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Types of Treatment for Brain Tumors

Types of Treatment for Brain Tumors

Different types of brain tumor treatments have different goals. Here is a list of treatments and their goals:

  • Surgery. The goal of surgery is to remove the tumor while leaving as much of the brain as possible intact. It is often the first step in treatment for most brain tumors. Resection (removing the tumor) is usually done if the tumor can be removed safely. Surgery establishes an exact diagnosis. It also reduces the tumor volume. Sometimes the surgeon cannot remove the whole tumor because it is near vital brain structures. Or, if the tumor has invaded the space like fingers of a glove, it is very difficult to cut out. If the tumor is in a deep area of the brain or in an area that cannot be reached safely by the surgeon, a biopsy is performed.

  • Radiation therapy. The goal of radiation is to kill cancer cells using X-rays, gamma rays, or proton beams. Doctors may use this treatment to shrink a tumor before surgery or to try to get rid of any cancer cells left after surgery. Radiation therapy may also be used as the main treatment if surgery is not a good option, or to help relieve symptoms caused by a tumor. 

  • Chemotherapy. Doctors may give chemotherapy after surgery to take out the tumor or after a biopsy. Its goal is to reduce the chance that the cancer will grow and spread. This is called adjuvant chemotherapy. Most of the time you take the chemotherapy drugs as pills, but they may also be given as an infusion into a vein or directly into the cerebrospinal fluid around the brain. If you can’t have surgery, your doctor may still give you chemotherapy, sometimes along with radiation therapy. A major obstacle for chemotherapy drugs to reach the brain is called the blood-brain barrier. The blood-brain barrier is the tight sealing of blood vessels that help to prevent potentially hazardous substances from going to the brain. But there are ways to get around this barrier. You may also get chemotherapy if your cancer returns after treatment. 

  • Targeted therapy. Newer medicines target different parts of tumor cells or nearby blood vessels. These therapies are usually given in the setting of a clinical trial. They work differently from standard chemotherapy drugs. Some of these targeted drugs are now used to help treat certain brain tumors, usually when surgery is not an option. 

If you or a family member has been diagnosed with a brain tumor, you may want to consider getting a second opinion before beginning treatment. In fact, some insurance companies require a second opinion for such diagnoses. According to the American Cancer Society, it's very rare that the time it will take to get a second opinion will affect the success of your treatment. The peace of mind a second opinion provides may be well worth the effort. 

Finally, keep in mind that doctors and researchers are finding new ways to treat brain tumors. These new methods are tested in clinical trials. Before beginning treatment, ask your health care team if there are any clinical trials you should consider.

Dr. Albert Kim, Neurosurgeon

Dr. Kim is a Washington University neurosurgeon at Barnes-Jewish who focuses his practice on surgery of the brain, including stereotactic radiosurgery, skull based surgery, cerebrovascular surgery, and brain tumor treatment.

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