Treatment for brain tumours
Your treatment will be planned by a team of specialists. They’ll talk to you about the best treatment for you.
It’s not unusual to have a combination of treatments so you may be seen by different doctors such as:
a neurosurgeon who specialises in brain operations
a neurologist who treats brain conditions
a cancer specialist (oncologist) who treats cancer with radiotherapy and chemotherapy.
You’ll also usually see a specialist nurse who looks after people with conditions affecting the brain or/and a specialist nurse for teenagers with cancer.
Because there are different types of brain tumours, treatment won’t be the same for everyone. Your doctors look at the type of brain tumour, its size and where it is in the brain before deciding on the best treatment for you.
Here are the main treatments to treat brain tumours - you might have a combination of these:
surgery - an operation to remove all or as much of the tumour as possible
radiotherapy - uses high-energy x-rays to treat cancer cells
chemotherapy - uses anti-cancer drugs to destroy cancer cells.
Your specialist doctor and nurse will explain your treatment and answer your questions. It’s important you understand what’s involved. You’ll probably need some time to talk it through with your family.
Medicines you may need to take
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You might need to take these medicines for a while to reduce or control the symptoms of the brain tumour:
steroids, which reduce swelling or inflammation in the brain and so they can help with symptoms
medicines that help prevent fits , known as anticonvulsants that are given if you’ve had any fits (seizures).
Surgery for brain tumours
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Removing the tumour
For general info about what happens before and after an operation see our surgery section.
Your surgeon will try to remove all or as much of the tumour as possible. Before the operation they’ll talk to you about what’s involved and the pros and cons of the operation. It’s important you understand all this, so make sure you ask all your questions.
You’ll usually be in hospital for about a week or sometimes longer. Your doctor or nurse will tell you what to expect before and after the operation as this won’t be the same for everyone.
Before the operation you’ll probably need to have some of your hair shaved off. This is done in the anaesthetic room. Some people prefer to have all of their hair shaved off and to cover up with a wig or a baseball cap while it grows back. It’s totally up to you.
Sometimes, it’s not possible to remove the tumour. Your specialist may think that another treatment would be better for you. They’ll discuss this with you and you can ask any questions to help you understand your options.
What happens after the operation?
Straight after the operation you’ll be monitored very closely for the first 12-24 hours. At first you might be attached to a machine called a ventilator that helps you breathe. Your nurse or doctor will tell you if this is likely to happen.
Your head might be bandaged and you’ll have a tube from the wound draining extra blood that’s collected into a plastic bottle. You may also have another tube draining extra cerebrospinal fluid (fluid that surrounds the brain) to make sure you don’t get too much pressure building up inside your brain. Your doctor will remove these tubes as soon as it’s safe, usually after a couple of days..
You’ll have a drip of salt water (saline) to give you fluids until you’re eating and drinking again. There may be some swelling and bruising around your face and eyes. But if you have this it will settle down after a few days.
When you wake up you might have a headache. You’ll be given painkillers regularly until this eases off. Tell your nurse or doctor if you’re in pain so that they can give you something stronger.
Radiotherapy for brain tumours
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Radiotherapy uses high-energy x-rays to treat cancer cells. It can be used:
after the operation to treat any cells that may have been left behind.
instead of an operation when a brain tumour can’t be removed.
if a brain tumour comes back after surgery.
to treat the spine as well as the head (with some types of brain tumour).
Types of radiotherapy
You might hear doctors talk about stereotactic radiotherapy, or stereotactic radiosurgery. These treatments can give very targeted radiotherapy to the tumour, or treat very small brain tumours, and can also help to reduce side effects. Your doctors will explain this to you and you can read more in our section on radiotherapy.
You’ll have your treatment in the radiotherapy department of the hospital. It’s usually given Monday - Friday, with a rest at the weekend. The number of treatments or session you have will depend on your situation, but it can last from 2-7 weeks.
The treatment only takes a few minutes and it isn’t painful but you’ll need to lie really still. You’ll be on your own in the room and you can talk to the radiographer through an intercom. In some hospitals you can have music playing while you have your treatment.
You might have to wear a see-through perspex device called a mould or shell to keep your head as still as possible during radiotherapy treatment.
This makes sure exactly the right area is treated. Your mould is made before your treatment is planned. You’ll be able to see and breathe properly, but it might make you feel a bit closed in (claustrophobic). You only have to wear it for a few minutes at a time and most people find they get used to it pretty quickly. Let your nurse or radiographer know if you’re worried about this.
If you’re having stereotactic radiotherapy you might need to wear a frame that’s fitted to your head to help keep it perfectly still during treatment.
How difficult the side effects are will depend on the type of radiotherapy you’re having and how long it lasts for. Your doctor and specialist nurse will tell you more about what to expect. Always let them know about any side effects you’re having - there’s usually something they can do to make things easier.
The most common side effects
Your hair in the treatment area will start to thin and fall out shortly after your treatment starts. Your doctor or nurse can show you where you will lose your hair.
It usually starts to grow back within 3 months of finishing treatment. Sometimes hair grows back with a slightly different colour and texture and maybe not as thickly as before.
Losing your hair can be scary and really upsetting. But there’s lots of ways to cover up with hats, bandannas, baseball caps, scarves, or wigs until it grows back. Getting a shorter haircut before it starts to fall out sometimes makes it a little easier to cope with.
Although hair loss is usually temporary, for some people it can be permanent depending on the dose of your treatment. Your specialist will usually be able to tell you if this is likely. This is hard to deal with and you’ll be given advice and support to help you cope.
You might get some skin changes - a bit like sunburn - in the area that’s being treated, usually 3−4 weeks after treatment. If you’ve got pale skin it might get red, sore or itchy. If you’ve got darker skin it can get darker and have a blue/black tinge. The radiographer or specialist nurse will give you advice on looking after your skin.
Get plenty of rest but try to get some gentle exercise, like taking short walks, if you’re feeling up to it. This helps to give you more energy and to keep your muscles toned.
Let your doctor know if this is a problem - they can prescribe anti-sickness medicines to help with this.
Tell your doctor if you have headaches and they’ll prescribe painkillers for you.
Feeling drowsy (somnolence)
Occasionally, you might start to feel extremely drowsy and spend more time sleeping about 4-8 weeks after radiotherapy. Sometimes it’s very obvious and you may feel like sleeping all day long. It’s called somnolence and if this happens it gradually gets better over a few weeks
After treatment you might find your symptoms get a bit worse before they get better. This can be scary but it’s usually a reaction to the radiotherapy. It doesn’t mean the radiotherapy hasn’t worked or the tumour has got worse. If it happens let your doctor or nurse know.
Side effects that happen months or years after treatment has finished are called late- or long-term effects. This can include things like hormone or growing problems. You’ll be seen regularly for follow-up appointments and your doctors will be checking you for any late effects of treatment. Your doctors will explain more about this to you.
Chemotherapy for brain tumours
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Chemotherapy is the use of special anti-cancer drugs to destroy tumour cells. To treat brain tumours it can be given:
to shrink a tumour to make it easier to remove with surgery
when surgery isn’t possible
after radiotherapy to reduce the chance of the tumour coming back (adjuvant chemo)
when a brain tumour has come back after treatment.
There are different chemotherapy drugs that can be used such as, lomustine (CCNU), procarbazine, vincristine and temozolomide (Temodal®). But there are lots of other drugs that are used and your doctor or nurse can tell you more about this.
We have more information about lomustine, procarbazine, vincristine and temozolomide. This information is written for anyone who’s looking for information about chemo drugs, not just for young adults. You can also call our cancer support specialists for more information about chemo drugs.
Chemotherapy drugs can be given on their own or in combination with others. They can be given by injection into a vein (intravenously) or as tablets. Occasionally chemo is given directly into the spinal cord (intrathecal chemotherapy). There’s more information in our section on how chemotherapy is given.
Another way of giving chemo for brain tumours is by placing a type of wafer containing chemotherapy in the area of the brain where the tumour is during an operation. As the wafer dissolves, the chemo drug is slowly released into the area of the brain that needs treatment.
Chemotherapy can cause side effects that usually gradually get better when treatment is over. Some of the common ones are:
Being more at risk of an infection
You need to let your doctor or nurse know if you have signs of an infection like feeling hot and shivery, because it can quickly make you very unwell .
This is a common side effect so it’s important to get plenty rest, but balance this with some gentle exercise like short walks if you can. This helps give you more energy and keeps your muscles toned.
You’ll be given anti-sickness medicines to take regularly – let your nurse or doctor know if the ones you’re taking aren’t working for you.
If you lose your hair it will usually start to grow back again after your treatment stops.
Your doctor and nurse will tell you more about the side effects to expect depending on the chemo you have. Let your doctor or nurse know about any side effects as there’s often something that can be done to control them.
Supportive treatment for brain tumours
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As part of your treatment for a brain tumour you’ll probably be given drugs called steroids and possibly some medicine to prevent fits (anticonvulsant drugs).
Steroids help reduce the swelling that often surrounds brain tumours. Although they don’t treat the tumour itself, they can improve symptoms and make you feel better. Steroids are often given before and after surgery, and sometimes during or after radiotherapy and chemotherapy.
If you take steroids for some time, you may have some temporary side effects. These can include:
a change in the shape of your face (making it more rounded)
slightly more risk of getting an infection
mood changes (feeling ‘hyper’ or overactive or feeling low)
increase in the sugar level in your blood - your blood and urine will be tested to check for this.
Side effects can be hard to cope with especially with all the other stuff you have to deal with. Remember there are lots of people who can support you, and the side effects will go away or gradually get better when the treatment is over.
Tumours in the brain can sometimes cause fits. Anticonvulsants are drugs that help prevent them. You might be prescribed these before surgery, or to take on a more long-term basis. Your doctors will tell you about any side effects of these drugs.
This information is about having treatment for brain tumours. We also have more information about:
If you're looking for information about brain tumours in people of all ages, please see our general brain tumours section.