About Brain Tumors: Clinical Care
For nearly all brain tumors, surgical removal is commonly recommended provided this can be done safely.
When surgical removal is not possible, diagnosis is often made by stereotactic needle biopsy. When a tumor regrows
and can be safely removed, sometimes a second surgical removal will be recommended.
For tumors that are well-localized in the brain, conformal radiation
is often recommended. This is radiation
delivered to the tumor and to a surrounding area of brain, but avoiding the remainder of the brain to the extent
possible. When cancer has spread to the brain, whole-brain radiation
is sometimes recommended because multiple
tumors may be present throughout brain, including undetectable areas of tumor. Conformal radiotherapy and
whole-brain radiation are generally delivered 5 days per week for 2-6 weeks. Stereotactic radiosurgery
radiation that is very precisely targeted to a small area of brain and delivered all at once in a single day.
It is recommended less commonly than conformal and whole-brain radiation.
Chemotherapy refers to strong anti-cancer drugs. It may be administered by mouth or by vein, depending which
drug is being used. Many chemotherapy drugs are available, and the choice depends on the type of tumor.
The side effects vary greatly. If chemotherapy is recommended, your neuro-oncologist should provide details
on the drugs recommended and the expected side effects.
A steroid medication, usually dexamethasone, may be recommended to relieve symptoms caused by a brain tumor or to
relieve swelling caused by the tumor. Dexamethasone has many potential side effects, and your neuro-oncologist or
nurse should discuss these with you if this treatment is recommended for you.
Other aspects of treatment
- Treatment of symptoms such as headaches, seizures, symptoms caused by impairment of a
specific brain region, and changes in mental function is described under
- You may benefit from referral to physicians with other specialties, e.g. hematology-oncology,
neuro-ophthalmology, endocrinology, or physical medicine & rehabilitation, for recommendations for
- The emotional aspects of dealing with a brain tumor can be overwhelming. Feel free to discuss these
with your neuro-oncologist or nurse. Recommendations sometimes include referal to the
Clinic in the Cancer Center, counseling, or antidepressant treatment.
- A social worker may be able to help with issues related to disability, social security, insurance,
expense of medications, caring for patients in the home, and many others.
- Nutrition evaluations may be available by special request.
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