Treatment Options

50% of all brain tumor research is funded by community-based organizations...

 

Please note:
This page is not for the purposes of diagnosis or promoting treatments.
A medical professional was not consulted regarding these statements.
Consult a doctor or medical professional prior to starting any type of treatment.

 

What are the Standard Therapies?

There are three standard types of treatment for patients with brain tumors: surgery, radiation therapy, and chemotherapy. There continues to be a vast amount of research investigating the use of these treatments simultaneously. For example, during surgery a device may be placed at the site of the tumor to deliver either localized radiation or chemotherapy. Chemotherapy may be administered at the same time as radiation, to increase the efficacy of treatments and tumor response to treatment.

Usually, either at the time of biopsy or shortly thereafter, surgeons will remove as much of the tumor as is possible and proceed with radiation followed by chemotherapy.

What is the goal of standard treatments?

The goal is to remove the tumor by surgery. The secondary goal is to kill as much of the tumor as possible through chemotherapy and radiation. Lastly, where resurrection or termination is not successful, stop the tumor cells from dividing and maintain a dormant state and delay tumor growth for as long as possible.

Is surgery always an option?

No. The tumor may be in a location where surgery would be too dangerous to conduct. Surgery may not be done in cases where the tumor is highly infiltrated into other areas of the brain and a solid primarily tumor mass cannot be located. There are other reasons that may suggest that surgery is not an option. However, it is important to consult with a specialist to determine if surgery is appropriate. It is also advisable to get a second opinion, as surgery may not be an option after treatment has begun.

What types of radiation are there?

There is increasing variation in how radiation is administered. Radiation can be administered to a focused, pin-pointed area of the brain, or to the whole brain. Generally, radiation will not be used twice on the same area of the brain because it is considered inefficient and is likely to damage healthy brain tissue. It is for this reason that whole brain radiation is used less frequently. However, in cases where the tumor is highly infiltrated, whole brain radiation may be used.

Radiation may be used in place of surgery in areas where surgery would be dangerous due to the tumor’s location in the brain. The “Gamma Knife” procedure is an example of such a treatment.

Radiation is administered at a medical facility. A specifically determined intensity of radiation is administered through the skull while the patient wears a protective, custom-made mask to protect areas of the brain that are not intended to receive treatment.

Radiation may be administered for varying periods of time and in varying doses, depending on the treatment regiment.

Stabilization, even if the tumor does not shrink, can be a positive sign in radiation treatments.

What types of chemotherapy are there?

There are many different types of chemotherapy used in treating primary brain tumors. The most frequently used is a relatively new treatment commonly known as temodar. The drug has given hope to some, demonstrating that advances are being made and there is potential for progress when we continue to devote effort and resources to finding a cure.

In addition to temodar, CCNU, BCNU, and procarbonzine are also standard chemotherapy treatments. It is strongly recommended that a patient learn how the chemotherapy is administered, what foods and drugs may interact with the treatment, and the side-effects of the drugs. Some medical professionals recommend abstaining from certain vitamins or herbal supplements while receiving chemotherapy, as drug interactions are unknown. Others do not have such concerns.

The type of chemotherapy used is guided by the type of tumor found during the biopsy. Chemotherapy “cocktails,” or mixtures, have also been the subject of debate among specialists. It is important to research and question healthcare providers as to options as to chemotherapy treatments in addition to or in place of standardized treatments.

Chemotherapy can have severe side-effects and may be very damaging to the immune system. Additional drugs to control side effects may also be necessary, for example to address constipation and nausea or low blood counts.

What are some alternative treatments?

Clinical Trials Clinical trials are necessary to finding new treatments and a cure for brain tumors. While the phrase “clinical trial” may sound scary and be thought of as a last resort, the phrase refers to the Federal Drug Administration’s classification of the treatment. A clinical trial involves a treatment that has not been approved by the FDA to treat the type of brain tumor a patient has been diagnosed with. In many cases the drug or treatment may be FDA approved to treat another disease. In most cases research indicates that there is evidence that the treatment may have an effect on brain tumors. When the FDA approved drug is used for another treatment, it is commonly referred to as “off label”.

Clinical trials are classified by stages and are named as either Phase I, II or III. A Phase I study will involve a small group of patients to determine safety and dosage of the treatment. A Phase II study evaluates the efficacy of the treatment. A Phase III study is more wide spread and health care experts monitor the effects of the treatment. Many treatments that have become “standard”, such as the use of Temodar (the most common chemo used to treat the disease), are still considered a Phase III study as the effects are still studied by researchers. These studies are also governed by the FDA and patients must meet certain guidelines before being able to participate. For example, many early stage clinical trials require that the patient be able to walk to participate. An exception to the FDA guidelines may be made by a doctor under the “compassionate use” designation. You should consult with a medical professional before beginning any treatments and always educate yourself about all aspects of the treatment.

Find a clinical trial by contacting brain tumor centers or hospitals. Online resources, such as www.virtualtrials.com and www.clinicaltrials.gov are also valuable.

Vaccination Research suggests that there may be a way to create a vaccination to the disease, and possibly prevent a recurrence, by using sample tissue taken from the brain tumor during the initial biopsy or surgery. If this therapy is to be used, samples must be preserved from the initial surgery. Consult with your surgeon about such preservation.


Non-chemical treatments Early research suggests that gene-therapy may be able to “fix” the malfunctioning DNA that causes brain cancer and malignancy. Studies also suggest that using viral treatments, such as certain types of herpes, may affect the ability of cancer cells to reproduce and limit the spread of the cancer throughout the brain. Both therapies look at stopping the cellular division of the cancerous cells.

Nutrition Many claims have been made about vitamins, minerals, and herbal supplements and their ability to treat brain tumors. Studies have provided mixed results on products such as melatonin, Vitamin A and high doses of anti-oxidants. One thing is certain, however. Proper nutrition is important to build up the body so that it is strong enough to endure treatment, even if it is not an immunotherapy in and of itself.

Non-standard medications Drugs that have proven to stop blood flow in the body, such as antiangiogenisis drugs, have been used to treat brain tumors. The theory is that the cancer cannot spread if the blood supply is cut off. Many of these drugs are used along with chemotherapies or other standard treatments.

Immunotherapies are also the subject of research. These treatments aim to work with the immune system to allow the body to fight off the cancer using its natural defense mechanism.