Brain Tumors Treatment, Part 4

by National Cancer Institute

(Page 6 of 6)

In children, radiation may damage the pituitary gland and other areas of the brain. This could cause learning problems or slow down growth and development. In addition, radiation during childhood increases the risk of secondary tumors later in life. Researchers are studying whether chemotherapy may be used instead of radiation therapy in young children with brain tumors.

Side effects may be worse if chemotherapy and radiation therapy are given at the same time. The doctor can suggest ways to ease these problems.

Chemotherapy

The side effects of chemotherapy depend mainly on the drugs that are used. The most common side effects include fever and chills, nausea and vomiting, loss of appetite, and weakness. Some side effects may be relieved with medicine.

Patients who receive an implant (a wafer) that contains a drug are monitored by the health care team for signs of infection after surgery. An infection can be treated with an antibiotic.

Supportive Care

At any stage of disease, people with brain tumors receive supportive care to prevent or control problems and to improve their comfort and quality of life during treatment. Patients may have treatment to control pain and other symptoms of a brain tumor, to relieve the side effects of therapy, and to ease emotional problems.

These are common types of supportive care for people with brain tumors:

• Steroids — Most patients with brain tumors need steroids to help relieve swelling of the brain.

• Anticonvulsant medicine — Brain tumors can cause seizures. Patients may take an anticonvulsant medicine to prevent or control seizures.

• Shunt — If fluid builds up in the brain, the surgeon may place a shunt to drain the fluid.

Many people with brain tumors receive supportive care along with treatments intended to slow the progress of the disease. Some decide not to have antitumor treatment and receive only supportive care to manage their symptoms.

Rehabilitation

Rehabilitation can be a very important part of the treatment plan. The goals of rehabilitation depend on the person's needs and how the tumor has affected daily activities. The health care team makes every effort to help the patient return to normal activities as soon as possible. Several types of therapists can help:

• Physical therapists — Brain tumors and their treatment may cause paralysis. They may also cause weakness and problems with balance. Physical therapists help patients regain strength and balance.

• Speech therapists — Speech therapists help patients who have trouble speaking, expressing thoughts, or swallowing.

• Occupational therapists — Occupational therapists help patients learn to manage activities of daily living, such as eating, using the toilet, bathing, and dressing.

Children with brain tumors may have special needs. Sometimes children have tutors in the hospital or at home. Children who have problems learning or remembering what they learn may need tutors or special classes when they return to school.

Followup Care

Regular followup is very important after treatment for a brain tumor. The doctor checks closely to make sure that the tumor has not returned. Checkups may include careful physical and neurologic exams. From time to time, the patient may have MRI or CT scans. If the patient has a shunt, the doctor checks to see that it is working well. The doctor can explain the followup plan — how often the patient must visit the doctor and what tests will be needed.

The NCI has prepared a booklet for people who have completed their treatment to help answer questions about followup care and other concerns. Facing Forward Series: Life After Cancer Treatment 11 provides tips for making the best use of medical visits. It describes the kinds of help people may need. Support for People with Brain Tumors

Living with a serious disease such as a brain tumor is not easy. Some people find they need help coping with the emotional and practical aspects of their disease. Support groups can help. In these groups, patients or their family members get together to share what they have learned about coping with the disease and the effects of treatment. Patients may want to talk with a member of their health care team about finding a support group. Groups may offer support in person, over the telephone, or on the Internet.

People living with a brain tumor may worry about caring for their families, keeping their jobs, or continuing daily activities. Concerns about treatments and managing side effects, hospital stays, and medical bills are also common. Doctors, nurses, and other members of the health care team can answer questions about treatment, working, or other activities. Meeting with a social worker, counselor, or member of the clergy can be helpful to those who want to talk about their feelings or discuss their concerns. Often, a social worker can suggest resources for financial aid, transportation, home care, or emotional support.

The Cancer Information Service can provide information to help patients and their families locate programs, services, and publications. The Promise of Cancer Research

Doctors all over the country are conducting many types of clinical trials. These are research studies in which people take part voluntarily. Studies include new ways to treat brain tumors. Research has already led to advances, and researchers continue to search for more effective approaches.

Patients who join these studies have the first chance to benefit from treatments that have shown promise in earlier research. They also make an important contribution to medical science by helping doctors learn more about the disease. Although clinical trials may pose some risks, researchers take very careful steps to protect their patients.

Researchers are testing new anticancer drugs, doses, and treatment schedules. They are working with various drugs and drug combinations, as well as combinations of drugs and radiation therapy. They also are testing new methods and schedules of radiation therapy.

About the Author

www.nci.nih.gov
The National Cancer Institute's research programs are extensive and contain many innovative initiatives. I invite you to explore our Web site to find out more about the exciting work being conducted here at NCI and by NCI-supported scientists throughout the country.