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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.
A team of doctors and other health professionals will plan your care. This is known as a multidisciplinary team (MDT) and may include:
The MDT may also include other health care professionals, including a:
Before you have any treatment, your doctor will explain its aims. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should be given full information about:
If you do not understand what you've been told, let the staff know straight away so that they can explain again. Some cancer treatments can be very complex, so it's not unusual for people to need repeated explanations.
It is often a good idea to have a friend or relative with you when the treatment is explained, to help you remember the discussion more fully. You may also find it useful to write down a list of questions before you go to your appointment.
Patients often feel that the hospital staff are too busy to answer their questions, but it's important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.
You can always ask for more time to decide about the treatment if you feel that you can’t make a decision when it 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 do not have it. It is essential to tell a doctor or the nurse in charge, so that they can record your decision in your medical notes. You do not have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can give you the best advice.
Your MDT use national treatment guidelines to decide on the most suitable treatment for you. Even so, you may want another medical opinion. Either your specialist, or your GP, will be willing to refer you to another specialist for a second opinion, if you feel it will help. Getting a second opinion may cause a delay in 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 friend or relative with you, and have a list of questions ready; so that you can make sure your concerns are covered during the discussion.
Often, people are concerned about the possible side effects associated with treatment. Many of the treatments for brain tumours can cause side effects. However, improved ways of reducing or avoiding many of these problems have made most of the treatments much easier to cope with.
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 your 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 with treatment.
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.
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. Some low-grade gliomas, for example, may be carefully monitored if they are not causing problems, and others may be treated with radiotherapy alone. Rare tumours of the brain, such as germinomas or lymphomas, are sometimes treated without an operation, using radiotherapy and chemotherapy.
Surgery can range from having a biopsy (see Surgery| for more information) 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 is a chance that abnormal cells may be left behind following surgery. Or, in the case of high-grade tumours, radiotherapy may be recommended even if all of the tumour has been surgically removed.
When surgery is not possible, or not necessary, radiotherapy, with or without chemotherapy, is used as the main treatment.
In both primary and secondary brain tumours, treatment for particular symptoms may be necessary. For example, anticonvulsant medicines to prevent seizures (fits) and steroids| to reduce any inflammation and swelling around the tumour.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.