Medical science has developed a number of treatments for a brain tumor, giving doctors options in prescribing a course of therapy with the best potential for a favorable outcome. At the Florida Hospital Neuroscience Institute, patients are advised and treated by an interdisciplinary team that may include a neuo-oncologist, a neurosurgeon, a radiation oncologist and a pathologist. The exact course of treatment depends on the patient’s age, health and ability to handle a particular procedure; if the tumor is benign or malignant; where it is located; how far it has progressed; and the patient’s own feelings.
Surgically removing the tumor if possible without damaging surrounding brain structures is usually the first choice. Most benign tumors have a more consistent shape and usually can be completely removed if not too deep in the brain tissue. Malignant tumors spread into surrounding tissue making it more difficult to remove them. They often recur by regenerating from cells trapped in surrounding tissue.
Radiation therapy is used to treat tumors that cannot be accessed by surgery. The radiation does not remove the tumor but can shrink it. Stereotatic radiosurgery – using advanced technology such as the Leksell Gamma Knife© 4C at Florida Hospital – offers another non-invasive therapy that aims sharply focused radiation on the tumor. This one-time treatment damages the tumor’s ability to continue growing. It can only be done for small or medium size tumors. It is often the first treatment for brain metastasis (tumors coming from other parts of the body such as the lungs).
Chemotherapy employs the use of drugs to kill cancer cells or stop them from growing. Sometimes different medications are used in concert. Typically, the therapy occurs in cycles, killing cancer cells more efficiently and giving normal cells time to recover. Chemotherapy involves a number of unpleasant side effects, so the oncologist will use the minimum amount of drugs needed to effectively treat the tumor. In some cases, chemotherapy is used to shrink tumors prior to surgery. In a combined procedure, wafers with cancer-killing drugs are inserted directly into the tumor.
Targeted drug therapy aims recently developed drugs at specific parts of tumors and cells that contribute to growth. Bevacizumab is one example used to reduce a tumor’s ability to create new blood vessels, starving it of nutrients. Other drug treatments for a brain tumor include steroids to prevent swelling in the brain, anti-seizure medications to prevent seizures caused by pressure on the brain tissue, and antibiotics to treat infection.
New treatments for brain tumor are constantly being researched and developed. An experimental gene therapy injects a gene infected by a virus into the tumor. The doctors inject an anti-virus drug that kills the infected cancer cells. Another therapy – electric field treatments – transmits a mild electric current that affects tumor cells through electrodes on the scalp.
If brain tissue has been damaged by the tumor, or through surgical procedures, rehabilitation therapy may be needed to regain lost motor skills, speaking ability and strength. Supportive care may be needed to help reduce the effects caused by the tumor or the treatment. Ongoing monitoring by a neurologist is necessary to assure any recurrence is detected early, and to treat disease or after effects of treatment.