Treatment for brain tumours
Treatments such as surgery, radiotherapy or chemotherapy may be used alone or in combination to treat brain tumours. The choice of treatment will depend on a number of factors, including the type of brain tumour and its size, the grade of the tumour, its position and your general health.
Listen to this information – An overview of treatment for brain tumours
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With most primary brain tumours, surgery is often the first treatment if the tumour can be removed without causing harm to the surrounding brain tissue.
However, certain tumours may not need to be operated on immediately, or at all. For example, some low-grade gliomas may be carefully monitored if they’re not causing problems; others may be treated only with radiotherapy. Rare tumours of the brain, such as germinomas or lymphomas, are sometimes treated using radiotherapy and chemotherapy instead of an operation.
Surgery can range from having a biopsy to find out which type of tumour it is, to a major operation where the tumour is completely removed.
Radiotherapy is often used after surgery. It may be given if a tumour has not been completely removed, or if there’s a chance that abnormal cells may be left behind after surgery. For high-grade tumours, radiotherapy may be recommended even if all of the obvious tumour has been surgically removed.
When surgery isn’t possible or not needed, radiotherapy, with or without chemotherapy, is used as the main treatment.
Symptom control treatment
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In both primary and secondary brain tumours, treatment for particular symptoms may be needed. This may include medicines to prevent seizures (fits) called anticonvulsants, and steroids to reduce any inflammation and swelling around the tumour.
Planning your treatment
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In most hospitals a team of specialists will talk to you about the treatment they feel is best for you. This multidisciplinary team (MDT) will include a:
neurosurgeon - a doctor who specialises in operating on the brain or nervous system
neurologist - a doctor who specialises in treating illnesses of the brain and nervous system
clinical oncologist - a doctor who specialises in treating cancer with radiotherapy and chemotherapy
specialist nurse - who gives information and support to people with brain tumours.
The MDT may also include other healthcare professionals such as a dietitian, physiotherapist, occupational therapist, psychologist or a counsellor.
The MDT will take a number of factors into account when advising you on the best course of action. These factors include your age, general health, the type and size of the tumour, and whether it has begun to spread.
If two treatments are equally effective for your type and stage of cancer, your doctors may offer you a choice of treatments. Sometimes people find it hard to make a decision. If you’re asked to make a choice, make sure you have enough information about the different options, what’s involved and the possible side effects, so that you can decide on the right treatment for you.
Remember to ask questions about any aspects that you don’t understand or feel worried about. It may help to discuss the benefits and disadvantages of each option with your cancer specialist, nurse specialist or with our cancer support specialists.
If you have any questions about your treatment, don’t be afraid to ask your doctor or nurse. It often helps to make a list of questions and to take a relative or close friend with you.
Before you have any treatment, your doctor will explain its aims. They will usually ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you’re asked to sign the form you should be given full information about:
the type and extent of the treatment
its advantages and disadvantages
any significant risks or side effects
any other treatments that may be available.
If you don’t understand what you’ve been told, let the staff know straight away so they can explain again. Some cancer treatments are complex, so it’s not unusual for people to need explanations repeated.
People sometimes feel that hospital staff are too busy to answer their questions, but it’s important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions.
You can always ask for more time if you feel that you can’t make a decision when your treatment is first explained to you.
You are also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You don’t have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.
The benefits and disadvantages of treatment
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Many people are frightened at the idea of having cancer treatments, particularly because of the side effects that can occur. However, these can usually be controlled with medicines.
Treatment can be given for different reasons, and the potential benefits will vary depending upon the individual situation. Surgery can be done with the aim of curing some types of brain tumour. Occasionally, additional treatments are also given to reduce the risk of it coming back.
If the tumour is at a more advanced stage or in a part of the brain that’s difficult to reach without risk of damage, the treatment may only be able to control it. This can lead to an improvement in symptoms and a better quality of life. However, for some people in this situation the treatment will have little effect on the tumour and they may get the side effects without any of the benefit.
If you’ve been offered treatment that aims to cure the brain tumour, deciding whether to accept the treatment may not be difficult. However, if a cure is not possible and the treatment is to control the tumour for a period of time, it may be more difficult to decide whether to go ahead.
Making decisions about treatment in these circumstances is always difficult, and you may need to discuss in detail with your doctor whether you wish to have treatment. If you choose not to, you can still be given supportive (palliative) care, with medicines to control any symptoms.
Your multidisciplinary team (MDT) uses national treatment guidelines to decide the most suitable treatment for you.
Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion. Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident that it will give you useful information.
If you do go for a second opinion, it may be a good idea to take a relative or friend with you, and have a list of questions ready so that you can make sure your concerns are covered during the discussion.
You might find it helpful to watch our video explaining the possible benefits and disadvantages of getting a second opinion.