Treatment depends on the tumor's size, location, and type, as well as the patient's age and general health. The main treatments include surgery, radiation therapy, and chemotherapy. A combination of treatments—surgery and radiation therapy, for example—is often used. Before treatment, a patient may be given corticosteroid drugs to reduce swelling of brain tissue. Anticonvulsant drugs also may be prescribed to prevent or control tumor-related seizures.
When possible, surgery is the treatment of choice for primary brain tumors. Surgery can successfully remove some benign and malignant brain tumors. Even if the entire tumor cannot be removed, surgeons will likely take out as much as possible to help relieve symptoms.
In some cases, a tumor cannot be removed surgically or surgery is too risky. For example, the tumor may abut or wrap around critical normal tissues. Damage to these tissues during surgery could cause the patient significant disability.
Stereotactic surgery, which uses computers and imaging devices to create three-dimensional pictures of the brain, can be used to remove tumors or to place radioactive materials in the tumor. Stereotactic surgery is especially helpful in reaching tumors deep in the brain. It can help pinpoint the tumor's edges, too, meaning that surgeons remove less normal tissue. This lowers the chances of side effects and brain injury.
Radiation therapy, which uses high-powered x-rays to kill cancer cells, often follows surgery. It helps destroy any pieces of the tumor that could not be surgically removed and any remaining cancer cells. Radiation therapy is also used when surgery is not an option.
Because high-dose radiation can damage normal tissue, doctors try to precisely target the tumor, limiting the amount of radiation to surrounding parts of the brain. Radiation also can be given by putting radioactive material into the tumor itself.
Two newer methods of delivering radiation—Gamma Knife and CyberKnife—allow doctors to more precisely aim the radiation beam at the tumor and better spare surrounding normal tissue.
Chemotherapy uses drugs to stop the growth of cancer cells. It can be taken by mouth, injected into a vein or muscle, or placed directly into a body part. In general, chemotherapy tends to be less effective against brain tumors than surgery or radiation.