The type, grade and location of the tumour will help determine the appropriate treatment for a brain tumour. Treatment will also depend on your general state of health, quality of life and whether the tumour is primary or secondary. A team of doctors and other health professionals (known as a multi-disciplinary team – MDT) will plan your specific treatment path. This team may include a neurosurgeon (a doctor who specialises in operating on the brain or nervous system), a neurologist (a doctor who specialises in treating illnesses of the brain and nervous system), a clinical oncologist (a doctor who treats cancer with radiotherapy and chemotherapy), a neuropsychologist (a specialist in assessing how the brain is functioning in response to a tumour being, or having been, present), a radiotherapist and a specialist nurse.
Before you have any treatment, your doctor should give you information on the planned treatment, explain any advantages or disadvantages of the treatment, and outline any risks or possible side-effects. Once you have understood the options available to you, you can then decide which path you wish to take.
If you feel that you cannot make a decision immediately, it is fine for you to ask for more time to think about it. You are also free to choose not to go ahead with the treatment if you are sure that is your preference.
Surgery
For primary brain tumours, if the tumour can be removed without causing harm to the surrounding tissue, surgery may be the first treatment. Surgery can range from a biopsy (taking a sample of the tumour for analysis) to a major operation in which the tumour is completely or partially removed. The patient is usually given a general anaethetic so they are asleep during the procedure.
For some tumours it may be judged best not to operate, but to monitor the tumour with regular scans (‘watch and wait’). It may be because the tumour is slow-growing and not causing undue harm at present, or perhaps the tumour is in a position that makes surgery very risky. In cases such as this, other treatment options are usually favoured.
Radiotherapy
Radiotherapy is usually given after surgery if a tumour has not been completely removed or if there is the possibility that some abnormal cells remain. When surgery is not possible or necessary, radiotherapy with or without chemotherapy is the main treatment.
There are numerous different types of radiotherapy currently available. These include:
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Radiosurgery (e.g. Gamma Knife and Cyberknife)
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Proton beam therapy
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Boron neutron capture therapy
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Photodynamic therapy (PDT)
Not all of these treatments are available on the NHS, nor are they appropriate for every tumour type. You are encouraged to speak to your consultant about the options available to you.
Chemotherapy
This is the use of special anti anti-cancer (cytotoxic) drugs which disrupt the growth of cancer cells. ChemotherapyIt is not used to treat all brain tumours, but can be effective for inoperable primary brain tumours or as part of the treatment for secondary brain tumours. Some types of chemotherapy are given as tablets or capsules, and some are administered intravenously (into a vein). and tThese treatments can normally be given to you as an outpatient.
Steroids
Steroids control the swelling due to accumulation of fluids often associated with brain tumours. They may be used temporarily following surgery or during radiation as these treatments often cause oedema (swelling). Any long-term use of steroids for the relief of symptoms requires close monitoring due to potential side effects.