The brain governs essential neurological functions, including mood, memory, strength, sensation, and coordination. Brain tumors can disrupt these functions by occupying space and exerting pressure on brain tissue, leading to symptoms such as headaches, nausea, seizures, weakness, speech difficulties, and changes in vision or hearing. In some cases, brain tumors may be asymptomatic and are detected incidentally through imaging studies like MRI. Upon diagnosis, a multidisciplinary team of specialists evaluates the tumor to determine the most appropriate treatment strategy.
Primary Brain Tumors– These originate within the brain and can be benign (less likely to grow or invade normal brain tissue) or malignant (more likely to grow or invade normal brain tissue). Primary brain tumors rarely metastasize to other parts of the body.
Metastatic (Secondary) Brain Tumors – These result from cancer that has spread to the brain from another part of the body. Metastatic brain tumors are always malignant and are more prevalent than primary brain tumors.
Advancements in molecular biology have highlighted the importance of understanding the genetic and molecular characteristics of brain tumors. Additional tests on biopsy or surgical specimens can identify specific biomarkers, such as EGFR, ALK, MGMT, 1p19q, IDH1, and TERT. The presence or absence of these markers can influence treatment decisions. It is advisable to discuss with your healthcare provider whether molecular testing is appropriate for your condition.
Treatment strategies for brain tumors depend on various factors, including the tumor’s type, location, size, grade (aggressiveness), molecular profile, patient age, and overall health. Potential treatments may involve surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy, anti-mitotic therapy, or a combination of these modalities.
Radiation therapy utilizes high-energy X-rays or particles to target and destroy tumor cells. It works by damaging the DNA within cancer cells, inhibiting their ability to grow and divide. While surrounding healthy cells may also be affected, they typically possess the capacity to repair themselves more effectively than tumor cells.
Radiation therapy can be administered post-surgery or, in certain cases, as an alternative to surgery. Consulting with your oncology team can help determine if radiation therapy is a suitable option for your treatment plan.
EBRT involves delivering radiation from an external source, typically a linear accelerator (linac), to the tumor site. The treatment is non-invasive and painless, similar to undergoing an X-ray. Radiation is precisely directed to the targeted area, minimizing exposure to surrounding healthy tissue. Patients are not radioactive after treatment. EBRT is usually administered daily, Monday through Friday, over a period ranging from a single session to several consecutive weeks, depending on the treatment plan.
Prior to initiating treatment, a planning session called simulation is conducted. This session includes a CT scan performed while the patient is positioned on a table, often with the aid of a custom-fitted mask or head frame to ensure accurate positioning during each treatment. The radiation oncologist uses the simulation data, along with other imaging studies such as MRI, to develop a personalized treatment plan.
Various advanced techniques can enhance the precision of EBRT:
These techniques are particularly beneficial when the tumor is located near sensitive areas of the brain or if the patient has previously undergone radiation therapy. Your radiation oncologist can advise on the most suitable approach for your specific situation.
SRS and SRT are highly precise forms of radiation therapy that deliver concentrated doses to the tumor, minimizing exposure to surrounding healthy tissue. SRS typically involves a single high-dose treatment, while SRT administers smaller doses over multiple sessions, usually up to five. These techniques may require the use of a rigid head frame or a custom-fitted mask to ensure accurate targeting. SRS and SRT can be used alone, in conjunction with other radiation therapies, or as alternatives to surgery, depending on the specific case.
Proton beam therapy utilizes protons instead of X-rays to deliver radiation. The unique physical properties of protons allow for precise delivery of radiation to the tumor with minimal exit dose, potentially reducing exposure to surrounding healthy brain tissue. This precision may lead to fewer side effects during and after treatment. Proton therapy can also facilitate the delivery of higher radiation doses or re-irradiation in certain cases. However, proton therapy is not widely available and may not be suitable for all tumor types.
Maintaining overall well-being during radiation therapy is crucial. Consider the following recommendations:
Side effects from radiation therapy vary depending on the treatment area and individual patient factors. Common side effects may include:
It’s important to communicate any side effects to your healthcare team, as they can provide interventions to manage and alleviate symptoms.
Dr. O’Connor and Dr. Montes are radiation oncologists specializing in cancer treatment using radiation therapy. Our multidisciplinary team includes radiation therapists, physicists, dosimetrists, oncology nurses, medical assistants, an oncology nurse navigator, and certified nutrition specialists, all dedicated to providing comprehensive care throughout your treatment journey.
If you have further questions or need additional information, please feel free to ask.
