Brain Tumour Oncology
Oncology treatment includes both radiotherapy treatment or drug treatment (chemotherapy). If you have a brain tumour your treatment plan will usually be discussed with you. There will be input from both surgeons and oncologists as to what treatment might be most helpful for you.
Surgery to remove tissue or part or all of the organ will usually be the first treatment, if it is possible and you are well enough to cope with an operation. A scan is done within 72 hours after operation to assess whether there is any remaining tumour and this will help shape further treatment plans.
The pathology from the resection will provide information on what genetic or biological markers are present in the tumour. This will identify the specific features driving your cancer and guide which treatments might give you most benefit.
Radiotherapy
Often a brain tumour cannot be entirely resected. Even with a successful operation there will be a risk that your tumour can grow back. The purpose of post-operative radiotherapy is to control any remaining disease and delay or prevent relapse of the tumour. The pathology of your tumour and how well you are will determine:
- The dose of radiation
- The number of weeks of radiation treatment
- Whether drugs are added in at the same time
Ask your team about the schedule of your treatment.
The different types of radiotherapy include
Radical radiotherapy
High dose radiation is recommended for the more fast-growing tumours. This gives the best chance of tumour control, but it is a long and very tiring treatment. It can take up to 30 treatments given over six weeks (daily Monday to Friday each week). With the fast-growing tumours drug treatment may be given at the same time as radiotherapy to increase the benefit.
Short course radiotherapy
If you are less well and the six-week course would be difficult, then there is the option of shorter course treatment. This can be given daily over three weeks, 15 treatments in total. Another option is to treat three times a week over two weeks reaching six treatments.
Repeat radiotherapy
If you have had radiotherapy before and your tumour grows back, it may still be possible to give further treatment. This can vary from a short course of one to two weeks up to a full six-week course. The treatment will depend on how you are and the extent of the disease.
Chemotherapy
Concurrent Chemotherapy
This is a drug treatment given at the same time as radiotherapy. Most often this is the single drug temozolamide given orally (by mouth) along with radiotherapy. This drug works better in specific groups of patients depending on the biology of the tumour.
Adjuvant Chemotherapy
This is drug treatment given after surgery and radiotherapy. The options can include temozolomide which may be given for as long as 12 months after radiotherapy. Another option is a combination of drugs which gets given by a mix of tablets and injection once every three weeks for up to six doses in total.
Palliative Chemotherapy
If the disease is too advanced for surgery or radiotherapy, it may be possible to consider drug treatment alone to help control it. This may be just a single drug in oral form. If your tumour has had previous treatment but grows back then further drug treatment can also be considered in this situation. This could be oral or injection drugs. The term palliative means only that the treatment will not be able to cure your cancer. Palliative treatment aims to help control disease. Your team will explain which drug options might be helpful for you and why.
