brain tumor is an abnormal mass of tissue in which some cells grow and multiply uncontrollably, apparently unregulated by the mechanisms that control normal cells. The growth of a tumor takes up space within the skull and interferes with normal brain activity. A tumor can cause damage by increasing pressure in the brain, by shifting the brain or pushing against the skull, and by invading and damaging nerves and healthy brain tissue. The location of a brain tumor influences the type of symptoms that occur. This is because different functions are controlled by different parts of the brain. Brain tumors rarely metastasize (spread) to other parts of the body outside of the central nervous system (CNS). The CNS includes the brain and spinal cord.
Some tumor types are more common in children than in adults. When childhood brain tumors occur in adults, they often occur in a different part of the brain than in children. Although most primary tumors attack member of both sexes with equal frequency, some, such as meningiomas, occur more frequently in women, whereas others, such as medulloblastomas, more commonly affect boys and young men.
The prognosis for brain tumor patients is as individual as the patients themselves. Your doctors will help you understand the possible repercussions of your specific tumor.
Symptoms due to increased pressure in the skull
The brain is contained within the skull and has a fixed amount of space. If a tumour grows in the brain it will often cause an increase in pressure within the skull, which can cause symptoms to develop. An increase of pressure in the skull is called raised intracranial pressure (ICP). The most common symptoms of raised pressure within the brain are headaches, feeling sick (nausea) and being sick (vomiting).
Of course, many other things can cause headaches or feelings of sickness, but if you have either of these for over a week with no sign of getting better, it’s important that you see your GP to get them checked out.
A seizure can be a frightening experience. If you have one you should seek medical help so that the cause can be diagnosed and treated. It’s important to remember that a seizure can be caused by medical conditions other than a brain tumour.
As well as the symptoms described here, raised intracranial pressure can also cause changes to your sight, such as blurred vision, ‘floating objects’ and tunnel vision. It may also make you confused or affect your balance.
Symptoms connected with the tumour’s position
Some symptoms may be caused by tumours in particular parts of the brain. Sometimes a headache can feel worse on the same side of the head as the tumour. In general, each area of the brain controls different functions. A tumour in a particular part of the brain may prevent that area of the brain from working normally.
Some of these symptoms are listed on the following pages, grouped under the different parts of the brain. They are included as a guide. An exact diagnosis can only be made by a doctor and confirmed by tests.
The diagram showing the lobes and functions of the brain show some of the different functions of each area of the brain.
Frontal lobe − changes in personality and intellect; uncoordinated walking or weakness of one side of the body; loss of smell; occasional speech difficulties.
Parietal lobe − difficulty speaking or understanding words; problems with writing, reading or doing simple calculations; difficulty coordinating certain movements, and finding your way around; numbness or weakness on one side of the body.
Temporal lobe − seizures, which may cause strange sensations: a feeling of fear or intense familiarity (déjà vu), strange smells or blackouts; speech difficulties; memory problems.
Occipital lobe − loss of vision to one eye, which the person may not notice at first and may sometimes be discovered during routine eye tests.
Cerebellum − lack of coordination; slurred speech (dysarthia); unsteadiness; flickering involuntary movement of the eyes (nystagmus); vomiting and neck stiffness.
Brain stem − unsteadiness and an uncoordinated walk; facial weakness, a one-sided smile or drooping eyelid; double vision; difficulty speaking and swallowing; vomiting or headache just after waking (this is rare). Symptoms may appear gradually.
Meninges – headaches, sickness and problems with sight and movement.
Pituitary gland – the pituitary gland produces lots of different hormones so a tumour in the gland can cause a variety of symptoms including: irregular periods; infertility; weight gain; lethargy; high blood pressure; diabetes; mood swings; and enlarged hands and feet. A tumour in the pituitary gland can also cause pressure on the nerves to the eyes, causing tunnel vision.
All the above symptoms may be caused by conditions other than a brain tumour. If you have any of the symptoms described it’s important to see your GP.
Driving
As brain tumours can cause changes in the way the brain works, it may be dangerous to drive. In the UK, there are laws that restrict some people with brain tumours from driving for a while. The restrictions vary with the type of tumour you have, and the type of driving license you hold.
You’ll not usually be allowed to drive for at least a year after the condition has been diagnosed and, in some circumstances, you may not be allowed to drive again. With some types of benign tumours you may be able to drive again once you have recovered from your treatment.
It’s your legal responsibility, not your doctor’s, to tell the Drivers and Vehicle Licensing Authority (DVLA) about your illness. The DVLA will advise you of any restrictions on your right to drive. You can speak to the DVLA on 0300 790 6806 (car and motorcycle licence holders) or 0300 790 6807 (bus, coach and lorry driver licence holders). You should also inform your vehicle insurance company.
brain tumor diagnoses
Identifying a brain tumor usually involves a neurological examination, brain scans, and/or an analysis of the brain tissue. Doctors use the diagnostic information to classify the tumor from the least aggressive (benign) to the most aggressive (malignant). In most cases, a brain tumor is named for the cell type of origin or its location in the brain. Identifying the type of tumor helps doctors determine the most appropriate course of treatment.
A neurological examination is a series of tests to measure the function of the patient s nervous system and physical and mental alertness. If responses to the exam are not normal, the doctor may order a brain scan or refer the patient to a neurologist or neurosurgeon, who will then order a brain scan.
A brain scan is a picture of the internal structures in the brain. A specialized machine takes a scan in much the same way a digital camera takes a photograph. Using computer technology, a scan compiles an image of the brain by photographing it from various angles.
Some types of scans use a contrast agent (or contrast dye), which helps the doctor see the difference between normal and abnormal brain tissue. The contrast agent is injected into a vein and flows into brain tissue. Abnormal or diseased brain tissue absorbs more dye than normal healthy tissue. The most common scans used for diagnosis are as follows:
A biopsy is a surgical procedure in which a sample of tissue is taken from the tumor site and examined under a microscope. The biopsy will provide information on types of abnormal cells present in the tumor. The purpose of a biopsy is to discover the type and grade of a tumor. A biopsy is the most accurate method of obtaining a diagnosis.
An open biopsy is done during a craniotomy. A craniotomy involves removing a piece of the skull in order to get access to the brain. After the tumor is resected (completely removed) or debulked (partially removed), the bone is usually put back into place. A closed biopsy (also called a stereotactic or needle biopsy) may be performed when the tumor is in an area of the brain that is difficult to reach. In a closed biopsy, the neurosurgeon drills a small hole into the skull and passes a narrow hollow needle into the tumor to remove a sample of tissue.
Once a sample is obtained, a pathologist examines the tissue under a microscope and writes a pathology report containing an analysis of the brain tissue. Sometimes the pathologist may not be able to make an exact diagnosis. This may be because more than one grade of tumor cells exists within the same tumor. In some cases, the tissue may be sent to another institution for additional analysis.
about diagnostic tests
Because an MRI uses magnetic fields, people who have metal implanted in their body in any form should let the doctor know about it before scheduling the procedure. An MRI may not be an option for these patients because the intense magnetic fields can damage some types of implanted medical devices. Patients should advise the doctor if they have a pacemaker, cardiac monitor, surgical clip, or facial tattoos.
In a standard MRI scan, the patient lies on a narrow table, which slides through a long, cylindrical tube with a narrow opening. Although there is enough room for the patient s body inside the cylinder, the patient will not be able to move around. The scan takes approximately 15-45 minutes. During the scan, the patient will hear loud banging sounds, caused by the electronics within the machine. Patients may request earplugs to reduce noise. Some people find the MRI claustrophobic and ask for a sedative beforehand to relax. Other people request an open MRI.
An open MRI machine does not have a cylinder, so the patient is not enclosed. The procedure lasts approximately 45 minutes. There is some discussion among doctors concerning the quality of the images of an open MRI compared to the standard or closed MRI.
Contrast agents may cause reactions in some patients. Gadolinium, the contrast agent used with an MRI, may cause temporary headaches. Patients with chronic renal disease may develop a condition called nephrogenic system fibronolysis (NSF). The FDA recommends using gadolinium only when clearly necessary in patients with stage 4 and 5 renal disease, which it defined as a glomerular filtration rate lower than 30 mL per minute per 1.73 m2. If patients with renal insufficiency receive gadolinium, then specific steps are taken to limit the possibility of NSF occurring, Patients undergoing MRI with gadolinium are screened for risk factors prior to receiving the scan.
Iodine is the contrast agent most commonly used for CT scanning. If you know you are allergic to iodine, tell your doctor. Allergic reactions can include rashes, a warm. sensation, or, in rare cases, difficulty breathing.
CT scans involve exposure to ionizing radiation, which is known to cause cancer. This is a concern for people who may need multiple CT scans and for children, because they are more sensitive to radiation than adults. It is wise for people who have had frequent x-ray exams and parents of children who have brain tumors to keep a record of their x-ray history. This information can help doctors make informed decisions and minimize radiation over-exposure
Brain Tumor
Treatment for brain tumors depends on a number of factors including the type, location and size of the tumor as well as the patient's age and general health. Treatment methods and schedules differ for children and adults.
Brain tumors are treated with surgery, radiation therapy and chemotherapy. Our doctors also are studying a vaccine for treating a recurrent cancer of the central nervous system that occurs primarily in the brain, known as glioma.
Depending on your needs, several methods may be used. Our team includes neurosurgeons, medical oncologists, radiation oncologists, nurses, a dietitian and a social worker, who work together to provide the best possible care.
Before treatment begins, most patients are given steroids, drugs that relieve swelling or edema. Your may receive anticonvulsant medicine to prevent or control seizures.
If hydrocephalus is present, you may need a shunt to drain cerebrospinal fluid. A shunt is a long, thin tube placed in a ventricle of the brain and then threaded under the skin to another part of the body, usually the abdomen. It works like a drainpipe. Excess fluid is carried away from the brain and is absorbed in the abdomen. In some cases, the fluid is drained into the heart.
Some tumors cannot be removed. In such cases, your doctor may do only a biopsy. A small piece of the tumor is removed so that a pathologist can examine it under a microscope to determine the type of cells it contains. This helps your doctor decide which treatment to use.
Sometimes, a biopsy is done with a needle. Doctors use a special head frame (like a halo) and CT scans or MRI to pinpoint the exact location of the tumor. The surgeon makes a small hole in the skull and then guides a needle to the tumor. Using this technique to do a biopsy or for treatment is called stereotaxis.
Other advanced techniques during surgery include brain mapping to find functional pathways near tumors, endoscopy to perform biopsies and open spinal fluid pathways through a small scope and advanced frameless stereotaxic computer assisted tumor resections. Intraoperative MRI also is available to help maximize tumor removal.
Radiation therapy may be given in two ways. External radiation comes from a large machine. Generally, external radiation treatments are given five days a week for several weeks. The treatment schedule depends on the type and size of the tumor and your age. Giving the total dose of radiation over an extended period helps to protect healthy tissue in the area of the tumor.
External radiation may be directed just to the tumor, the surrounding tissue or the entire brain. Sometimes the radiation is also directed to the spinal cord. When the whole brain is treated, the patient often receives an extra dose of radiation to the area of the tumor. This boost can come from external radiation or from an implant.
Radiation also can come from radioactive material placed directly in the tumor, or implant radiation therapy. Depending on the material used, the implant may be left in the brain for a short time or permanently. Implants lose a little radioactivity each day. The patient stays in the hospital for several days while the radiation is most active.
The Gamma Knife, or stereotactic radiosurgery, is another way to treat brain tumors. The Gamma Knife isn't actually a knife, but a radiation therapy technique that delivers a single, finely focused, high dose of radiation precisely to its target. Treatment is given in just one session. High-energy rays are aimed at the tumor from many angles. In this way, a high dose of radiation reaches the tumor without damaging other brain tissue.
Chemotherapy is usually given in cycles. A treatment period is followed by a recovery period, then another treatment period and so on. Patients often don't need to stay in the hospital for treatment and most drugs can be given in the doctor's office or clinic. However, depending on the drugs used, the way they are given and the patient's general health, a short hospital stay may be necessary.
Advances in chemotherapy include direct placement into the tumor cavity using a new technique called convection enhanced delivery.
Reviewed by health care specialists at UCSF Medical Center
Some tumor types are more common in children than in adults. When childhood brain tumors occur in adults, they often occur in a different part of the brain than in children. Although most primary tumors attack member of both sexes with equal frequency, some, such as meningiomas, occur more frequently in women, whereas others, such as medulloblastomas, more commonly affect boys and young men.
The prognosis for brain tumor patients is as individual as the patients themselves. Your doctors will help you understand the possible repercussions of your specific tumor.
Symptoms of brain tumours
Symptoms due to increased pressure in the skull
The brain is contained within the skull and has a fixed amount of space. If a tumour grows in the brain it will often cause an increase in pressure within the skull, which can cause symptoms to develop. An increase of pressure in the skull is called raised intracranial pressure (ICP). The most common symptoms of raised pressure within the brain are headaches, feeling sick (nausea) and being sick (vomiting).
Of course, many other things can cause headaches or feelings of sickness, but if you have either of these for over a week with no sign of getting better, it’s important that you see your GP to get them checked out.
Headaches
A pressure headache is usually dull and constant, and occasionally throbbing. Severe headaches are uncommon. A headache may get worse when you cough, sneeze, bend down or do any hard physical work. All of these tend to raise pressure in the brain. Headaches may be worse at night and may wake you.Feeling sick (nausea) and vomiting
If the raised pressure makes you sick, it may be worse in the morning than during the day. It may also get worse if you suddenly change position, for example from sitting or lying to standing.Seizures
Seizures (fits) are another common symptom of brain tumours. Some people may experience muscle spasms, which could be twitching or jerking of an arm or leg, or sometimes the whole body. Occasionally they can cause moments of unconsciousness.A seizure can be a frightening experience. If you have one you should seek medical help so that the cause can be diagnosed and treated. It’s important to remember that a seizure can be caused by medical conditions other than a brain tumour.
Drowsiness
Another possible symptom is drowsiness. This can happen as the pressure in the skull increases. You may find that you sleep more or that you drop off during the day when you wouldn’t normally.As well as the symptoms described here, raised intracranial pressure can also cause changes to your sight, such as blurred vision, ‘floating objects’ and tunnel vision. It may also make you confused or affect your balance.
Symptoms connected with the tumour’s position
Some symptoms may be caused by tumours in particular parts of the brain. Sometimes a headache can feel worse on the same side of the head as the tumour. In general, each area of the brain controls different functions. A tumour in a particular part of the brain may prevent that area of the brain from working normally.
Some of these symptoms are listed on the following pages, grouped under the different parts of the brain. They are included as a guide. An exact diagnosis can only be made by a doctor and confirmed by tests.
The diagram showing the lobes and functions of the brain show some of the different functions of each area of the brain.
Frontal lobe − changes in personality and intellect; uncoordinated walking or weakness of one side of the body; loss of smell; occasional speech difficulties.
Parietal lobe − difficulty speaking or understanding words; problems with writing, reading or doing simple calculations; difficulty coordinating certain movements, and finding your way around; numbness or weakness on one side of the body.
Temporal lobe − seizures, which may cause strange sensations: a feeling of fear or intense familiarity (déjà vu), strange smells or blackouts; speech difficulties; memory problems.
Occipital lobe − loss of vision to one eye, which the person may not notice at first and may sometimes be discovered during routine eye tests.
Cerebellum − lack of coordination; slurred speech (dysarthia); unsteadiness; flickering involuntary movement of the eyes (nystagmus); vomiting and neck stiffness.
Brain stem − unsteadiness and an uncoordinated walk; facial weakness, a one-sided smile or drooping eyelid; double vision; difficulty speaking and swallowing; vomiting or headache just after waking (this is rare). Symptoms may appear gradually.
Meninges – headaches, sickness and problems with sight and movement.
Pituitary gland – the pituitary gland produces lots of different hormones so a tumour in the gland can cause a variety of symptoms including: irregular periods; infertility; weight gain; lethargy; high blood pressure; diabetes; mood swings; and enlarged hands and feet. A tumour in the pituitary gland can also cause pressure on the nerves to the eyes, causing tunnel vision.
All the above symptoms may be caused by conditions other than a brain tumour. If you have any of the symptoms described it’s important to see your GP.
Personality changes
Sometimes brain tumours may cause changes in personality or behaviour. This usually happens when the tumour is in the brain’s cerebral hemispheres. This situation can be very unsettling for the person and their family. Sometimes a referral to a psychologist for assessment and support can help.Driving
As brain tumours can cause changes in the way the brain works, it may be dangerous to drive. In the UK, there are laws that restrict some people with brain tumours from driving for a while. The restrictions vary with the type of tumour you have, and the type of driving license you hold.
You’ll not usually be allowed to drive for at least a year after the condition has been diagnosed and, in some circumstances, you may not be allowed to drive again. With some types of benign tumours you may be able to drive again once you have recovered from your treatment.
It’s your legal responsibility, not your doctor’s, to tell the Drivers and Vehicle Licensing Authority (DVLA) about your illness. The DVLA will advise you of any restrictions on your right to drive. You can speak to the DVLA on 0300 790 6806 (car and motorcycle licence holders) or 0300 790 6807 (bus, coach and lorry driver licence holders). You should also inform your vehicle insurance company.
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brain tumor diagnoses
Identifying a brain tumor usually involves a neurological examination, brain scans, and/or an analysis of the brain tissue. Doctors use the diagnostic information to classify the tumor from the least aggressive (benign) to the most aggressive (malignant). In most cases, a brain tumor is named for the cell type of origin or its location in the brain. Identifying the type of tumor helps doctors determine the most appropriate course of treatment.
A neurological examination is a series of tests to measure the function of the patient s nervous system and physical and mental alertness. If responses to the exam are not normal, the doctor may order a brain scan or refer the patient to a neurologist or neurosurgeon, who will then order a brain scan.
A brain scan is a picture of the internal structures in the brain. A specialized machine takes a scan in much the same way a digital camera takes a photograph. Using computer technology, a scan compiles an image of the brain by photographing it from various angles.
Some types of scans use a contrast agent (or contrast dye), which helps the doctor see the difference between normal and abnormal brain tissue. The contrast agent is injected into a vein and flows into brain tissue. Abnormal or diseased brain tissue absorbs more dye than normal healthy tissue. The most common scans used for diagnosis are as follows:
MRI (Magnetic Resonance Imaging) is a scanning device that uses magnetic fields and computers to capture images of the brain on film. It does not use x-rays. It provides pictures from various planes, which permit doctors to create a three-dimensional image of the tumor. The MRI detects signals emitted from normal and abnormal tissue, providing clear images of most tumors.There some drawbacks to these diagnostic tests, however. Please refer to What else should I know about diagnostic tests? for more information.
CT or CAT Scan (Computed Tomography) combines sophisticated x-ray and computer technology. CT can show a combination of soft tissue, bone, and blood vessels. CT images can determine some types of tumors, as well as help detect swelling, bleeding, and bone and tissue calcification. Usually, iodine is the contrast agent used during a CT scan.
PET Scan (Positron Emission Tomography) provides a picture of the brain s activity, rather than its structure, by measuring the rate at which a tumor absorbs glucose (a sugar). The patient is injected with deoxyglucose that has been labeled with radioactive markers. The PET scan measures the brain s activity and sends this information to a computer, which creates a live image. Doctors use PET scans to see the difference between scar tissue, recurring tumor cells, and necrosis (cells destroyed by radiation treatment).
A biopsy is a surgical procedure in which a sample of tissue is taken from the tumor site and examined under a microscope. The biopsy will provide information on types of abnormal cells present in the tumor. The purpose of a biopsy is to discover the type and grade of a tumor. A biopsy is the most accurate method of obtaining a diagnosis.
An open biopsy is done during a craniotomy. A craniotomy involves removing a piece of the skull in order to get access to the brain. After the tumor is resected (completely removed) or debulked (partially removed), the bone is usually put back into place. A closed biopsy (also called a stereotactic or needle biopsy) may be performed when the tumor is in an area of the brain that is difficult to reach. In a closed biopsy, the neurosurgeon drills a small hole into the skull and passes a narrow hollow needle into the tumor to remove a sample of tissue.
Once a sample is obtained, a pathologist examines the tissue under a microscope and writes a pathology report containing an analysis of the brain tissue. Sometimes the pathologist may not be able to make an exact diagnosis. This may be because more than one grade of tumor cells exists within the same tumor. In some cases, the tissue may be sent to another institution for additional analysis.
about diagnostic tests
Because an MRI uses magnetic fields, people who have metal implanted in their body in any form should let the doctor know about it before scheduling the procedure. An MRI may not be an option for these patients because the intense magnetic fields can damage some types of implanted medical devices. Patients should advise the doctor if they have a pacemaker, cardiac monitor, surgical clip, or facial tattoos.
In a standard MRI scan, the patient lies on a narrow table, which slides through a long, cylindrical tube with a narrow opening. Although there is enough room for the patient s body inside the cylinder, the patient will not be able to move around. The scan takes approximately 15-45 minutes. During the scan, the patient will hear loud banging sounds, caused by the electronics within the machine. Patients may request earplugs to reduce noise. Some people find the MRI claustrophobic and ask for a sedative beforehand to relax. Other people request an open MRI.
An open MRI machine does not have a cylinder, so the patient is not enclosed. The procedure lasts approximately 45 minutes. There is some discussion among doctors concerning the quality of the images of an open MRI compared to the standard or closed MRI.
Contrast agents may cause reactions in some patients. Gadolinium, the contrast agent used with an MRI, may cause temporary headaches. Patients with chronic renal disease may develop a condition called nephrogenic system fibronolysis (NSF). The FDA recommends using gadolinium only when clearly necessary in patients with stage 4 and 5 renal disease, which it defined as a glomerular filtration rate lower than 30 mL per minute per 1.73 m2. If patients with renal insufficiency receive gadolinium, then specific steps are taken to limit the possibility of NSF occurring, Patients undergoing MRI with gadolinium are screened for risk factors prior to receiving the scan.
Iodine is the contrast agent most commonly used for CT scanning. If you know you are allergic to iodine, tell your doctor. Allergic reactions can include rashes, a warm. sensation, or, in rare cases, difficulty breathing.
CT scans involve exposure to ionizing radiation, which is known to cause cancer. This is a concern for people who may need multiple CT scans and for children, because they are more sensitive to radiation than adults. It is wise for people who have had frequent x-ray exams and parents of children who have brain tumors to keep a record of their x-ray history. This information can help doctors make informed decisions and minimize radiation over-exposure
Brain Tumor
Treatment
Brain tumors are treated with surgery, radiation therapy and chemotherapy. Our doctors also are studying a vaccine for treating a recurrent cancer of the central nervous system that occurs primarily in the brain, known as glioma.
Depending on your needs, several methods may be used. Our team includes neurosurgeons, medical oncologists, radiation oncologists, nurses, a dietitian and a social worker, who work together to provide the best possible care.
Before treatment begins, most patients are given steroids, drugs that relieve swelling or edema. Your may receive anticonvulsant medicine to prevent or control seizures.
If hydrocephalus is present, you may need a shunt to drain cerebrospinal fluid. A shunt is a long, thin tube placed in a ventricle of the brain and then threaded under the skin to another part of the body, usually the abdomen. It works like a drainpipe. Excess fluid is carried away from the brain and is absorbed in the abdomen. In some cases, the fluid is drained into the heart.
Surgery
Surgery is the usual treatment for most brain tumors. To remove a brain tumor, a neurosurgeon makes an opening in the skull. This operation is called a craniotomy. Whenever possible, the surgeon attempts to remove the entire tumor. If the tumor cannot be completely removed without damaging vital brain tissue, your doctor may remove as much of the tumor as possible. Partial removal helps to relieve symptoms by reducing pressure on the brain and reduces the amount of tumor to be treated by radiation therapy or chemotherapy.Some tumors cannot be removed. In such cases, your doctor may do only a biopsy. A small piece of the tumor is removed so that a pathologist can examine it under a microscope to determine the type of cells it contains. This helps your doctor decide which treatment to use.
Sometimes, a biopsy is done with a needle. Doctors use a special head frame (like a halo) and CT scans or MRI to pinpoint the exact location of the tumor. The surgeon makes a small hole in the skull and then guides a needle to the tumor. Using this technique to do a biopsy or for treatment is called stereotaxis.
Other advanced techniques during surgery include brain mapping to find functional pathways near tumors, endoscopy to perform biopsies and open spinal fluid pathways through a small scope and advanced frameless stereotaxic computer assisted tumor resections. Intraoperative MRI also is available to help maximize tumor removal.
Radiation Therapy
Radiation therapy, also called radiotherapy, is the use of high-powered rays to damage cancer cells and stop them from growing. It is often used to destroy tumor tissue that cannot be removed with surgery or to kill cancer cells that may remain after surgery. Radiation therapy also is used when surgery is not possible.Radiation therapy may be given in two ways. External radiation comes from a large machine. Generally, external radiation treatments are given five days a week for several weeks. The treatment schedule depends on the type and size of the tumor and your age. Giving the total dose of radiation over an extended period helps to protect healthy tissue in the area of the tumor.
External radiation may be directed just to the tumor, the surrounding tissue or the entire brain. Sometimes the radiation is also directed to the spinal cord. When the whole brain is treated, the patient often receives an extra dose of radiation to the area of the tumor. This boost can come from external radiation or from an implant.
Radiation also can come from radioactive material placed directly in the tumor, or implant radiation therapy. Depending on the material used, the implant may be left in the brain for a short time or permanently. Implants lose a little radioactivity each day. The patient stays in the hospital for several days while the radiation is most active.
The Gamma Knife, or stereotactic radiosurgery, is another way to treat brain tumors. The Gamma Knife isn't actually a knife, but a radiation therapy technique that delivers a single, finely focused, high dose of radiation precisely to its target. Treatment is given in just one session. High-energy rays are aimed at the tumor from many angles. In this way, a high dose of radiation reaches the tumor without damaging other brain tissue.
Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. The doctor may use just one drug or a combination, usually giving the drugs orally or by injection into a blood vessel or muscle. Intrathecal chemotherapy involves injecting the drugs into the cerebrospinal fluid.Chemotherapy is usually given in cycles. A treatment period is followed by a recovery period, then another treatment period and so on. Patients often don't need to stay in the hospital for treatment and most drugs can be given in the doctor's office or clinic. However, depending on the drugs used, the way they are given and the patient's general health, a short hospital stay may be necessary.
Advances in chemotherapy include direct placement into the tumor cavity using a new technique called convection enhanced delivery.
Reviewed by health care specialists at UCSF Medical Center
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