- Posted by jdavis on July 25, 2011
Many people with brain tumors want to take an active part in making decisions about their medical care. They want to learn all they can about their disease and their treatment choices. However, shock and stress after a diagnosis of a brain tumor can make it hard to think of everything to ask the doctor. It often helps to make a list of questions before an appointment. To help remember what the doctor says, patients may take notes or ask whether they may use a tape recorder. Some also want to have a family member or friend with them when they talk to the doctor – to take part in the discussion, to take notes, or just to listen.
Preparing for Treatment
The doctor can describe treatment choices and discuss the results expected with each treatment option. Treatment depends on a number of factors, including the type, location, size, and grade of the tumor. For some types of brain cancer, the doctor also needs to know whether cancer cells were found in the cerebrospinal fluid.
These are some questions a person may want to ask the doctor before treatment begins:
- What type of brain tumor do I have?
- Is it benign or malignant?
- What is the grade of the tumor?
- What are my treatment choices? Which do you recommend for me? Why?
- What are the benefits of each kind of treatment?
- What are the risks and possible side effects of each treatment?
- What is the treatment likely to cost?
- How will treatment affect my normal activities?
- Would a clinical trial (research study) be appropriate for me? Can you help me find one?
Types of Treatment
Treatment for brain tumor should be individualized for you. Your treatment regimen is based on your age and general health and the size, location, and type of your tumor. The most widely used treatments are surgery, radiation therapy, and chemotherapy. In some cases, more than one of these is used.
Most people with a brain tumor undergo surgery. The purposes of surgery are to confirm that the abnormality seen on the brain scan is indeed a tumor and to remove the tumor. If the tumor cannot be removed, the surgeon will take a sample of the tumor to identify its type. In some cases, mostly in benign tumors, symptoms can be completely cured by surgical removal of the tumor. Your neurosurgeon will attempt to remove the tumor when possible.
Stereotactic surgery is a newer “knifeless” technique that destroys a brain tumor without opening the skull. CT or MRI scan is used to pinpoint the exact location of the tumor in the brain. High-energy radiation beams are trained on the tumor from different angles. The radiation destroys the tumor. This technique is sometimes called “gamma knife.” The advantages of “knifeless” procedures are that they have fewer complications and the recovery time is much shorter.
These are some questions a person may want to ask the doctor before having surgery:
- How will I feel after the operation?
- What will you do for me if I have pain?
- How long will I be in the hospital?
- Will I have any long-term effects? Will my hair grow back? Are there any side effects from using metal or fabric to replace the bone in the skull?
- When can I get back to my normal activities?
- What is my chance of a full recovery?
Radiation therapy (also called radiotherapy) is the use of high-energy rays to kills tumor cells and stop them from growing and multiplying. Radiation therapy is sometimes used for people who cannot undergo surgery. In other cases, it is used after surgery to kill any tumor calls that may remain. Radiation therapy is a local therapy. This means that it affects only cells in its path. It does not harm cells elsewhere in the body or even elsewhere in the brain.
Radiation can be administered in either of 2 ways.
- External radiation uses a high-energy beam of radiation targeted at the tumor. The beam travels through the skin, the skull, healthy brain tissue, and other tissues to get at the tumor. The treatments are usually given 5 days a week for about 4-6 weeks. Each treatment takes only a few minutes.
- Internal or implant radiation uses a tiny radioactive capsule that is placed inside the tumor itself. The radiation emitted from the capsule destroys the tumor. The radioactivity of the capsule decreases a little bit each day; the amount of radioactivity of the capsule is carefully calculated to run out when the optimal dose has been given. You need to stay in the hospital for several days while receiving this treatment.
Chemotherapy is the use of powerful drugs to kill tumor cells. The drugs are given by mouth or through an IV line. Some medications are given through the shunt put in place to drain excess fluid from your brain.
Chemotherapy is usually given in cycles. Most regimens are designed so that 2-4 cycles are completed. There is then a break in the treatment to see how your tumor has responded to the therapy.
The side effects of chemotherapy are well known and are very difficult to tolerate for some people. They include nausea and vomiting, mouth sores, loss of appetite, loss of hair, and many others. Some of these side effects can be relieved or improved by medication.