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Treatment Options
Treatment Options
The experts of the INI have extensive experience in treating the majority of brain tumors. From diagnosis to treatment, we offer the most advanced surgical and nonsurgical treatments, including intraoperative imaging systems, no-stitch surgery and endoscopic-assisted, pituitary surgery.
What to Expect
Typically, once a brain tumor is discovered, a high-quality MRI (magnetic resonance imaging scan) is taken. The MRI allows the neuroradiologist and neurosurgeon to diagnose the type of brain tumor you have. Sometimes, if it appears the tumor is small, benign and causing no symptoms, it may not need any treatment other than monitoring. In other situations, the best treatment may be focused radiation, or Gamma Knife treatment.
In many cases, the tumor will require a biopsy and/or must be removed. A neuropathologist will be available at the time of biopsy to assist the neurosurgeon in deciding what the best surgical options will be.
Rest assured our team of experts will explore the options available to you and recommend those providing the highest quality of life after surgery and best long-term outlook.
Treatment Planning
After careful diagnosis and discussion with the multidisciplinary team of experts, a treatment plan with be discussed and agreed upon by the patient and the medical team. That team of doctors and specialists will take into account the following criteria when deciding on the correct treatment plan:
- Type, size, location and characteristics of the tumor cells and blood vessels
- How aggressive the tumor is (low-grade or high-grade)
- Age and health of the patient, as well as patient preferences for treatment options
Treatment Options Overview
The primary treatments for brain tumors are:
- Observation
- Surgery
- Radiation Therapy
- Chemotherapy
Observation
If the brain tumor is slow-growing, small, and produces few symptoms; if it is in a location prohibiting safe removal; or the patient’s age or health does not make them a candidate for surgery or other treatments, the team of doctors might recommend observation or “watchful waiting.”
During this time, the patient will receive regular examinations and image testing by a neurosurgeon to monitor any changes in the tumor. If the tumor changes, for example it grows larger or begins to produce worsening symptoms, other treatment options may be considered.
Surgery
Surgery is one of the most-common treatments for patients with brain tumors. The highly-experienced surgeons at the INI, along with the state-of-the-art facilities and technology, enable us to treat a wide range of tumors with the top treatment options available.
If the surgeon is able to reach the tumor without damage to surrounding brain tissue, surgery is generally the best initial treatment. In many cases, additional treatment is used afterward to ensure all cancerous tissue has been destroyed, such as radiation therapy and/or chemotherapy.
Historically, some of the biggest challenges in treating brain tumors have included the difficulties doctors had in precisely locating the tumor during surgery, being able to accurately see if the entire tumor was removed, or being able to monitor if any nearby brain tissue was damaged.
The neurosurgeons and doctors at the INI utilize the most advanced equipment available to them before, during and after surgery, including intraoperative imaging systems. With intraoperative imaging, neurosurgeons have a nearly-instant assessment of the brain during surgery. While the patient is still on the operating table, high-resolution scans of the brain can allow the surgeon to see the exact location, shape, and size of the tumor, and can confirm instantly how much of the tumor has been removed, all while helping to preserve vital areas of the brain and reducing the need for a second surgery.
If the neurosurgeon is able to remove the tumor completely, it is called a resection or complete removal. If the neurosurgeon is only able to remove part of the tumor because it is difficult to reach or it is near sensitive areas of the brain, it is called a partial removal. Even a partial removal can be successful, as it can relieve symptoms and sometimes increase the effectiveness of other treatments.
During surgery is also when doctors usually conduct a biopsy. A biopsy is the removal of a small sample of a brain tumor so it can be examined under a microscope. The quick results of the biopsy can confirm the diagnosis and assist the doctors in recommending the appropriate treatment options.
Radiation Therapy
Radiation therapy is a cancer treatment using high-energy x-rays or other types of radiation (light energy) to destroy cancer cells or to prevent the tumor from growing. It is also referred to as radiotherapy. Radiotherapy is a non-surgical, painless option best for treating cancers in areas of the brain difficult to reach through surgery. It can also be a tool used after surgery is performed to destroy any cancer cells that may remain, or it can be used to relieve symptoms caused by brain tumors (called palliative radiation).
There are two main types of radiation therapy: external beam radiation (also referred to as focused radiation) and stereotactic radiosurgery.
External Beam Radiation
External beam radiation uses a machine called a linear accelerator to deliver radiation to the cancer from outside the body. It is the most common type of radiation therapy for brain tumors. It can focus just on the area of the brain where the tumor is located (the tumor itself and nearby brain tissue), or it can be applied to the entire brain.
Treatment can be done in single or multiple doses over a period of time. Side effects can depend on the type and dose of radiation given, but generally can cause fatigue, headaches and some irritation to the scalp.
Stereotactic Radiosurgery
Despite the name, stereotactic radiosurgery is not actually surgery, as it requires no incision and is painless to the patient. Radiosurgery is a type of radiation therapy using multiple, narrow beams of radiation coming from different angles to give highly-focused radiation to a brain tumor while sparing the surrounding normal tissue.
Radiosurgery usually takes about one to two hours and is typically done in one treatment. In most cases, the patient can go home the same day. Side effects may include fatigue, headache and nausea.
The INI offers different types of state-of-the-art radiosurgery options – among the best in the world – based on the type and size of the tumor, and the treatment and outcome required:
- Gamma Knife Radiosurgery
- CyberKnife
- Image-Guided Radiotherapy (IGRT)
- Intensity-Modulated Radiation Therapy (IMRT)
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to treat cancer cells. There are two primary types of chemotherapy drugs: drugs that kill cancer cells and those that prevent the cells from reproducing.
Chemotherapy drugs can be taken by mouth in pill form or can be injected into a vein or muscle. Both methods allow the drugs to enter the bloodstream, reaching the cancer cells throughout the body.
A third type of chemotherapy can be used during surgery. After all or part of a brain tumor has been removed, the neurosurgeon may place one or more dissolving disc-shaped wafers in the site where the tumor was. Over the next several days, the wafers slowly release a chemotherapy drug, assisting in killing remaining cancer cells or slowing the growth of the remaining tumor.
The treatment method and the length of treatment depend on the type of cancer cells and their location in the brain.
