The decision of treatment in brain tumors is chosen according to the type, location, size of the tumor, the general health of the patient, and the mutual choices of the patient and the physician.
- Surgical therapy: The most common treatment option for brain tumors is surgical therapy. Particularly in non-sensitive brain regions, small size tumors can be removed completely by surgery. However, it may also be preferable to leave a portion of the tumor if the tumor size is large and close/attached to the sensitive areas of the brain. Even removing a portion of the brain tumor can help reduce complaints and symptoms. Surgery to remove brain tumor carries many risks such as infection and bleeding. Other risks may be due to brain functions and important structures at the location of the tumor.
- Technological innovations used in tumor surgery
- Ultrasonography: By using ultrasonography during surgery, the location and limits of the tumors are determined and minimal damage to the brain tissue is achieved and the tumor tissue can be removed as much as possible.
- Neuromonitorization: It is used to record and instantly evaluate stimuli that come from the brain to preserve different functions according to the location of the tumors during surgery (such as protection from facial paralysis in vestibular schwannomas).
- Neuronavigation: It is a high-level computer technology that provides 3-D imaging for the removal of tumors that are located in the brain, for taking a biopsy and for removal of deeply located abscesses. In this technique, the patient’s previously drawn MRI or tomography images are loaded on the neuronavigation device. In this way, it provides an approach to the lesion in the brain with great accuracy during surgery. This may reduce the potential damage that could be done to healthy tissue during surgery.
- Intraoperative fluorescence use: This technique is used to determine tumor tissue and its limits better during surgery. During surgery, the tumor tissue is stained intravenously and with the specific imaging method of the most modern microscope, the tumor tissue is displayed in a different color from the brain. In this way, the tumor tissue, which is difficult to distinguish from normal brain tissue in normal light, becomes evident in fluorescent light. Thus it is possible to remove the whole tumor.
- Radiotherapy and radiosurgery: Radiation therapy uses high-energy rays, such as X-rays, to kill tumor cells. Radiation therapy can come from a machine outside the body, or in very rare cases, a radiation source can be placed inside the body near the brain tumor. With advanced devices in recent years, radiotherapy can be focused and applied to the region only where the tumor is located, with sharp limits, so as not to overflow the surrounding normal tissue. In radiosurgery, a large number of radiation beams are used to give the tumor focused radiation to kill tumor cells in a very small area. Each one of radiation rays is not strong enough to damage the brain, but at the point where all the rays merge into the brain tumor, a large dose of radiation is created to kill the tumor cells. Radiation therapy that is applied to the whole brain can usually be used to treat cancer that has spread to the brain from other parts of the body and that has created a large number of tumors in the brain. The side effects of radiation therapy depend on the type of radiation received and its dose. Common side effects those are seen during or immediately after radiation include fatigue, weakness, headache, memory loss, and scalp irritation.
- Chemotherapy: It is the treatment of killing tumor cells with specific drugs. It can be used as a pill, orally or intravenously. Many chemotherapy drugs are available and can be used depending on the type of cancer. The side effects of chemotherapy depend on the type and dosage of medications taken. Chemotherapy can cause nausea, vomiting and hair loss. The response of tumors to chemotherapy may vary depending on tumor types.