Treatment of a brain tumour is different from treatment of tumours in other parts of the body. Brain surgery needs to be extremely precise and not all therapeutic drugs are able to cross the blood brain barrier.
The type, grade and location of the tumour will help determine the treatment for a brain tumour. Treatment will also depend on your general state of health, quality of life and whether the tumour is primary or secondary. A team of doctors and other health professionals (known as a multi-disciplinary team - MDT) will plan your specific treatment path. This team will usually include a neurosurgeon (a doctor who specialises in operating on the brain or nervous system), a neurologist (a doctor who specialises in treating illnesses of the brain and nervous system), a clinical oncologist (a doctor who treats cancer with radiotherapy and chemotherapy) and a specialist nurse.
Consent
Before you have any treatment, the doctor should give you information on the planned treatment, explain any advantages or disadvantages of the treatment and outline any risks or possible side effects. Once you have understood the medical treatment you will be asked to sign a form to say that you give your permission.
If you feel that you cannot make a decision immediately, it is fine for you to ask for more time to think about it. You are also free to choose not to go ahead with the treatment if you are sure that is your preference.
Surgery
For primary brain tumours, if the tumour can be removed without causing harm to the surrounding tissue, surgery may be the first treatment. However for low grade gliomas it may well be thought best to leave surgery and simply monitor the tumour. Surgery can range from a biopsy (taking a sample of the tumour for analysis) to a major operation in which the tumour is completely or partially removed.
Radiotherapy
Radiotherapy is usually given after surgery if a tumour has not been completely removed or if there is the possibility that abnormal cells remain. When surgery is not possible or necessary, radiotherapy with or without chemotherapy is the main treatment.
Chemotherapy
This is the use of special anti cancer (cytotoxic) drugs which disrupt the growth of cancer cells. It is not used to treat all brain tumours but can be effective for inoperable primary brain tumours or as part of the treatment for secondary brain tumours. Some types of chemotherapy are given as tablets or capsules and some are administered intravenously (into a vein) and these treatments can normally be given to you as an outpatient.
Steroids
Steroids control the swelling due to accumulation of fluids often associated with brain tumours. They may be used temporarily following surgery or during radiation as these treatments often cause oedema (swelling). Any long term use of steroids for the relief of symptoms requires close monitoring due to potential side effects.
