Brain Cancer (cont.)

Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Radiation therapy (also called radiotherapy) is the use of high-energy rays to kill tumor cells and stop them from growing and multiplying.

• Radiation therapy is sometimes used for people who cannot undergo surgery. In other cases, it is used after surgery to kill any tumor cells that may remain.
• Radiation therapy is a local therapy. This means that it affects only cells in its path. It does not harm cells elsewhere in the body or even elsewhere in the brain.

Radiation can be administered in either of two ways.

• External radiation uses a high-energy beam of radiation targeted at the tumor. The beam travels through the skin, the skull, healthy brain tissue, and other tissues to get at the tumor. The treatments are usually given five days a week for about four to six weeks. Each treatment takes only a few minutes. The gamma knife and cyber knife are two terms that describe methods that use external radiation to kill cancer cells in the brain.
• Internal or implant radiation uses a tiny radioactive capsule that is placed inside the tumor itself. The radiation emitted from the capsule destroys the tumor. The radioactivity of the capsule decreases a little bit each day; the amount of radioactivity of the capsule is carefully calculated to run out when the optimal dose has been given. You need to stay in the hospital for several days while receiving this treatment.

Chemotherapy is the use of powerful drugs to kill tumor cells.

• A single drug or a combination may be used.
• The drugs are given by mouth or through an IV line. Two drugs, temozolomide (Temodar) and bevacizumab (Avastin), have recently been approved for the treatment of malignant gliomas. They are more effective and have fewer adverse effects when compared with older drugs. Temozolomide has another advantage in that it is administered orally, eliminating the need for intravenous lines and hospital stays for chemotherapy.
• Chemotherapy is usually given in cycles. A cycle consists of a short period of intensive treatment followed by a period of rest and recovery. Each cycle lasts a few weeks.
• Most regimens are designed so that two to four cycles are completed. There is then a break in the treatment to see how the tumor has responded to the therapy.
• The side effects of chemotherapy are well known and are very difficult to tolerate for some people. They include nausea and vomiting, mouth sores, loss of appetite, loss of hair, and many others. Some of these side effects can be relieved or improved by medication.

New therapies (for example, use of nanotechnology to deliver drugs to tumor cells) for cancer are being developed all the time. When a therapy shows promise, it is studied in laboratories and improved as much as possible. It is then tested on people with cancer; these tests are called clinical trials.

• Clinical trials are available for virtually every kind of cancer.
• The advantage of clinical trials is that they offer new therapies that may be more effective than existing therapies or have fewer side effects.
• The disadvantage is that the therapy has not been proven to work or does not work in everyone.
• Many people with cancer are eligible for participation in clinical trials.
• To find out more, ask your health-care provider. A list of clinical trials is available at the web site of the National Cancer Institute.

There are many "holistic" and other treatments for brain tumors cited in Internet sites, health magazines, and other publications (for example, Transfer Factor, Cellect, Vitalzym). Most of these have no scientific data to reinforce their claims and, when visiting these sites, readers are urged to read the fine print as most say the product(s) are not intended to treat specific diseases. Patients should discuss any such substances with their doctors before buying and using these items. Some are listed by the FDA as dietary supplements and warn that they have not been proved to be effective or safe.