Tuesday, September 7, 2010

Treating Brain Tumors

(Portions of this note are excerpts from the National Cancer Institute page on Pediatric Brain Cancer.)
There are three standard treatment methods for brain tumors:  surgery, radiation, and chemotherapy.  A patients oncologist will work with them to determine if they will use one or a combination of the different therapies.  Each one has their own advantages and disadvantages that need to be examined before a treatment plan can be developed.


Surgery is when a neurosurgeon goes in and physically removes the tumor from the head.  Surgery is the fastest way to remove a massive bulk of the tissue and is usually the first treatment used.  In some cases of benign tumors, there is no further need for additional treatment.  Even in cases of malignant (or cancerous) tumors, a complete resection vastly increases the chances of long term survival.  The obvious disadvantage of surgery is the possibility of damaging good tissue which could result in loss of functions or even death.  Also, there are certain areas of the brain that are inoperable due to the risk of damaging critical functions such as breathing.
Here is a link to a video of a brain tumor removal.


Radiation therapy uses X-rays or some other radiation to kill cancer cells or keep them from growing.  Unfortunately, radiation does not distinguish between good cells and tumor cells so there are some side-effects.  Short term, the patient may experience nausea, redness around the treatment site, and loss of hair.  Long term, children may have growth and other developmental problems.  Because of this, researchers are looking for ways to minimize the effects of radiation. 
One of these relatively new methods is the use of proton radiation.  Proton radiation uses a highly focused beam of energy to eliminate the “scatter” of traditional radiation.  This scatter is what causes many of the long term effects.
Check out this CBS news article which describes proton radiation and look for Dr. Peter Philips who we’ve consulted with at Children’s Hospital of Philadelphia.


Chemotherapy uses one or more drugs to kill cancer cells or prevent their growth.  The drugs can be administered either orally or intravenously.  (I just had a flashback to trying to teach Isabella how to swallow pills when she was going through her chemotherapy.)   There are many different types of chemotherapy drugs and each work differently and against different tumor types.  Chemotherapy is usually administered in cycles.  One of the biggest hurdles of chemotherapy for treating brain cancer is the challenge of the drugs to pass the the blood-brain-barrier (BBB), which is the body’s natural defense to protect the brain.
Although the long term effects of chemotherapy are relatively few, the short term effects range from mild to fairly serious.  For example, chemotherapy can cause someone’s hair to fall out, nausea, and suppression of the immunity system which would make the patient susceptible to infections.
Isabella was treated with all three methods for her cancer.  First, the neurosurgeon removed the 10cm tumor from her head which removed 95% of the tumor.  Then, she got chemotherapy for several months in the HeadStart clinical trial.  Finally, she received the proton radiation at Mass General Hospital, which is only one of 7 proton radiation centers in the country.
In upcoming articles, I will be describing alternative and new treatment options for brain cancer.

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