If you’re diagnosed with neurological (CNS) cancer, your treatment plan will depend on several factors, such as:
- The location of the tumor
- The grade of the tumor
- Your age and overall health
The standard treatments for neurological (CNS) cancer include:
- Active surveillance: Active surveillance means your doctor will closely monitor your tumor through regular exams and tests, but won’t provide treatment unless the condition worsens. Active surveillance is used to avoid or delay treatments that can cause side effects, such as surgery or radiation therapy. This method may also be used if your tumor is slow-growing and doesn’t cause symptoms.
- Surgery: Surgery can be used to diagnose and treat many neurological (CNS) tumors. Some surgical procedures remove tumor tissue to help reduce pressure on surrounding areas of the brain. Once your surgeon removes as much of the tumor as possible, you may need radiation therapy or chemotherapy to destroy any remaining cancer cells.
- Radiation therapy: Radiation therapy uses radiation like high-energy X-rays to destroy cancer cells or prevent them from growing. It may be recommended after surgery to kill any remaining cancer cells.
- Chemotherapy: Chemotherapy is a treatment that uses drugs to destroy cancer cells or stop them from dividing. Chemotherapy is generally given by mouth or injected into a vein or muscle. The treatment may be used to shrink the tumor before radiation therapy or surgery. Sometimes, chemotherapy is given directly to the tumor site during surgery.
- Targeted therapy: Targeted therapy uses drugs or other substances to find and destroy certain cancer cells. Targeted therapies are designed to cause less harm to normal, healthy cells than radiation therapy or chemotherapy. Targeted therapy options for neurological (CNS) cancer include:
- Monoclonal antibody therapy: Monoclonal antibodies are lab-made immune system proteins. They attach to a specific target on cancer cells or other cells. The antibodies can destroy cancer cells, stop their growth or keep them from spreading. This therapy is given by infusion through a vein. It may be used alone or to transport drugs or substances to the cancer cells.
- Bevacizumab: This is a type of monoclonal antibody used to treat recurrent glioblastoma. It helps prevent the development of new blood vessels that tumors need to grow.
Another treatment option may be a clinical trial. Clinical trials are research studies designed to help improve current cancer treatments or study new cancer treatments. Clinical trials provide the standard of care or better. They have made possible many of the treatments available today.
You may also benefit from supportive care, which can reduce symptoms caused by the disease or treatments. Supportive care may include:
- Medications to control seizures, swelling or fluid buildup in the brain
- Relaxation techniques
- Emotional or spiritual support, such as counseling
- Nutrition counseling
Ask your oncologist about which support care resources are available to you.
Neurological (CNS) Cancer Treatment by Tumor Type
Here’s a breakdown of available treatments for each tumor type. Your healthcare provider will talk with you to determine what treatment plan is best for you.
Astrocytic Tumor Treatment
- Brain stem gliomas:
- Radiation therapy
- Pineal astrocytic tumors:
- Surgery and radiation therapy, as well as chemotherapy for high-grade tumors
- Pilocytic astrocytomas:
- Surgery to remove the tumor and radiation therapy to destroy remaining tumor cells
- Diffuse astrocytomas:
- Surgery with or without radiation therapy, or
- Surgery followed by radiation therapy and chemotherapy
- Anaplastic astrocytomas:
- Surgery and radiation therapy, sometimes with chemotherapy, or
- Surgery and chemotherapy, or
- A clinical trial of chemotherapy delivered directly to the brain during surgery, or
- A clinical trial of a new treatment combined with a standard treatment
- Glioblastomas:
- Surgery followed by chemotherapy and radiation given at the same time, followed by chemotherapy only, or
- Surgery followed by radiation therapy, or
- Chemotherapy delivered directly to the brain during surgery, or
- Chemotherapy and radiation given at the same time, or
- A clinical trial that combines a new treatment with a standard treatment
Oligodendroglial Tumor Treatment
- Oligodendrogliomas:
- Surgery with or without radiation therapy; sometimes chemotherapy after radiation therapy
- Anaplastic oligodendrogliomas:
- Surgery followed by radiation therapy with or without chemotherapy, or
- A clinical trial that combines a new treatment with the standard of care
Mixed Glioma Treatment
Mixed gliomas are treated with surgery and radiation, sometimes followed by chemotherapy.
Ependymal Tumor Treatment
- Grade I and grade II ependymomas:
- Surgery, followed by radiation therapy if any tumor cells remain
- Grade III anaplastic ependymomas:
- Surgery and radiation therapy
Medulloblastoma Treatment
Treatment for medulloblastoma includes:
- Surgery and radiation therapy to the spine and brain, or
- A clinical trial of chemotherapy added to radiation therapy and surgery
Pineal Parenchymal Tumor Treatment
- Pineocytomas:
- Surgery and radiation therapy
- Pineoblastomas:
- Surgery, radiation therapy and chemotherapy
Meningeal Tumor Treatment
- Grade I meningiomas:
- Active surveillance if you don’t have symptoms, or
- Surgery to remove the tumor, followed by radiation therapy if tumor cells remain, or
- Stereotactic radiosurgery (external radiation that precisely targets a tumor) for tumors less than 3 centimeters, or
- Radiation therapy for tumors that can’t be removed by surgery
- Grade II and III meningiomas and hemangiopericytomas:
- Surgery and radiation therapy
Germ Cell Tumor Treatment
There’s currently no standard treatment for germ cell tumors. Your treatment will depend on:
- The tumor’s location in the brain
- Whether it can be removed by surgery
- What the tumor cells look like under a microscope
- The tumor’s markers
Craniopharyngioma (Grade I) Treatment
Treatment for craniopharyngiomas includes:
- Surgery to remove the entire tumor, or
- Surgery to remove as much of the tumor as possible, followed by radiation therapy
Side Effects from Neurological (CNS) Cancer Treatment
Your side effects depend on your diagnosis and the type of treatments you receive. Ask your physician about side effects you may experience and how to manage them.
Side effects from surgery may include:
- Pain
- Fatigue
- Loss of appetite
- Swelling, drainage, bruising, numbness, bleeding or infection at the surgical site
Side effects from radiation therapy may include:
- Fatigue
- Skin dryness, blistering, peeling or itching
- Nausea
- Hair loss
Side effects from chemotherapy may include:
- Fatigue
- Nausea and vomiting
- Loss of appetite
- Constipation
- Diarrhea
- Hair loss
- Risk of infection
- Headaches
- Muscle pain
- Nerve damage and related pain
- Stomach pain
- Mouth and throat sores
- Blood disorders
- Difficulty concentrating or making decisions
- Sexual issues
- Infertility
- Heart problems
Targeted therapy side effects may include:
- Diarrhea
- Liver problems
- Issues with wound healing and blood clotting
- Fatigue
- Mouth sores
- High blood pressure
- Changes in your nails
- Hair loss
- Skin problems, like dryness or a rash
- Rarely, a hole in the wall of the gallbladder, rectum, small intestine, large bowel, stomach or esophagus
There are many ways to help manage your side effects, so talk to your oncologist about what’s best for you.
Cancer and treatment can also have social, emotional and financial effects. Talk to your social worker or oncologist about resources like mental health counseling, financial counseling, support groups and more.