Treatment Options for Brain Cancer
Surgery, radiation therapy, and chemotherapy are common treatments for brain cancer, and they can be used alone or in combination. The specific approach depends on the cancer's characteristics and location.
Targeted and electric field therapies are additional options for managing brain cancer. Clinical trials, like those researching immunotherapy, also offer promising new treatments that could improve the outlook for people with this condition.
A brain tumor happens when cells in your brain begin to grow and divide out of control. While some brain tumors are benign (noncancerous), others are malignant (cancerous).
There are a few different treatments that may be used for brain cancer, either alone or together. And clinical trials are currently testing new treatments for brain cancer that can help to improve your outlook.
Keep reading to learn more about each treatment, how it's used, and the side effects associated with it.
Can you survive brain cancer?
It's possible to survive brain cancer. But survival can vary greatly based on many factors, such as the type of brain cancer that you have and your age.
Surgery for brain cancer
Surgery is a part of treatment for many brain cancers. During surgery, a neurosurgeon will try to remove as much of the tumor as possible without affecting the function of your brain.
Surgery is often done by craniotomy. This is where a small opening is made in your skull, allowing for access to your brain. You may be under general or local anesthesia during surgery.
While operating, a neurosurgeon can use various techniques to help them safely remove your tumor without damaging the surrounding tissue. These can include:
Using surgery in combination with other brain cancer treatments like radiation therapy (RT) may be able to eliminate smaller, less aggressive cancers. But this can be more challenging for cancers that are larger or more aggressive.
Surgery can also be used for other purposes. These include inserting a shunt or drain to reduce intracranial pressure or placing an Ommaya reservoir to help deliver chemotherapy (chemo).
Side effects of surgery for brain cancer
Some of the possible side effects of surgery for brain cancer may include:
a reaction to the anesthetic
infections
bleeding
swelling of the brain
seizures
loss of brain function
Radiation therapy for brain cancer
RT uses high-energy radiation to destroy cancer cells. It's often given for brain cancer using a radiation source located outside of your body. This is called external beam RT.
Radiation has the potential to damage healthy brain tissue, so several methods have been developed to help lower this risk. An example of one is conformational RT, which makes a 3D image of your tumor and shapes the radiation to fit to it.
You may receive RT after surgery to help kill any remaining cancer cells. RT may also be one of the main treatment options if your cancer can't be operated on. This may be the case if your cancer is:
very extensive
located deep within your brain
found at or around an area that's vital for brain function
Side effects of radiation therapy for brain cancer
Some of the potential side effects of RT for brain cancer are:
fatigue
nausea or vomiting
headache
hair loss
cognitive changes, which can include issues with memory, difficulties with concentration, or changes in personality
increased risk of a second cancer
Chemotherapy for brain cancer
Chemo uses drugs that disrupt the ability of cancer cells to grow and divide. It can be used along with other treatment types, such as surgery or RT, or alone when other treatments haven't been effective.
While many chemo drugs are given directly into your bloodstream or taken orally, this isn't always possible with brain cancer. The reason is that many chemo drugs can't cross the blood-brain barrier.
As such, some chemo may be given directly into your cerebrospinal fluid. Other types of chemo may also be given as a wafer that's placed in your brain during surgery.
A few examples of chemo drugs used for brain cancer, either alone or in combination, are:
carmustine
lomustine
procarbazine
temozolomide
vincristine
Side effects of chemotherapy for brain cancer
The possible side effects of chemo include:
nausea or vomiting
diarrhea
mouth sores
loss of appetite
hair loss
low blood counts, which can cause:
anemia
an increased risk of infections
easy bleeding
Targeted therapy for brain cancer
Targeted therapy uses drugs that target specific markers on or in cancer cells. Currently, there are only a handful of targeted therapy drugs used for brain cancer.
Bevacizumab (Avastin) inhibits a protein that promotes the growth of blood vessels around tumors. It's given by an intravenous (IV) line and may be used to treat glioblastoma.
Everolimus (Afinitor) blocks the activity of a protein involved in cell growth and division. It's taken as a pill and is used for some types of astrocytomas.
Side effects of targeted therapy for brain cancer
Specific side effects can vary based off of the targeted therapy drug used. But some of the more general side effects of targeted therapy drugs may include:
fatigue
loss of appetite
nausea
diarrhea
mouth sores
headache
an increased risk of infections
Alternating electric field therapy for brain cancer
Alternating electric field therapy exposes a tumor to electric fields that affect its ability to grow. This type of therapy involves the use of a wearable device called the Optune system that generates those electric fields.
The Optune system is used for people who recently received a diagnosis of glioblastoma or those who have recurrent glioblastoma.
Side effects of alternating electric field therapy for brain cancer
Some of the side effects that you may have while using alternating electric field therapy include:
skin irritation where the device and its electrodes are placed on your scalp
headache
seizures
low blood counts and digestive side effects when used with chemo
Clinical trials for brain cancer
Clinical trials evaluate potentially new or improved ways to treat a disease or disorder. They're essential for testing the safety and effectiveness of new treatments before they're made more widely available.
One type of treatment that's being heavily researched for brain cancer is immunotherapy. This is a type of cancer treatment that helps your immune system respond to cancer. It's already used for many other cancer types.
For some people with brain cancer, receiving treatment through a clinical trial may be recommended. This is particularly true if you have a cancer that:
is rare or very aggressive
has a limited number of approved treatment options
hasn't responded to conventional treatments
has come back after treatment
If you're interested in a clinical trial for brain cancer, talk with your medical care team. They can recommend clinical trials you may qualify for.
You can also find clinical trials through the website of the National Brain Tumor Society or by searching ClinicalTrials.gov.
What's the outlook for a person with brain cancer?
The outlook for people with brain cancer depends on many factors. These include:
the type of brain cancer you have
the grade of the cancer, which estimates how quickly the tumor may grow
where the tumor is in your brain
how large the tumor is
whether or not the tumor can be removed using surgery and, if so, how much of the tumor can be removed
the presence of certain genetic changes in the tumor cells
your age and overall health
For example, the 5-year relative survival rate for adults ages 20–44 years old with diffuse astrocytoma, a slow-growing cancer, is 73%. In contrast, the 5-year relative survival rate is 22% in the same age group for glioblastoma, an aggressive cancer.
If you've recently received a diagnosis of brain cancer, your medical care team will consider all of the factors above to give you a better idea of your individual outlook.
Relative survival rate vs. survival rate
A relative survival rate suggests how long someone with a condition may live after receiving a diagnosis compared with someone without the condition of the same race, sex, and age over a specific time. This is different from overall survival rate, which is a percentage of people still alive for a specific time after receiving a diagnosis of a condition.
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