There are many types of brain tumors, each of which varies biologically. Due to these distinctions, various types of tumors respond differently to treatment.
Surgery, radiation therapy and chemotherapy are the three main options for brain tumor treatment. These therapies may be used alone or in combination.
There are several reasons surgery may be performed for brain tumors:
- To biopsy the tumor tissue for accurate diagnosis
- To remove the entire tumor, or at least as much of it as possible
- To help relieve pressure on the skull being caused by the tumor
Surgery is the preferred treatment for brain tumors that can be removed without causing significant damage to normal (“healthy”) brain tissue. Depending on the location of the tumor within the brain, it may be possible to perform an operation called a craniotomy to remove a large amount of the tumor. Tumors deep in the brain, which may be difficult to reach surgically, can be safely operated on using a computerized navigation system.
At Lahey, an intra-operative neuro-navigation device is used to help localize a brain tumor with a high degree of accuracy. This allows for much smaller and more precise surgical incisions and less manipulation of the brain during a tumor resection.
When a craniotomy does not seem appropriate for the patient, a stereotactic needle biopsy can be performed to biopsy the tumor. In a stereotactic needle biopsy, the portion of the tumor to be biopsied is located three-dimensionally and the corresponding information is entered into a computer. The computer then calculates the information and positions a needle to remove the biopsy sample in a safe, minimally invasive manner.
Radiation therapy, either in conventional form or using focused radiation (also called stereotactic radiosurgery), is often the next step in the treatment plan for tumors that are either partially or entirely surgically irremovable. Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells. When radiosurgery is performed at Lahey, a modified linear accelerator is used to deliver the pinpoint radiation to areas deep within the brain without injuring the surrounding brain structures.
In addition to radiation, a patient may be treated with various chemotherapy agents, or drugs that kill tumor cells and stop tumor growth. Most chemotherapeutic drugs are given intravenously (into a vein) or orally (by mouth). Administering chemotherapy for brain tumors presents a unique challenge, as the drug must readily cross the blood-brain barrier to reach the tumor cells.
Chemotherapy is generally a systemic treatment, meaning the drugs enter the bloodstream and circulate throughout the body, affecting nearly all cells. Side effects of chemotherapy depend on the drug(s) used and the doses the patient receives. The most common side effects include loss of appetite, nausea, vomiting, hair loss, mouth sores and infertility.