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BRAIN TUMOR TREATMENTS |
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Brain tumors are treated by
multidisciplinary teams of highly skilled specialists whose
decisions are based on: Results of diagnostic tests Tumor size, position, and growth pattern The patient's health history and current medical status The wishes of the patient and his family. Surgery Surgery is the treatment of choice for accessible brain tumors, which can be removed without causing serious neurologic damage. The procedure most often performed is a craniotomy, but the goals of any type of brain tumor surgery include: Removing as much of the tumor as possible Removing tumor tissue for microscopic analysis Allowing neurosurgeons to see exactly how the tumor is situated and how it is growing Creating an entry channel for chemotherapy drugs and forms of radiation that are implanted in the brain. Before undergoing brain surgery, patients are often given: Steroids to reduce swelling of brain tissue Anticonvulsant medications to prevent or control seizures Radiation treatments to reduce tumor size. Patients whose benign brain tumors can be completely removed may not require any additional treatment, but periodic physical and neurologic examinations and CT or MRI scans are sometimes recommended to determine whether the tumor has returned. Because surgeons cannot be sure that every bit of an infiltrating or metastasizing tumor has been removed, radiation and chemotherapy are used to eradicate cells that may have escaped the scalpel. If a tumor cannot be completely removed, removing a portion of it (debulking) can alleviate the patient's symptoms, enhance the sense of well-being, and increase the effectiveness of other treatments. Radiation therapy External radiotherapy, generally delivered on an outpatient basis, directs radiation to the tumor and the area around it. Implant radiation therapy involves placing tiny pieces of radioactive material in the brain. Left in place permanently, or for a short time, these radioactive pellets release measured doses of radiation each day. Patients are usually hospitalized during the several days the pellets are most active. Stereoactic radiosurgery involves fitting the patient with a frame to stabilize the head, using imaging techniques to determine the exact location of tumor cells, and using a sophisticated instrument called a gamma knife to administer radiation precisely to that point. Chemotherapy One or more cancer-killing drugs may be taken by mouth or injected into a blood vessel, muscle, or the cerebrospinal fluid. Chemotherapy may be used with radiation and surgery as part of a patient's initial treatment, or used alone to treat tumors that recur in the same place or in another part of the body. When a young child has a brain tumor, chemotherapy is often used to eliminate or delay the need for radiation. Other treatments If a brain tumor cannot be cured, treatment is designed to make the patient as comfortable as possible and preserve as much of his neurologic functioning as possible. The patient's doctor may prescribe: Analgesics to relieve pain Anticancer drugs to limit tumor growth Anticonvulsants to control seizures Steroids to reduce swelling of brain tissue. Potential therapies Scientists are studying ways to empower chemotherapy drugs to penetrate the blood-brain barrier (which protects the CNS by separating the brain from blood circulating throughout the body), and attack cancer cells that have infiltrated tissue inside it. Brain tumor researchers are also investigating: Less invasive surgical procedures Methods of incorporating chemotherapy drugs into tumor cells to reduce the need for radiation Laboratory techniques that enable physicians to select the chemotherapy drugs most likely to kill particular types of tumors Gene therapy in which genetically engineered material is transported to tumor cells by viruses that infect tumor cells and convert them to normal cells, stop their growth, or kill them. Alternative treatment Alternative treatments have not been shown to cure brain tumors and should never be substituted for conventional therapy. However, complementary therapies (used with, not instead of, standard treatments) can help some patients cope with the stress of their illness and side effects of their treatment. Biofeedback can teach patients to influence and control heart rate, muscle tension, and other stress-related body functions. Some patients claim that guided imagery (visualization) helps them feel healthier and more in control of their disease. Massage, meditation, and reflexology help some patients relax; while yoga is said to soothe the body, spirit, and mind. Hydrotherapy uses ice, liquid, and steam to improve circulation and relieve pain. Therapeutic touch practitioners say they can relieve pain and other symptoms by moving their hands in slow, rhythmic motions several inches above the patient's body. Botanical therapies, homeopathic treatment, traditional Chinese medicine treatments, nutritional focuses on diet and supplements, and detoxification can also be incorporated as complementary therapies. |
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