Treatment for lymphoma in the brain
Central nervous system lymphoma is one of the only types of brain tumour that is not treated with surgery. This is because there is a big risk that cancer cells will be left behind and so the surgery will not cure the cancer. Trials have shown that surgery is not a useful treatment for this type of brain tumour. However, surgery is often needed to take a sample (biopsy) of the tumour to diagnose it.
Chemotherapy generally works very well for lymphoma in the brain. You usually have chemotherapy as your first treatment. The difficulty with lymphoma that has started in the brain is getting the chemotherapy drugs to the cancer cells. If you have the drugs injected into a vein, they need to be able to cross the blood - brain barrier.
You may have a drug called methotrexate injected into the fluid around your spinal cord. This is similar to having a lumbar puncture. The drug can then circulate around the brain and reach the lymphoma cells. This type of treatment is called intrathecal chemotherapy.
Different combinations of chemotherapy drugs have been tried, including CHOP (cyclophosphamide, doxorubicin, vincristine and the steroid prednisolone) and CHOD-BVAM (cyclophosphamide, doxorubicin, vincristine the steroid dexamethasone, carmustine, methotrexate and cytarabine. Sometimes steroids are used on their own.
If chemotherapy cannot control the lymphoma, you may have radiotherapy. There is a risk of lymphoma cells spreading to other areas of the brain. So you usually have radiotherapy treatment to the whole of your brain rather than treatment targeted just at the area of the lymphoma.
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