (FSR)

This technique minimizes injure to normal tissue by carefully targeting radiation. The treatment involves many smaller treatments rather than one big "shot" of radiation. Normal brain tissues and cranial nerves can endure many smaller treatments but cannot tolerate single large treatments. FSR also offers the biological benefit of fractionation, which is to exploit the different sensitivities of normal versus cancer tissue. These advantages are helpful when treating lesions near structures such as the optic nerves, which cannot accept high levels of radiation.

For this procedure, the patient is fitted with a plastic mask that aids in targeting the radiation and locating the tumor during treatment. The patient lies on a table and X-rays are taken to decide correct positioning. The treatment is given in several smaller units called arcs. The number of treatments depends on the size and location of the tumor.

Stereotactic Radiosurgery

Stereotactic radiosurgery is a highly precise form of radiation therapy used mainly to treat tumors and other abnormalities of the brain. Despite its name, stereotactic radiosurgery is a non-surgical procedure that delivers a single high-dose of precisely-targeted radiation using highly focused gamma-ray or x-ray beams that touch on the specific area or areas of the brain where the tumor or other abnormality resides, minimizing the amount of radiation to health brain tissue. Although stereotactic radiosurgery is often completed in a one-day session, physicians sometimes recommend multiple treatments, especially for tumors larger than one inch in diameter. The procedure is frequently referred to as fractionated stereotactic radiosurgery when two to five treatments are given and as stereotactic radiotherapy when more than five treatments are given.

Stereotactic radiosurgery is an important alternative to invasive surgery, especially for tumors and blood vessel abnormalities located deep within or close to vital areas of the brain. Radiosurgery is used to treat many types of brain tumors, either benign or malignant and primary or metastatic and single or multiple. Sometimes radiosurgery is performed after surgery to treat any residual tumor cells. Additionally, radiosurgery is used to treat arteriovenous malformations (AVMs), a tangle of expanded blood vessels that disrupts normal blood flow in the brain and sometimes bleeds. AVMs are the leading cause of stroke in young people. Radiosurgery is also a treatment option for other neurological conditions. A similar technique may be used in other parts of the body and is known as Stereotactic Body Radiosurgery (SBRS).

Stereotactic radiosurgery works in the same way as other forms of radiation treatment. It does not actually remove the tumor; rather, it damages the DNA of tumor cells. As a result, these cells lose their capability to reproduce. Following the treatment, benign tumors usually shrink over a period of 18 months to two years. Malignant and metastatic tumors may shrink more rapidly, even within a couple of months. When treated with radiosurgery, arteriovenous malformations (AVMs) begin to thicken and close off slowly, typically over several years.

Chemotherapy

Although chemotherapy provides only modest advantage for many patients with brain tumors, it plays an increasingly important role in pain relief. Chemotherapy benefits only a small number of patients with glioma over the long term.

Chemotherapy, in its most general sense, is the treatment of disease by chemicals especially by killing micro-organisms or cancerous cells. In popular usage, it refers to antineoplastic drugs used to treat cancer or the combination of these drugs into a cytotoxic standardized treatment regimen. In its non-oncological use, the term may also refer to antibiotics. In that sense, the first modern chemotherapeutic agent was Paul Ehrlich's arsphenamine, an arsenic compound discovered in 1909 and used to treat syphilis. This was later followed by sulfonamides discovered by Domagk and penicillin discovered by Alexander Fleming.

Most commonly, chemotherapy acts by killing cells that divide rapidly, one of the main properties of cancer cells. This means that it also harms cells that divide rapidly under normal circumstances: cells in the bone marrow, digestive tract and hair follicles; this results in the most common side effects of chemotherapy myelosuppression (decreased production of blood cells), mucositis (inflammation of the lining of the digestive tract) and alopecia (hair loss).

Other uses of cytostatic chemotherapy agents are the treatment of autoimmune diseases such as multiple sclerosis, Dermatomyositis, Polymyositis, Lupus, rheumatoid arthritis and the suppression of transplant rejections. Newer anticancer drugs act directly against abnormal proteins in cancer cells; this is termed targeted therapy.

Other Drugs

Corticosteroids are indispensable for controlling increased intracranial pressure and reducing tumor sizes. Unfortunately, the long-term use of these agents can result in substantial toxic effects. Anti-convulsant drugs are sometimes administered after surgery in patients who have had seizures.

Deep vein thrombosis or pulmonary emboli can occur in 20 percent to 30 percent of patients with primary brain tumors. Conventional therapy with heparin and warfarin is usually effectual and well tolerated.

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