Brain Cancer

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Quick GuideUnderstanding Cancer: Metastasis, Stages of Cancer, Pictures

Understanding Cancer: Metastasis, Stages of Cancer, Pictures

What tests do doctors use to diagnose brain cancer?

The initial test is an interview that includes a medical history and physical examination of the person by a health-care provider. The results of this interaction will determine if other specific tests need to be done.

The most frequently used test to detect brain cancer is a CT scan (computerized tomography). This test resembles a series of X-rays and is not painful, although sometimes a dye needs to be injected into a vein for better images of some internal brain structures. Another test that is gaining popularity because of its high sensitivity for detecting anatomic changes in the brain is MRI (magnetic resonance imaging). This test also shows the brain structures in detail better than CT. If the tests show evidence (tumors or abnormalities in the brain tissue) of brain cancer, then other doctors such as neurosurgeons and neurologists that specialize in treating brain ailments will be consulted to help determine what should be done to treat the patient. Occasionally, a tissue sample (biopsy) may be obtained by surgery or insertion of a needle to help determine the diagnosis. Other tests (white blood cell counts, electrolytes, or examination of cerebrospinal fluid to detect abnormal cells or increased intracranial pressure) may be ordered by the health-care practitioner to help determine the patient's state of health or to detect other health problems.

What is the treatment for brain cancer?

A treatment plan is individualized for each brain cancer patient. The treatment plan is constructed by the doctors who specialize in brain cancer, and treatments vary widely depending on the cancer type, brain location, tumor size, patient age, and the patient's general health status. A major part of the plan is also determined by the patient's wishes. Patients should discuss treatment options with their health-care providers.

Surgery, radiation therapy, and chemotherapy are the major treatment categories for most brain cancers. Individual treatment plans often include a combination of these treatments. Surgical therapy attempts to remove all of the tumor cells by cutting the tumor away from normal brain tissue. This surgery that involves opening the skull (craniotomy) is often termed invasive surgery to distinguish it from noninvasive radiosurgery or radiation therapy described below. Some brain cancers are termed inoperable by surgeons because attempting to remove the cancer may cause further brain damage or death. However, a brain cancer termed inoperable by one surgeon may be considered operable by another surgeon. Patients with a diagnosis of an inoperable brain tumor should consider seeking a second opinion before surgical treatment is abandoned.

Radiation therapy attempts to destroy tumor cells by using high-energy radiation focused onto the tumor to destroy the tumor cells' ability to function and replicate. Radiosurgery is a nonsurgical procedure that delivers a single high dose of precisely targeted radiation using highly focused gamma-ray or X-ray beams that converge on the specific area or areas of the brain where the tumor or other abnormality is located, minimizing the amount of radiation to healthy brain tissue. Equipment used to do radiosurgery varies in its radiation source; a gamma knife uses focused gamma rays, and a linear accelerator uses photons, while heavy-charged particle radiosurgery uses a proton beam. Tomotherapy is a type of radiotherapy in which radiation is delivered in a highly precise and individualized manner that minimizes radiation exposure to healthy tissue; it has also been used to treat brain cancer.

Chemotherapy attempts to destroy tumor cells using chemicals (drugs) that are designed to destroy specific types of cancer cells. There are many chemical agents used; specific drug therapies are numerous, and each regimen is usually designed for the specific type of brain cancer and individualized for each patient. For example, bevacizumab (Avastin) is a drug approved for treatment of glioblastomas (glioblastoma multiforme). Chemotherapy can be administered intrathecally (into the cerebrospinal fluid by a spinal tap or through a surgically placed permanent reservoir under the scalp attached through a sterile tubing placed into the fluid-containing chambers in the brain), by IV administration, and biodegradable chemically impregnated polymers. All treatments attempt to spare normal brain cells.

Other treatment options may include hyperthermia (heat treatments), immunotherapy (immune cells directed to kill certain cancer cell types), or steroids to reduce inflammation and brain swelling. These may be added on to other treatment plans.

Clinical trials (treatment plans designed by scientists and physicians to try new chemicals or treatment methods on patients) can be another way for patients to obtain treatment specifically for their cancer cell type. Clinical trials are part of the research efforts to produce better treatments for all disease types. Stem cell treatments for brain and brain stem cancers and other conditions may be available, because research with patients is ongoing using these potential therapies. The best treatment for brain cancer is designed by the team of cancer specialists in conjunction with the wishes of the patient.

Medically Reviewed by a Doctor on 5/19/2016

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