Types of treatment for brain tumours
This page gives an overview of treatment for brain tumours. You can find the following information
Types of treatment for brain tumours
The most suitable treatment for a brain tumour depends on the type of tumour. It also depends on the position in the brain and the tumour size and grade. A team of health professionals work together to decide on the best treatment for you. Your specialists will also consider your age and general health, and your own wishes about your treatment.
Removing a growing brain tumour is important because as the tumour gets bigger it increases the pressure inside the head. It is this increased pressure that causes some of the symptoms of brain tumours. The surgeon is sometimes able to remove the whole tumour but often this is not possible and they can only remove part of it. Even if your surgeon doesn’t think your brain tumour can be completely removed, they are still likely to want to take out as much as possible. This reduces pressure around the brain tumour and reduces symptoms.
Your specialist may suggest radiotherapy after surgery, or possibly as a treatment on its own. You may have radiotherapy just to the tumour, or you may have it to the whole brain or the brain and spine.
Your specialist is most likely to recommend chemotherapy to help relieve symptoms in advanced brain tumours or tumours that have come back. It may also sometimes be used before or with radiotherapy treatment.
NHS guidelines say that everyone with a brain tumour should be under the care of a multi disciplinary team (MDT). An MDT is a team of health professionals who work together to decide on the best way to care for you.
The specialist MDT is likely to include the following health professionals
- Brain and spinal cord surgeons (neurosurgeons)
- Brain and spinal cord specialists (neurologists)
- Chemotherapy and radiotherapy specialists (neuro oncologists)
- Clinical nurse specialists
- A psychologist
- Palliative care specialists, for help with controlling symptoms
- A specialist in scans of the brain and spinal cord (neuro radiologist)
- Pathologists who are expert in brain and spinal cord diseases
The MDT might also include other professionals such as physiotherapists, dieticians, speech therapists and occupational therapists.
The most suitable treatment for any brain tumour depends on the following things.
- The type of brain tumour
- The position of the tumour and how close it is to vital or delicate parts of the brain
- Size of the tumour
- Grade of the tumour
- Your age
It may be possible to remove a particular type and grade of tumour with surgery. But the same type and grade of tumour may not be removable if it is growing in a very delicate area of the brain. If the surgery would cause too much damage, your treatment team may suggest a different type of treatment.
As well as the factors above, your surgeon will need to consider the following things.
- Your general health
- Your medical history
- How the tumour is affecting you
- Your own wishes about your condition and treatment
Your doctors will discuss your options with you. If you have other medical conditions that make it risky for you to have a major brain operation, your doctors can plan other treatment options that may be more suitable for you.
Surgery, radiotherapy and chemotherapy are all used to treat brain tumours. New treatments are being developed all the time for brain tumours that respond poorly to treatment, or are in parts of the brain that are difficult to reach. A combination of treatments may be the best way of removing or controlling your tumour.
You may have surgery for a brain tumour
- To remove the whole tumour
- Remove most of the tumour (called a subtotal resection or debulking)
- To take a biopsy of the tumour
- To remove all or part of a growing benign tumour
Removing a growing tumour is important because the inside of the skull is a fixed size. If a tumour gets bigger, it takes up more space and increases the pressure inside your head. It is the increased pressure that causes some of the symptoms of brain tumours. Very low grade, slow growing brain tumours may not develop quickly enough to cause these problems. So for a very slow growing tumour, you may not need surgery straight away or even at all.
Even if your surgeon doesn't think they can completely remove your brain tumour, they are still likely to want to take out as much of it as possible. This is called subtotal resection or debulking. It can help by slowing down the progress of the tumour and relieving symptoms. It also makes it easier to treat the tumour cells left behind with radiotherapy or chemotherapy. With smaller tumours it is easier for treatment to reach all the cancer cells, particularly in the centre of the tumour.
We have a whole section about brain tumour surgery with detailed information about what will happen.
Your specialist may suggest radiotherapy after surgery or possibly as a treatment on its own. Depending on your type of treatment, your doctor will decide to treat
- Just the tumour or the area where the tumour was before it was removed (the tumour bed)
- The tumour (or tumour bed) plus a surrounding margin of healthy brain tissue
- The whole brain
- The whole brain and spinal cord
For certain types of brain or spinal cord tumours, specialists may use stereotactic radiotherapy or radiosurgery. These types of radiotherapy give radiotherapy beams to the head from many different points. So they give a very high radiation dose to the tumour but lower doses to the area around the tumour. This type of treatment is a very precise treatment given to treat small tumours or tumours that are close to very important structures in the brain.
It can be difficult to get some chemotherapy drugs into the brain to reach the cancer cells. Many drugs can't get from the bloodstream into the central nervous system because they can't get through the tissues surrounding the brain and spinal cord. This is called the blood brain barrier.
Some chemotherapy drugs can cross the blood brain barrier. Some drugs can cross into areas where the tumour has disrupted the normal barrier. Chemotherapy can be given as tablets or capsules or as injections into a vein. It is possible to inject some drugs into the fluid that circulates around the brain and spinal cord. Doctors call this intrathecal treatment.
Sometimes surgeons put chemotherapy implants into the area where they have removed a brain tumour. For example, there are wafers that break down slowly inside the brain, releasing a steady amount of a chemotherapy drug for a long time.
We have a section about brain tumour chemotherapy with detailed information about what will happen and the drugs used.
The links below take you to information about treatments for different types of primary brain tumours, including
- Gliomas in children
- Primitive neuroectodermal tumour (PNET)
- Pituitary tumours
- Acoustic neuroma
- Pineal region tumours
- Spinal cord tumours
We also have information about treating secondary brain tumours, where cancer cells have spread to the brain from another part of the body.
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