Brain Tumors Program
Diagnosis & Treatment Options
DIAGNOSIS
The first step in diagnosing a brain tumor is an assessment to identify any neurological deficits the patient may have, such as weakness of an arm or leg or mental confusion. A CT scan or MRI determines the location of the tumor. An arteriogram may also be preformed to inspect the vessels supplying blood to the tumor. A Positron Emission Topography, or PET scan, can provide a picture of brain activity, rather than structure, by measuring levels of injected glucose (sugar) labeled with a radioactive tracer. Different degrees of brightness and color represent different types of tissue or organ function. A PET scan is not regularly used for diagnosing tumors, but is used with other scans to determine the grade of the tumor or distinguish between necrosis (dead tissue) and scar tissue. A biopsy may be necessary to determine the type of tumor.
TREATMENT OPTIONS
Patients with brain tumors have several treatment options. Depending on the tumor type and stage, patients may be treated with surgery, radiation therapy or chemotherapy, and some patients may receive a combination of treatments.
Surgery
Surgery may be recommended if a tumor is located in area where removal is optimal and the likelihood of success is high. Surgical treatment for a tumor means that the patient will undergo an operative procedure where the cancerous growth is removed by manual and instrumental means. The surgery may be followed by radiation or other treatment.
Radiation Therapy & The CyberKnife System
Radiation Therapy is the use of high-energy rays to damage cancerous cells to stop their growth. Like surgery, radiation therapy treatments are localized, affecting cancer cells only in the targeted area. Radiation can come from a machine (external radiation). It can also be implanted into the body. A small container of radioactive material is placed directly into or near the tumor (internal radiation). Some patients receive both kinds of radiation therapy.
External radiation therapy is usually given on an outpatient basis in a hospital or clinic multiple days a week, for several weeks. Patients are not radioactive during or after the treatment.
For internal radiation therapy, the patient stays in the hospital for a few days. The implant may be temporary or permanent. Because the levels of radiation are high during the hospital stay, patients may not be able to have visitors or may only have visitors for a short time. Once an implant is removed, there is no radioactivity in the body. The amount of radiation in a permanent implant is taken down to a safe level before the patient leaves the hospital.
The CyberKnife System
Seton Brain & Spine Institute offers CyberKnife treatments, one of the most advanced and innovative technologies available for radiation treatment of certain types of brain tumors.
CyberKnife is a unique surgical tool that utilizes an image-guidance system, similar to what is found in high-tech image-guided missiles, to verify tumor location. Once the tumor location has been precisely mapped, the linear accelerator attached to a multi-jointed robotic arm goes to work, delivering multiple, highly-focused beams of radiation from many targeting positions and angles. These beams all intersect within the tumor or lesion, delivering a high dose of radiation with great accuracy, while sparing normal tissue. The CyberKnife system can treat tumors and lesions other devices cannot because of its increased flexibility and the ability to deliver multiple treatments. For more information about CyberKnife, please visit our CyberKnife feature page.
Chemotherapy
Chemotherapy is a form of cancer treatment that involves taking one or more of a type of drug that interferes with the DNA (genes) of fast-growing cells. These drugs are further subdivided into specific classes such as alkylating agents, antimetabolites, anthracyclines, and topoisomerase inhibitors. They are usually given by IV infusion (slowly injected into your vein), but can be given orally (in pill form) or by direct infusion into a limb or the liver. Chemotherapy is used for a number of purposes:
- to kill some cancers outright
- to induce long remissions in some cancers
- to decrease the likelihood of a recurrence or spreading after surgery or radiation (adjuvant chemotherapy)
- to slow the growth and alleviate symptoms, such as pain (palliation) in incurable or recurrent cancers
- to shrink large tumors to operable size
- to make radiation therapy more effective
