Developing a Brain Tumor Treatment Plan

Brain tumors are treated differently, depending on their cell type and location in the brain. Standard ways to treat brain tumors involve surgery, chemotherapy, radiation and/or targeted therapies. There are many factors that go into selecting the right type of treatment plan. Some tumors are sensitive to chemotherapy and others are not. In a similar fashion, some tumors are sensitive to radiation, while others are not. You and your doctor will decide which treatment or combination of treatments is best for you.

For many brain tumors, especially in glioblastomas, treatment order may be:

  • Surgery (resection or biopsy)
  • Radiation + temozolomide (chemotherapy drug) for 6 weeks
  • Monthly full dose temozolomide
  • Bevacizumab (a targeted agent) for recurrence

Cancerous brain tumors that originally start in the brain rarely spread to other parts of the body. It is more common for other cancers such as lung cancer, breast cancer and melanoma to spread to the brain. Many times these new cancerous growths are treated with radiation. Again, you will need to discuss and decide your treatment plan with your team of experts.

Surgical Treatment

Vanderbilt-Ingram's neuro-surgical oncologists use brain-mapping techniques to identify and avoid injury to sites of language, motor and sensory function during surgery to remove brain tumors. Our surgeons use advanced navigation to help locate the exact location of the tumor under the skull, and these image-guided systems are used throughout the surgery.

Our surgeons have performed more than 10,000 surgeries, so you can feel confident you are receiving experienced and knowledgeable care. With today's advanced technology, sophisticated intra-operative imaging tools and global positioning system (GPS), patients can expect better brain function preservation and surgical results.

Learn more about what to expect during brain tumor surgery.

Radiation Therapy

The goal of radiation therapy is to get a high enough dose of radiation into the body to kill cancer cells without harming healthy tissue. Your cancer treatment team will work with you to find the right treatment and dose of radiation. You will either receive external beam radiation therapy or brachytherapy, which is when radioactive sources are placed in or next to a tumor.

Many times brain tumors are treated with stereotactic radiotherapy, which is a type of external beam radiation therapy. This technique allows a radiation oncologist to precisely focus beams of radiation to destroy the brain tumor, while sparing healthy surrounding brain tissue. This is done with equipment to keep the body very still, such as a head frame. This is often done in one treatment, but some patients may need up to 5 treatments. Stereotactic radiotherapy may be the best treatment if a very small area is affected. You and your health care team will choose the treatment best for you.

Targeted Treatments & Chemotherapy

Temozolomide (chemotherapy)

Temozolomide (brand names Temodar and Temodal and Temcad) is one of the most common treatments for brain tumors. This drug is a type of chemotherapy that blocks cancer cell growth and may decrease the size of certain brain tumors in some. This drug targets and damages the cancer's DNA, which causes the tumor cells to die. This drug can also be injected through a vein. You and your doctor will decide which way is best. Temozolomide can be given every day at a low dose, with radiation. If you are just prescribed temozolomide, you may receive a higher dose for 5 days a month.

Bevacizumab (targeted therapy)

Bevacizumab (brand name Avastin) is a drug that slows blood vessel growth. The drug blocks a protein called vascular endothelial growth factor (VEGF). Sometimes cancer cells produce too much VEGF, and blocking this protein may keep new blood vessels from growing that feed the tumor. This could starve the tumor causing it to shrink or possibly stop growing.