Brain Tumors: Treatment Introduction

Many different types of treatment can be used for brain tumors. Which may work best for you? It depends on a number of factors. These include what type of tumor you have, how big it is, where it is in your brain, and whether your healthcare provider thinks it can be removed with surgery. Other factors include your age, overall health, and the side effects you’ll find acceptable.

A biopsy is usually done before treatment choices are offered. A biopsy is when a small piece of tissue is removed from the tumor and tested in a lab. This helps your healthcare team know the exact type of tumor and what treatments may be effective. A biopsy may be done as its own procedure or as part of a surgery to remove the tumor.

Learning about your treatment choices

You may have questions and concerns about your treatment choices. You may want to know how you’ll feel and function after treatment, and if you’ll have to change your normal activities. Your healthcare provider is the best person to answer your questions. They can tell you what your treatment choices are, what the goals of these treatments will be, how successful they’re expected to be, what treatment will be like, and what the risks and possible side effects are.

Your healthcare provider may suggest a specific treatment. Or you may be offered more than one choice and asked to decide which you’d like to use. It can be hard to make this decision. It's important to take the time you need to make the best decision. Talk with your healthcare team to discuss all of your questions.

Understanding the goals of treatment for brain tumors

Treatment may control or cure the brain tumor. It may also improve your quality of life by helping to control symptoms caused by the tumor. The goal of brain tumor treatment is to do 1 or more of these things:

• Remove or destroy the brain tumor

• Stop or slow the tumor's growth or spread

• Prevent or delay the tumor's return

• Decrease the swelling around the tumor

• Ease symptoms caused by the tumor, such as headaches or seizures

Ask your healthcare provider what the goals of your treatment are.

Types of treatment for brain tumors

Different types of brain tumor treatments have different goals. The types of treatment and their usual goals include:

• Surgery. Surgery is used to remove the tumor while leaving as much of the brain as possible intact. It's often the first step in treatment for most brain tumors. Removing the tumor (resection) is usually done if the tumor can be removed safely. Surgery gives the healthcare team an exact diagnosis. It also reduces the tumor size. In some cases, the surgeon can’t remove the whole tumor. This may be because it’s near vital parts of the brain. Or it may be growing into the brain. If the tumor is in an area of the brain that can’t be reached safely, a small amount of tissue is still taken out for testing (biopsy). 

• Radiation therapy. The goal of radiation is to kill cancer cells. This is done using X-rays, gamma rays, or proton beams. It may be done to shrink a tumor before surgery. Or it may be done to kill any cancer cells that may be left after surgery. Radiation therapy might be used as the main treatment if surgery isn't a choice. It can also help relieve symptoms caused by a tumor. 

• Chemotherapy. Chemotherapy may be used after surgery or biopsy. Its goal is to reduce the chance that the cancer will grow, spread, or come back. In many cases, chemotherapy is taken by mouth as pills. But these medicines may also be given as a liquid put into your blood through a vein (IV) or put right into the cerebrospinal fluid around your brain. If you can’t have surgery, you may still get chemotherapy. You might also get it along with radiation therapy. Chemotherapy may be used if the cancer comes back after treatment.  

• Targeted therapy. Newer medicines target different parts of cancer cells or nearby blood vessels. They work differently from standard chemotherapy medicines. A few targeted medicines are used to help treat certain kinds of brain tumors. They're usually used when surgery is not a choice or the tumor comes back after treatment.

• Other medicines. Other medicines might be used to help relieve or prevent symptoms caused by the tumor or its treatment. For instance, you might be given medicines to help prevent seizures or help control swelling in the brain. You may also receive antinausea medicine or medicine to treat chemotherapy-induced anemia.

Clinical trials for new treatments

Researchers are also finding new ways to treat brain tumors. These new methods are tested in clinical trials. Before starting treatment, ask your healthcare team if there are any clinical trials you should consider.

Working with your healthcare team

Your healthcare team will help you decide on the best treatment plan for you. It may take time to do so. Ask your healthcare provider how much time you can take to explore your choices. You may want to get a second opinion from another healthcare provider before deciding on treatment. A second opinion can give peace of mind and help you make sure you’re making the best choices for treatment. You may also want to talk with your family and friends.