Brain tumor treatment: Know the Best Treatment Options

Brain tumour treatment depends on various factors, such as size and location of the tumour, as well as the patient’s age and heath. The treatment/procedure also differs for adults and children. You need to consult a doctor for your treatment.

The common treatment methods for treating brain tumour are through surgery, chemotherapy and radiation therapy. Before the treatment, patients are given steroids for relieving oedema or swelling. You may even receive certain anticonvulsant medicines for preventing or controlling seizures.

In case of hydrocephalus presence, you may require a shunt to drain the cerebrospinal fluid. The shunt is a thin, long tube that’s placed inside the ventricle of the brain and threaded under the skin to another body part, generally abdomen. It works like a drainpipe that carries away the excess fluid from the brain and the fluid is further drained to the abdomen or heart.

Brain Tumor Treatment Options

Surgery

Surgery is a common brain tumour treatment for removing the tumour in the brain. A neurosurgeon will perform this treatment/procedure by opening the skull. The brain tumour operation is called craniotomy. In this treatment, the surgeon attempts removal of the whole tumour. If the brain tumour cannot be removed completely without damaging important brain tissues, the neurosurgeon will remove as many tumours as possible. This partial removal of the tumour will help in relieving some symptoms by reducing the amount of tumour and reducing pressure on the brain. Further, the patient is treated with chemotherapy or radiation therapy.

Some tumours are not possible to remove. In that case, the doctor performs a biopsy. In this procedure, a small tumour piece is removed from the brain and sent to a pathologist for examination under a microscope. This will determine the types of cell present in a tissue.

Other advanced techniques used for brain tumour surgery include brain mapping, which helps in finding functional pathways surrounding the tumour, opening spinal fluid pathways and performing endoscopy for biopsies through advanced frameless stereotaxic tumour resections that are assisted by a computer. Intraoperative MRI can also be used for maximum removal of the tumour.

Radiation Therapy

Radiation therapy or radiotherapy is a brain tumour treatment with the help of high-powered rays that may damage cancer cells and even stop them from growing further. It is used for destroying tissues that cannot be removed through a surgical procedure. It is also used when surgery is not possible.

Radiation therapy is performed in two ways – radiations from a machine or radiations from radioactive material. The external radiations coming from a huge machine take a week or several weeks for treatment. This treatment schedule will depend on the size of the tumour, location and patient’s age.

External radiation is directed to the tumour, surrounding tissue or the entire brain. In some cases, the radiation is also directed to the patient’s spinal cord. When the entire brain is treated, the patient receives an extra dose of external radiations to treat the tumour.

Radiation from radioactive material is done by placing that material directly on the tumour or implant radiation therapy. Depending on the radioactive material uses, the embedded implant is left in the brain for a short time or permanently. This implant will lose a small radioactivity every day. The patient will stay in the hospital for several days or weeks while the radioactive material is most active.

Another way to treat a brain tumour is by using stereotactic radiosurgery (SRS) or gamma knife. The gamma knife is not an exact knife but it’s a radiation technique for delivering single, focused high doses of radiation to its target. This treatment is done in one session. The high-energy radiations are focused at the tumour from different angles. This way, the high dose of radiation will reach the tumour without damaging any other part of the brain tissue.

Chemotherapy

Chemotherapy is a technique of using drugs to kill cancer cells. The doctor uses one drug or a drug combination, which is given orally or injected into the blood vessels or muscles. In intrathecal chemotherapy, the drugs are injected into the cerebrospinal fluid.

Chemotherapy is often given in cycles. The treatment duration is followed up by a proper recovery period and other procedures. The patients don’t have to stay in a hospital for this treatment and most medications are given at the doctor’s clinic. However, depending on the drugs used for treatment, the patient’s general health, and how drugs are given, the patient may have to opt for a short hospital stay.

The advancement in chemotherapy includes direct placement of drugs into the tumour cavity using a new technique termed as convection-enhanced delivery.

Targeted therapy

Besides the standard chemotherapy, the patient may be given a targeted therapy for targeting specific genes, tissues or proteins that contribute to the growth of the tumour. This treatment option may block the spreading of tumour cells or block the growth of tumour while avoiding any damage to the healthy cells.

All tumours don’t have the same targets, as some tumours may have more than one target. To find the best effective brain tumour treatment, the doctor may run a few tests for identifying proteins, genes and other factors within tumours. This will help doctors to better match each patient with the best possible treatment.

There are two types of targeted therapy for brain tumour treatment:

• Bevacizumab (Avastin, Mvasi): This is an anti-angiogenesis therapy for treating glioblastoma multiforme (GBM) when the major treatment does not work. This treatment is focused on stopping angiogenesis that helps in making new blood vessels. As the tumour needs nutrients by blood vessels for growth, this therapy aims at stating tumours and kills them eventually.
• Larotrectinib (Vitrakvi): This targeted therapy type is not specific for a particular type of tumour. Instead, it focuses on a particular genetic change known as NTRK fusion. This genetic change is found in various types of tumours, including brain tumours. This treatment is used for tumours that cannot be removed by surgery or other treatments/procedures.