Following a brain cancer diagnosis, one of your next steps will be to work with your doctor to develop a treatment path that will be most effective for your individual tumor. Because there are different types of brain cancers and other influencing factors, your treatment plan will be individually tailored to you and your needs.
Treatment Options Can Vary Depending on the Type of Tumor
To better understand why your doctor may recommend a particular treatment path, it might be helpful to understand how brain tumors are classified. If you have been diagnosed with a primary tumor, that means your cancer originated from cells within the brain.
However, if you have a secondary brain tumor, that means the original site of cancer is elsewhere in the body, such as in the lungs, and has spread to the brain. These secondary brain tumors are also referred to as metastatic.
Depending on whether you have a primary or secondary tumor, your brain cancer treatment options will vary. Your doctor will take your diagnosis into account, as well as other important factors discussed further on.
If you have been diagnosed with a primary tumor, your doctor will likely recommend a combination treatment approach commonly used for primary tumors. These types of tumors don’t typically respond well to chemotherapy or radiation therapy alone, so your first treatment will probably be a surgical procedure.
The larger and/or more aggressive your tumor, the more likely it is that your doctor will recommend surgery first. If the tumor is large, surgically removing as much as possible before adjunct radiation and/or chemotherapy will yield improved results. However, it’s important to understand that the surgeon may not be able to remove 100 percent of the tumor, and follow-up therapy to prevent any remaining cells from duplicating will be necessary.
Following surgery, after your diagnosis of a primary tumor is confirmed, your adjunct therapy will include fractionated radiation on a schedule of five times per week for a duration of six weeks. Additionally, your doctor will likely recommend a chemotherapy drug, such as Temozolomide, an oral medication taken daily.
Once your treatment is complete and the cancer is eradicated, your doctor will work with you to develop a lifelong follow-up schedule to monitor for recurrence.
Secondary tumors exhibit more variability than primary tumors, so it should not be surprising that secondary brain cancer treatment options are also more variable. Secondary tumors tend to respond to radiation and chemotherapy slightly better than primary tumors and have a better overall treatment prognosis.
When developing your treatment plan, your doctor will take a number of factors into consideration, including the size and location of your tumor and any health conditions you may have that complicate surgery. Your treatment may include a single or combination approach, depending upon which is most suitable for your individual situation.
Generally speaking, there are three standard treatment methods for cancer: radiation, chemotherapy and surgery. Chemotherapy is usually not an option for metastatic tumors because of the body’s natural protective system, called the blood-brain barrier (BBB), may prevent drugs from leaving the bloodstream and entering the brain. Whether chemotherapy will be effective depends on the original site of your cancer. For example, chemotherapeutic drugs for lung cancer may not readily cross the BBB and may not very effective in treating secondary brain cancer.
Surgery is usually chosen as the first treatment for your secondary tumor if you meet certain criteria:
- There is a clear correlation between neurological deficits and the tumor’s location.
- Your primary cancer is treatable and under control.
- You have one or two metastatic brain tumors, or a few tumors that are close to each other, which can be safely removed.
It is important to understand that the surgeon may not be able to remove 100 percent of the tumor, so any surgical procedure will need to be followed up with radiation therapy to ensure the cancer is fully eradicated from the body. Otherwise, any remaining cells may potentially grow into another tumor.
Radiation therapy may be used in conjunction with surgery, or in some cases, it may be the first-line treatment, particularly if your tumor is relatively small. There are two forms of radiation that are typically used: traditional (whole brain) radiation and Gamma Knife stereotactic radiosurgery.
Traditional radiation involves multiple sessions of low-dose radiation delivered to the entire brain. This method has long been the gold standard for brain cancer radiation therapy because of its effectiveness. Unfortunately, because it affects healthy cells as well as cancer cells, you may experience unpleasant side effects following treatment. However, for some patients, this is a preferred and necessary treatment.
Another form of radiation therapy, Gamma Knife stereotactic radiosurgery, typically involves just a single session and uses a highly focused beam of radiation to target your tumor specifically. The results are reduced side effects and an overall easier treatment process.
Your Treatment Path
As you see, your brain cancer treatment options are going to depend on a number of factors unique to you and your condition. Your doctor will work with you to develop a personalized treatment path that is appropriate for you and your needs.
Now that you have a better understanding of your brain cancer treatment options, you may find you have new questions. Keep these in mind at your next appointment, and keep the conversation going with your doctor. He or she will be happy to help you better understand your brain cancer treatment options, helping you to be confident and comfortable during this process.