No two metastatic brain cancer patients are exactly alike. So as your doctor develops your treatment plan, your doctor will take many factors into consideration to ensure he or she recommends only the brain cancer treatment options that are the most effective for your individual type of tumor.
Whether you are still working with your doctor to determine a treatment path or you already have a procedure scheduled, it can be helpful to know a little about each metastatic brain cancer treatment option and when each is the appropriate choice. Sometimes, your doctor will recommend one treatment over another or may prefer a combination approach. This will depend on factors such as the size of the tumor, the location of the tumor and the specific type of brain tumor you are treating.
An Overview of Metastatic Brain Cancer Treatment Options
Before discussing the factors that will influence your treatment plan, it is important to understand the treatment options available. They typically fall into two broad categories: open surgery and radiation therapy. Radiation therapy is often used alone, while surgery tends to be followed by some form of radiation to ensure the cancer is completely cleared.
Open surgery is just as straightforward as it sounds. The surgeon will perform an operation to remove all or part of the tumor using traditional surgical methods. Surgical removal of brain cancer is typically followed by radiation therapy to ensure all cancerous cells have been destroyed.
Radiation therapy falls into two categories, the first being whole-brain radiation, which treats the entire brain using multiple sessions of low-dose radiation. Whole-brain radiation has been the gold standard radiation therapy for metastatic brain cancers because of its effectiveness in shrinking tumors.
An emerging technology is Gamma Knife radiosurgery, which uses a directed beam of radiation to target only the tumor, sparing the surrounding tissues. This is completed in a single session and generally results in fewer unpleasant side effects commonly associated with whole brain radiation. This reduced side effect profile is one reason many doctors prefer Gamma Knife radiosurgery to whole brain radiation in eligible patients.
The Factors Influencing Your Treatment
The most effective way to treat metastatic brain cancer is to choose the right approach. Your tumor is different from the next person’s, which is why your doctor will evaluate multiple factors before deciding which brain tumor treatment path will be the most successful for your condition.
Factor #1 — The Size of the Tumor
The first factor your doctor will take into consideration is the size of your brain tumor. A small tumor can often be treated using only radiation therapy, which includes either whole brain or Gamma Knife radiosurgery.
If the tumor is large, your doctor will likely lean towards surgery to remove as much of the tumor as possible. Your surgery will be followed up with radiation therapy, again to ensure the cancer has been eliminated, preventing the need for retreatment.
Factor #2 — The Location of the Tumor
Though surgery is a typical treatment option for large tumors, the location can be an overriding factor. Regardless of the size of your tumor, if it is not easily accessible or is risky to access, your doctor will not operate. Instead, your doctor will recommend non-invasive procedures, such as radiation therapy.
Factor #3 — The Type of Tumor
Brain tumors are variable in origin and behavior, and the type of tumor you have will influence your doctor’s treatment recommendations. Some brain cancers develop from cells of the brain itself (primary tumors), while others have spread from cancer at another site in the body (metastatic tumors).
If your brain tumor is fast-growing, high grade and/or aggressive, there is a greater sense of urgency to prevent damage to surrounding tissues and spread of the cancer. In that case, your doctor will likely recommend surgery, unless you are not a good surgical candidate because of the tumor’s location or any complicating health conditions you may have.
For tumors that are slower-growing and less aggressive, your doctor will likely explore less-invasive treatment procedures. If time is of less concern, radiation therapy may be a better option for you, whether it be whole brain or Gamma Knife radiosurgery.
Developing the Plan That Is Right for You
There are many factors your doctor will take into consideration as he or she develops your treatment path. The characteristics of your tumor — such as size, location and type — are all key in determining which brain cancer treatment option will be most effective. However, there are other considerations, including your health history, complicating conditions, prescription medications and age.
As you learn more about your metastatic brain cancer treatment options, you may find that you have new questions. Be sure to address them with your neurosurgeon before treatment. It’s important that you are comfortable with the procedures you will be undergoing. It will help reduce your stress on this road to recovery, so you can focus on what matters most: getting better.