Brain Tumors Treatments
Northwestern Medicine specialists have expertise in the treatment of primary brain tumors, secondary brain tumors, and the neurologic complications of cancer and its treatment. If you are diagnosed with a brain tumor, your physician may recommend a single course of treatment including, surgery, medication, radiation therapy, chemotherapy or hormone therapy, or a combination of these procedures and therapies.
Surgery is a common treatment for many types of brain tumors, and is often the first course of treatment. For some slow-growing tumors, it may be the only treatment needed. Surgery may help to:
- Fully remove the tumor, if possible
- Relieve your symptoms
- Remove a small piece of the tumor to determine what type of tumor you have
- Place a small tube, called a shunt, in the area around your brain or spine
The type of surgery you may need depends upon:
- The type of tumor
- Size and location of the tumor
- The amount pressure on vital areas of your brain that the tumor is causing
- If the tumor can be fully removed
In brain surgery cases, your neurosurgeon will need to remove a small piece of your skull to access your brain tumor. This surgical procedure is called a craniotomy. The piece of skull is replaced at the end of the surgery. You may be asleep through most of the surgery, or you may need to be awake for part of the surgery, if the surgeon needs to check your brain function.
Brain tumors can be removed through surgery in several ways, such as:
- The surgeon may cut your tumor out with a scalpel or special surgical scissors
- If the tumor is very soft, the surgeon might use a vacuum device to remove it
- A special tool can be used to liquefy the tumor, after which it can be vacuumed out
- If a tumor is hard to reach with regular surgery, a laser may be used to kill cancer cells
Your neurosurgeon will try to remove your whole tumor if possible. If your surgical team can’t remove all of the tumor without harming your brain, they will take out as much of the tumor as possible. This is called debulking surgery. Reducing the size of a tumor through surgery can help lower the pressure on the brain or spine and relieve some of your symptoms.
Leading-edge surgical techniques
Northwestern Medicine is home to skilled neurosurgeons* trained in the latest techniques, including:
- Intraoperative MRI (iMRI): Northwestern Medicine Central DuPage Hospital is the only hospital in Illinois to offer full-field intraoperative MRI, a state-of-the-art surgical technology that provides high-quality, more detailed imaging viewable during surgery. By integrating this technology with advanced surgical techniques, your neurosurgeon can conduct scans during surgery to more safely and precisely remove brain tumors, especially around sensitive areas of the brain. This ensures maximum possible tumor removal, and minimizes the removal of healthy tissue
- Gamma Knife® radiosurgery: Gamma Knife® radiosurgery is an advanced cancer treatment used in multidisciplinary care plans at the Northwestern Medicine Cancer Care Center Warrenville. Gamma Knife® radiosurgery is particularly well suited to treat brain tumors in difficult locations with less damage to surrounding healthy tissues. Benign, malignant, recurrent or metastatic brain tumors can all benefit from the precision of this safer treatment option
- Endoscopic skull base surgery: Skull base surgery can be used to remove benign and cancerous tumors on the base of the brain or skull. This can be done using minimally invasive endoscopes to access these difficult-to-reach areas
Brain tumors often cause symptoms that may include headaches, pain, seizures, mood swing and other issues. To help you feel better and treat your symptoms, your physician may prescribe medication, including:
- Steroids to reduce brain swelling, which also helps reduce headache and pain
- Anticonvulsants to help prevent seizures or convulsions
- Medications to help prevent side effects of brain tumors or certain treatments, including chemotherapy, radiation therapy and surgery. These include:
- Antiemetics to help control nausea and vomiting
- Laxatives or stool softeners to treat constipation
- Pain relievers
- Medicine to help with anxiety, stress or depression
- Hormones to replace the ones your body isn’t making as a result of treatment or to treat certain types of tumors
Radiation therapy may be used to treat a brain tumor after surgery, or as your primary treatment when surgery isn’t an option. The type of radiation treatment recommended depends upon the stage and location of your tumor. Northwestern Medicine specialists are skilled in the very latest radiation therapy techniques, which allow them to precisely target your tumor with high levels of radiation, while striving to preserve healthy cells and limit your side effects. Your radiation treatment may include:
- Advanced radiation therapy treatments: These include Gamma Knife® radiosurgery, Tomotherapy®, and RapidArc®, advanced radiotherapy technologies that improve dose conformity and may shorten treatment times
- Proton therapy: Proton therapy is one of the most precise forms of radiation therapy, proton treatment can be controlled so most of the radiation ends up directly in the tumor, reducing the risk of damage to surrounding healthy tissues, and causing fewer short- and long-term side effects. Proton therapy has been effective in treating certain types of brain cancer. Northwestern Medicine is the first and only health system in Illinois, and the ninth in the country, to offer proton therapy at the Northwestern Medicine Chicago Proton Center* in Warrenville
- External beam radiation therapy (EBRT): EBRT directs high-energy rays of radiation from outside of your body directly at cancerous tissues inside. It effectively treats large areas of the body, such as your brain. Often, EBRT is followed by brachytherapy
- Brachytherapy: In this therapy, small radioactive seeds are implanted at the site of the tumor. Depending on the cancer, your physicians may recommend a low-dose rate (LDL) or a high-dose rate (HDL)
- 3-D conformal radiation therapy: In this technique, radiation beams are sculpted in the exact shape of the tumor, to better preserve nearby healthy tissue and organs
- Intensity modulated radiation therapy (IMRT): Ideal for difficult to reach tumors, IMRT uses advanced software to prepare a precise dose of radiation, matched to the tumor's size, shape and location
- Image guided radiation therapy (IGRT): Due to breathing and other body movements, the tumor can also move. IGRT allows our specialists to track the tumor’s movement for the most precise treatment possible
- TomoTherapy®: This leading-edge technology combines the advanced sculpting precision of IMRT with the accuracy of CT scanning technology to confirm the shape and position of the tumor prior to treatment
- Stereotactic radiosurgery: This treatment involves a single high dose of radiation. Sometimes it may be several high doses aimed right at the tumor from many different directions. Since it is very focused, the normal tissue around the tumor gets little or no radiation. A machine will beam the radiation to the tumor. Some of the most common machines used are the Gamma Knife®, the CyberKnife® and the linear accelerator
Chemotherapy uses medications to destroy cancer cells in your body, usually by stopping their ability to grow and divide. Chemotherapy medications can have improved effectiveness in treating brain tumors when used in combination with other treatments.
Temozolomide is the medicine most often used for many types of brain tumors. Your care team may also recommend one or a combination of chemotherapy medications to treat your tumor.
Chemotherapy is given in cycles. You are treated for a period of time and then you have some time to rest. Chemotherapy can be given on a single day, a few days in a row, or continuously for a set amount of time. Your cycle of treatment could repeat every week or every month.
Hormone therapyHormones can encourage some brain cancers to grow. Hormone therapy can help prevent the growth, spread and recurrence of your disease. If your care team determines that your cancer cells have receptors that attract hormones, medications may be prescribed to reduce your body’s production of these hormones or to stop the negative impact they have on your cancer.
If you have a brain tumor, a clinical trial may provide a promising alternative to your care. As a patient at Northwestern Medicine, you have access to some of the most advanced research trials available anywhere. Talk with your care team about your options.