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The 3 Pillars of Malignant Brain-Tumor Treatment
brain-tumor-treatmentby John Henson, M.D., F.A.A.N.

Q. What do you know about treatment for malignant brain tumors?
—Cristina, North Carolina

A. With all seriousness, not nearly enough.

Malignant brain tumors have defied successful treatment since their initial description a century ago. But in the last few years, this situation has begun to change rapidly.

The most common malignant brain tumor is glioblastoma, the type Sen. Ted Kennedy had. It’s also unfortunately a fatal type. Finding a cure is the goal for the future. The goal for today is to transform it into a chronic disease.

Mysterious Origins
Brain tumors are full of nasty tricks. They evade the immune system; their cells multiply without listening to normal biological controls, and they induce the brain to form new blood vessels to maintain their nutrient supply.

newsletter-graphicEach of these tricks results from gene alterations within the tumor cells. We’ve learned a lot about these alterations. What we still don’t know is why the genes transform from normal to abnormal in the first place.

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The Three Pillars of Brain-Tumor Treatment

The three major components of brain-tumor treatment are surgery, radiation and chemotherapy.

  • During the surgery, we remove as much of the tumor as we can without risking new problems, such as paralysis. Oddly enough, researchers have been unable to prove that this helps people live longer, in part because we can never completely remove the tumor and in part because it’s impossible to do a study in which some people don’t get surgery. But we think it helps prolong survival and we do know people have better neurological function if we can remove large amounts of the tumor.
  • Then, we recommend a six-week course of radiation, together with some chemotherapy pills, to start about two to three weeks after surgery. These treatments have minimal side effects.

One of the big advances in brain-tumor treatment has been to give radiation and chemotherapy together. In one study, this combination more than doubled the number of people alive after two years with glioblastoma—26 percent, compared to 10 percent. (Other types of brain tumors often have different types of treatment and better survival rates.)

We have some exciting new drugs that are rapidly changing the way we treat our patients. Despite these successes, most brain tumors are still very resistant to treatment, and we’re looking hard for a better way.

Board-certified neurologist
JOHN HENSON, M.D., F.A.A.N., specializes in neuro-oncology—nervous-system tumors—and is medical director of Swedish Neuroscience Institute’s Center for Advanced Brain Tumor Treatment in Seattle, Wash.

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Last updated and/or approved: June 2011.
Original article appeared in May/June 2009 former print magazine. Bio current as of that issue. This general health-care information is not meant as individual advice. Please see our disclaimer.
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