Cancer research has led to real progress in the detection and treatment of brain tumors. Continuing research offers hope that in the future even more people with brain tumors will be treated successfully.
Doctors all over the country are conducting many types of clinical trials (research studies in which people volunteer to take part). Clinical trials are designed to find out whether new approaches are safe and effective.
Doctors are trying to find better ways to care for adults and children with brain tumors. They are testing new drugs and combining drugs with radiation therapy. They are also studying how drugs may reduce the side effects of treatment.
Even if the people in a trial do not benefit directly, they may still make an important contribution by helping doctors learn more about brain tumors and how to control them. Although clinical trials may pose some risks, doctors do all they can to protect their patients.
People with brain tumors have several treatment options. The options are surgery, radiation therapy, and chemotherapy. Many people get a combination of treatments. Your doctor can describe your treatment choices, the expected results, and the possible side effects. Because cancer therapy often damages healthy cells and tissues, side effects are common. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. You and your health care team can work together to develop a treatment plan that meets your medical and personal needs.
Surgery
- Surgery is the usual first treatment for most brain tumors. Before surgery begins, you may be given general anesthesia, and your scalp is shaved. You probably won’t need your entire head shaved.
- Surgery to open the skull is called a craniotomy. The surgeon makes an incision in your scalp and uses a special type of saw to remove a piece of bone from the skull.
- You may be awake when the surgeon removes part or all of the brain tumor. The surgeon removes as much tumor as possible. You may be asked to move a leg, count, say the alphabet, or tell a story. Your ability to follow these commands helps the surgeon protect important parts of the brain.
- After the tumor is removed, the surgeon covers the opening in the skull with the piece of bone or with a piece of metal or fabric. The surgeon then closes the incision in the scalp.
- Sometimes surgery isn’t possible. If the tumor is in the brain stem or certain other areas, the surgeon may not be able to remove the tumor without harming normal brain tissue. People who can’t have surgery may receive radiation therapy or other treatment.
Radiation Therapy
- Radiation therapy kills brain tumor cells with high-energy x-rays, gamma rays, or protons.
- Radiation therapy usually follows surgery. The radiation kills tumor cells that may remain in the area. Sometimes, people who can’t have surgery have radiation therapy instead.
- Doctors use external and internal types of radiation therapy to treat brain tumors
Chemotherapy
Chemotherapy, the use of drugs to kill cancer cells, is sometimes used to treat brain tumors. Drugs may be given in the following ways:
- By mouth or vein (intravenous): Chemotherapy may be given during and after radiation therapy. The drugs enter the bloodstream and travel throughout the body. The side effects of chemotherapy depend mainly on which drugs are given and how much. Common side effects include nausea and vomiting, loss of appetite, headache, fever and chills, and weakness. If the drugs lower the levels of healthy blood cells, you’re more likely to get infections, bruise or bleed easily, and feel very weak and tired. Your health care team will check for low levels of blood cells. Some side effects may be relieved with medicine.
- In wafers that are put into the brain: For some adults with high-grade glioma, the surgeon implants several wafers into the brain. Each wafer is about the size of a dime. Over several weeks, the wafers dissolve, releasing the drug into the brain. The drug kills cancer cells. It may help prevent the tumor from returning in the brain after surgery to remove the tumor. People who receive an implant (a wafer) that contains a drug are monitored by the health care team for signs of infection after surgery. An infection can be treated with an antibiotic.
Every cancer diagnosis is different, just as every person who is diagnosed with cancer is different. Cancer knows no barriers to race, age, or social group. However there is one thing that each and every person who is diagnosed with cancer will have in common: help with fighting and beating the disease.
Life after being diagnosed with cancer will be different for everyone. Some people will have minimal disease and it will be a short chapter of their lives, while others will have a diagnosis that will change the course of the rest of their lives. Cancer diagnoses can change relationships, your routines, your work and home life. One thing is certain, no one person’s experience will be exactly the same. There are however, plenty of resources to learn about what life was like for other people, and what they did to achieve balance, maintain their health and personal life, keep peace of mind, and enjoy their lives with or after cancer.
Clinical Trials
The search for a cure for cancer is an ongoing, constant battle. Clinical trials are the basis upon which new treatments and medications are proven to help the fight against cancer, or if researchers should pursue another tactic. The advancement of medicine depends on willing and able cancer patients to volunteer for experimental treatments so that future generations will have proven and effective cures. Not every patient with cancer will be eligible for a clinical trial, as the scientific method needs specific patients with specific types of cancers. However, patients who are selected for trials may benefit from being at the cutting edge of new research, and gain time they otherwise might not have had.
The National Cancer Institute at the National Institutes of Health has a comprehensive database of over 10,000 ongoing clinical trials that both help advance medicine and help patients.
Financial Help
Unfortunately, cancer treatment can be costly, even if a patient has very comprehensive health insurance. For patients who do not have health insurance, the cost of treatment may seem insurmountable. Fortunately many pharmaceutical companies offer cost assistance to help make treatment more affordable. The National Comprehensive Cancer Network has compiled a Virtual Reimbursement Room where patients can find information for accessing financial help with their treatment costs.
When you’re told that you have a brain tumor, it’s natural to wonder what may have caused your disease. But no one knows the exact causes of brain tumors. Doctors seldom know why one person develops a brain tumor and another doesn’t.
Researchers are studying whether people with certain risk factors are more likely than others to develop a brain tumor. A risk factor is something that may increase the chance of getting a disease.
Studies have found the following risk factors for brain tumors:
- Ionizing radiation: Ionizing radiation from high dose x-rays (such as radiation therapy from a large machine aimed at the head) and other sources can cause cell damage that leads to a tumor. People exposed to ionizing radiation may have an increased risk of a brain tumor, such as meningioma or glioma.
- Family history: It is rare for brain tumors to run in a family. Only a very small number of families have several members with brain tumors.
Researchers are studying whether using cell phones, having had a head injury, or having been exposed to certain chemicals at work or to magnetic fields are important risk factors. Studies have not shown consistent links between these possible risk factors and brain tumors, but additional research is needed.
If you have symptoms that suggest a brain tumor, your doctor will give you a physical exam and ask about your personal and family health history. You may have one or more of the following tests:
- Neurologic exam: Your doctor checks your vision, hearing, alertness, muscle strength, coordination, and reflexes. Your doctor also examines your eyes to look for swelling caused by a tumor pressing on the nerve that connects the eye and the brain.
- MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of areas inside your head. Sometimes a special dye (contrast material) is injected into a blood vessel in your arm or hand to help show differences in the tissues of the brain. The pictures can show abnormal areas, such as a tumor.
- CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your head. You may receive contrast material by injection into a blood vessel in your arm or hand. The contrast material makes abnormal areas easier to see. Your doctor may ask for other tests:
- Angiogram: Dye injected into the bloodstream makes blood vessels in the brain show up on an x-ray. If a tumor is present, the x-ray may show the tumor or blood vessels that are feeding into the tumor.
- Spinal tap: Your doctor may remove a sample of cerebrospinal fluid (the fluid that fills the spaces in and around the brain and spinal cord). This procedure is performed with local anesthesia. The doctor uses a long, thin needle to remove fluid from the lower part of the spinal column. A spinal tap takes about 30 minutes. You must lie flat for several hours afterward to keep from getting a headache. A laboratory checks the fluid for cancer cells or other signs of problems.
- Biopsy: The removal of tissue to look for tumor cells is called a biopsy. A pathologist looks at the cells under a microscope to check for abnormal cells. A biopsy can show cancer, tissue changes that may lead to cancer, and other conditions. A biopsy is the only sure way to diagnose a brain tumor, learn what grade it is, and plan treatment.
Surgeons can obtain tissue to look for tumor cells in two ways:
- Biopsy at the same time as treatment: The surgeon takes a tissue sample when you have surgery to remove part or all of the tumor. See the Surgery section.
- Stereotactic biopsy: You may get local or general anesthesia and wear a rigid head frame for this procedure. The surgeon makes a small incision in the scalp and drills a small hole (a burr hole) into the skull. CT or MRI is used to guide the needle through the burr hole to the location of the tumor. The surgeon withdraws a sample of tissue with the needle. A needle biopsy may be used when a tumor is deep inside the brain or in a part of the brain that can’t be operated on. However, if the tumor is in the brain stem or certain other areas, the surgeon may not be able to remove tissue from the tumor without harming normal brain tissue. In this case, the doctor uses MRI, CT, or other imaging tests to learn as much as possible about the brain tumor.
The symptoms of a brain tumor depend on tumor size, type, and location. Symptoms may be caused when a tumor presses on a nerve or harms a part of the brain. Also, they may be caused when a tumor blocks the fluid that flows through and around the brain, or when the brain swells because of the buildup of fluid. These are the most common symptoms of brain tumors:
- Headaches (usually worse in the morning)
- Nausea and vomiting
- Changes in speech, vision, or hearing
- Problems balancing or walking
- Changes in mood, personality, or ability to concentrate
- Problems with memory
- Muscle jerking or twitching (seizures or convulsions)
- Numbness or tingling in the arms or legs
Most often, these symptoms are not due to a brain tumor. Another health problem could cause them. If you have any of these symptoms, you should tell your doctor so that problems can be diagnosed and treated.
When most normal cells grow old or get damaged, they die, and new cells take their place. Sometimes, this process goes wrong. New cells form when the body doesn’t need them, and old or damaged cells don’t die as they should. The buildup of extra cells often forms a mass of tissue called a growth or tumor. Primary brain tumors can be benign or malignant:
Benign brain tumors do not contain cancer cells:
- Usually, benign tumors can be removed, and they seldom grow back.
- Benign brain tumors usually have an obvious border or edge. Cells from benign tumors rarely invade tissues around them. They don’t spread to other parts of the body
Malignant brain tumors (also called brain cancer) contain cancer cells:
- Malignant brain tumors are generally more serious and often are a threat to life.
- They are likely to grow rapidly and crowd or invade the nearby healthy brain tissue.
- Cancer cells may break away from malignant brain tumors and spread to other parts of the brain or to the spinal cord. They rarely spread to other parts of the body.
There are many types of primary brain tumors. Primary brain tumors are named according to the type of cells or the part of the brain in which they begin. For example, most primary brain tumors begin in glial cells. This type of tumor is called a glioma.
Among adults, the most common types are:
- Astrocytoma: The tumor arises from star-shaped glial cells called astrocytes. It can be any grade. In adults, an astrocytoma most often arises in the cerebrum.
- Meningioma: The tumor arises in the meninges. It can be grade I, II, or III. It’s usually benign (grade I) and grows slowly.
- Oligodendroglioma: The tumor arises from cells that make the fatty substance that covers and protects nerves. It usually occurs in the cerebrum. It’s most common in middle-aged adults. It can be grade II or III.
Life after being diagnosed with cancer will be different for everyone. Some people will have minimal disease and it will be a short chapter of their lives, while others will have a diagnosis that will change the course of the rest of their lives. Cancer diagnoses can change relationships, your routines, your work and home life. One thing is certain, no one person’s experience will be exactly the same. There are however, plenty of resources to learn about what life was like for other people, and what they did to achieve balance, maintain their health and personal life, keep peace of mind, and enjoy their lives with or after cancer.
Your experience with cancer will depend on the type of cancer you have, your choices of treatment and the lifestyle you lead. Be sure to speak with your Doctor about the side effects of your disease and the treatments you choose. Your Doctor will be able to consult with you on realistic lifestyle expectations.