1. Which therapies are used to treat brain tumors?

2. Which medications are used for brain tumor patients?

3. What is radiation therapy?

4. What is stereotactic radiosurgery?

5. What is chemotherapy?

6. What are the newest chemotherapy drugs?

7. What is gene therapy?

1. Which therapies are used to treat brain tumors?

Surgery is the chief form of treatment for brain tumors that lie within the membranes covering the brain or in parts of the brain that can be removed without damaging critical neurological functions. Because a tumor will recur if any tumor cells are left behind, the surgeon's goal is to remove the entire tumor whenever possible. Radiation therapy and chemotherapy, in general, are used as secondary or adjuvant treatment for tumors that cannot be cured by surgery alone.  

2. Which medications are used for brain tumor patients?

Steroids and anti-convulsants (to stop seizures) are the most common medications used for brain tumor patients. Steroids are given to reduce inflammation of tissues and control swelling of the brain, particularly before and after surgery. They do not kill tumor cells, but used alone or combined with other forms of treatment, can cause remarkable improvement in a patients condition. If used for only a few days, steroids generally cause no side effects, but used over a long time or withdrawn without monitoring, steroids may produce several side effects. You should discuss monitoring of the steroid and all possible side effects with you doctor.

Other drugs commonly used with brain tumor patients are anti-convulsants. Some are used to keep seizures from happening (prophylactic) while others cut short (abort) seizures that have already started. Some of the more common drugs now used to prevent seizures are Dilantin, Tegratol, Depakote, and Phenobarbital. It is important to remember that side effects of these drugs vary greatly from person to person. But if side effects are a serious problem, there are plenty of newer drugs that can be used, either alone or in combination with others. Newer drugs include Neurontin (gabapentin), Topomax (toiramate), Lamictal (lamotrigine) and Gabitril (tiagabine).  

3. What is radiation therapy?

Radiation therapy is mainly used after surgery for tumors that cannot be removed completely, as well as for cases in which surgery would involve too great a risk to the patient. It may be given in a single dose each day, usually for 30 days with weekends off, or it may be "hyper fractionated" into two or more doses daily for the recommended course of treatment.

Standard radiation therapy delivers an external beam of radiation aimed at an entire region, such as the portion of the brain containing the tumor and typically delivers a daily dose of 1.8-2.0 Gy (Gray) to a total dose of 50-60 Gy over 5-7 weeks.  

4. What is stereotactic radiosurgery?

Stereotactic radiosurgery is a non-invasive therapeutic alternative for treating brain disorders. Instead of a scalpel, clinicians using stereotactic radiosurgery technology aim multiple"pencil-thin" beams or arced beams of high energy particles directly at the tumor site while sparing healthy tissue as much as possible. With stereotactic radiosurgery techniques, a higher dose of radiation is delivered to the specific site (or tumor) of 15-20 Gy and is usually given in one day. Both Gamma Knife and LINAC X Knife are types of stereotactic radiosurgery.  

5. What is chemotherapy?

Chemotherapy works to destroy tumor cells with drugs that may be given either alone or in combination with other treatments. A key problem with chemotherapy has been the difficulty in delivering sufficient amounts of drug directly to the tumor while sparing normal brain cells. Another problem is the blood-brain barrier mechanism that normally serve to keep harmful substances out of the brain - unfortunately, this same blood-brain barrier can also work to keep potentially helpful drugs out of the brain. Although chemotherapy is usually given by mouth or injected in the vein, some new techniques of intratumoral chemotherapy use either small pumps or biodegradable wafers to place the drug inside the tumor.  

6. What are the newest chemotherapy drugs?

There is currently a great deal of scientific activity focused on the area of the discovery of new chemotherapy drugs, many with novel or alternative mechanisms of action (how drugs work). Following is a brief list of the various categories of chemotherapies being used to treat brain tumors: Cytotoxic Agents, Anti-angiogenic drugs, Differentiating agents, Anti-invasion agents, Cell signal transduction modulators and Growth factor inhibitors.

7. What is gene therapy?

Currently for patients with malignant brain tumors who have a recurrence after surgery, radiation therapy or chemotherapy, gene therapy may provide an experimental option for treatment. Using gene therapy, researchers inject a substance into the brain tumor that changes the genetic makeup of the tumor cells.