Treatment for a brain tumor will depend on several factors, including:
If a small tumor is found on an MRI,CT or CAT scan and is causing no symptoms, the neurosurgeon may recommend watchful monitoring or observation with periodic tests. Treatment may be necessary later if the tumor grows or if symptoms develop or worsen.
More Information About Brain Tumor Treatment from Johns Hopkins Medicine
Infographic: Advancements in Brain Tumor Treatment
Brain tumor treatment continues to evolve with new techniques and technologies, and your doctor has more options than ever to choose from when designing your individualized treatment plan. Here’s a quick look at some newer developments that may improve the outlook for those living with brain tumors.
View full infographic.
Surgery is a common treatment for brain tumors. If a tumor is benign and in a part of the brain where neurosurgeons can safely and completely remove it, surgery is likely to be the only treatment needed beyond continued monitoring for recurrence.
The most common type of surgery to remove a brain tumor is called a craniotomy. This procedure involves making an incision in the scalp and removing a piece of bone from the skull.
The neurosurgeon can then access and remove the whole tumor, or as much of the tumor as possible without risk of severe damage to the brain. The neurosurgeon then replaces the bone and closes the incision.
Your surgeon will decide on a procedure based on the best possible outcome and the least invasive approach.
Intraoperative imaging uses special MRI or CT scan machines in the operating room to help neurosurgeons remove brain and spinal cord tumors safely and effectively.
Image-guided stereotactic surgery uses advanced computers to find a brain or spinal cord tumor and create a three-dimensional image of it so it is easier to remove.
Intraoperative brain mapping (awake brain surgery) is performed while the patient is awake but sedated to remove tumors that would otherwise be inoperable.
Neuroendoscopy is a minimally invasive way to remove some brain and spinal cord tumors through a small hole in the skull or through the nose using small cameras and instruments.
Radiation therapy is the treatment of tumors using X-rays and other forms of radiation (light energy) to destroy cancer cells or prevent the tumor from growing. It is also called radiotherapy.
Radiation therapy may be used to treat brain tumors that are malignant by location, meaning that the tumor itself may not be pathologically cancerous, but its location is dangerous. For example, a tumor may form around the carotid artery or arise from the skull base, making it difficult to remove surgically.
In these cases, radiation therapy might be used post-surgery to radiate remaining tumor tissue in precise areas of the brain. The two types used to treat brain tumor are external beam radiation therapy and stereotactic radiosurgery.
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Chemotherapy is the use of drugs to destroy cancer cells remaining after surgery, slow atumor's growth, or reduce symptoms.
Chemotherapy is occasionally recommended for the treatment of a brain tumor. It is only effective in treating some types of brain tumors, such as:
When chemotherapy is part of a treatment plan, doctors usually administer it after surgery. Sometimes, it is administered at the same time as radiation therapy. The delivery method and the length of the treatment depend on the type of tumor and where it is located.
Chemotherapy can be administered as pills (orally), intravenously (IV, by vein), or directly into the cavity left after surgical removal of a brain tumor (Gliadel wafers).
Systemic chemotherapy uses cytotoxic drugs to kill cells (cancerous and normal) throughout the body. This is the most common type of chemotherapy for non-brain cancer.
Targeted therapies are used more often to treat brain tumors than systemic chemotherapy. Cytostatic drugs identify and attack cancer cells (the target) with minimal harm to normal cells. These drugs keep cancer cells from reproducing.
Cytostatic drugs and targeted therapies may be used to treat metastatic brain tumors and recurrent brain tumors, as well as certain primary brain tumors.
Immunotherapy uses the body's immune system to fight cancer.
The cells, antibodies and organs of the immune system work to protect and defend the body against foreign invaders, such as bacteria or viruses. Doctors and researchers have found that the immune system might also be able to both determine the difference between healthy cells and cancer cells in the body, and eliminate the cancer cells
Some of these new treatments help “mark” cancer cells so they can be recognized as enemies by the patient's own immune system. Others affect the way cancer cells grow and spread, or interrupt the process that changes a normal cell into a cancerous one. This field also involves therapy that helps patients recover from the effects of other medications or radiation treatment.
Participating in Clinical Trials
Clinical trials are an important form of clinical research. We advise patients to learn about available clinical trials as soon as possible after a diagnosis is made, which may help patients consider all possible options while working with physicians to plan treatment.
Patients who want to take part in advancing brain tumor therapy by participating in clinical studies are advised to notify their doctor as soon as possible so that together they can make a decision that is in the patient's best interest.