Brain Cancer

Home » Brain Cancer » Treatment

Questions to Ask Your Doctor About Brain Cancer
(Free Handout)

Treatment

Treatment for brain cancer depends on the age of the patient, the stage of the disease, the type and location of the tumor, and whether the cancer is a primary tumor or brain metastases. The treatment plan is developed by the oncology team and the patient.

Treatment involves any combination of surgery, radiation therapy (including radiosurgery), and chemotherapy. Some tumors require several different surgical procedures, and some can be treated with radiation alone.

Surgery

Surgery is the treatment of choice for accessible primary brain tumors, when the patient is in good health. The goal of surgery is to remove as much of the tumor as possible without damaging nearby normal brain tissue. The prognosis improves when more than 90% of a tumor can be removed.

Removal is often complicated by the nature of the tumor (e.g., invasive, highly vascularized) and by its location. Partial removal (debulking) of the tumor can improve quality of life by alleviating symptoms and sometimes improve the effectiveness of radiation therapy or chemotherapy.

Before surgery, some important tests are performed. Patients over the age of 40 usually undergo an electrocardiogram (ECG or EKG) and a chest x-ray. Other tests are used to detect the presence of uncontrolled hypertension, diabetes, active coronary ischemia, or the presence of circulating anticoagulant (substance that inhibits normal blood clotting) in the blood. If any of these conditions are present, it may not be advisable to undergo craniotomy.

Craniotomy

Craniotomy is the treatment of choice and the goal is to remove as much of the tumor as possible. The procedure is performed under general anesthesia and involves opening the skull (cranium).

The neurosurgeon makes an incision into the scalp and several holes (called burr holes) are made in the skull. A bone saw is used to join the holes together to create a flap of bone.

The bone flap is then removed to expose the brain and remove as much of the tumor as possible. After the tumor has been partially or completely resected, the bone flap is replaced and secured using fine wire. Recovery from the procedure may take as long as 8 weeks.

Complications of craniotomy include bleeding (hemorrhage), swelling (edema), increased intracranial pressure (IICP), infection, and brain tissue damage.

In laser microsurgery, MRI is used to pinpoint the location of the tumor and a laser is used to destroy the tumor. This procedure may be used after craniotomy to remove remaining tumor tissue.

Brain-mapping is performed under local anesthesia and sedation. Electrodes stimulate nerves in the brain, measure responses, and allow communication with the patient. The surgeon removes as much of the tumor as possible without damaging vital areas of the brain, such as those that control motor function and speech.

In some cases, a chemotherapeutic agent called BCNU is used following surgery. In this treatment, the neurosurgeon places a wafer soaked with BCNU (Gliadel®, BiCNU®) into the surgical cavity after the tumor has been removed. By applying it directly to the diseased area of the brain, side effects are limited and the drug has a more beneficial effect.

Postoperative care includes drug therapy with corticosteroids, histamine inhibitors (block stomach acid), and antiepileptics. Corticosteroids (dexamethasone and Decadron®) help reduce swelling and can relieve various postoperative neurological effects.

An MRI scan, with and without contrast, is often obtained to determine the extent of residual disease following surgery. Sometimes, a plan for rehabilitation is needed.

© 1998-2009 Healthcommunities.com, Inc. All Rights Reserved.

Brain Cancer Resources

	Questions to Ask Your Doctor About Your Cancer The more knowledge you have, the easier it is to make decisions about your cancer treatment. Print this free handout to take with you on your next office visit.	Advertising Disclaimer
	Join Our Brain Cancer Forum Do you have a question, want to share medical advice, or just need to discuss your situation with someone else having a similar experience? The healthchannels forum is a resource for everyone to share and discuss their health and medical needs with others.
	Living with...Share your story Do you have a personal health story that you would like to share with others? As a source of free patient education, our goal is to provide our users with trustworthy information and support from others. That's why we've started our "Living with..." sections.
	Our "Living With..." support pages are a place to share experiences about living with a certain condition, disease, disorder, or illness and for loved ones of those dealing with health-related issues. Many people, especially when newly diagnosed, find comfort in knowing that others are having a similar experience. Help others by sharing your story. View stories already submitted. National Cancer Survivors Day is June 7, 2009 Share your survival story and help others in the fight against cancer. Read stories already submitted
To quickly access health information from your website's browser, download Healthcommunities.com's healthchannels toolbar. Advertising Disclaimer