Chemotherapy for adults with a brain tumour

If you are a diagnosed with a brain tumour, one of the treatments your medical team may offer is chemotherapy. This is the use of drugs to destroy tumour cells by disturbing their growth. Chemotherapy can be used on its own as a treatment, or alongside radiotherapy.

Chemotherapy may also be used before surgery or radiotherapy to shrink the tumour or after surgery or radiotherapy, to prevent the tumour from returning.

What is chemotherapy?

Chemotherapy is the use of cytotoxic (anti-cancer) drugs that affect the growth of tumour cells by interfering with the way they divide and create copies of themselves.

Chemotherapy acts on all dividing cells, including healthy cells, but healthy cells are able to repair themselves better than tumour cells, so fewer of them die after treatment.

Your health team will carefully consider the best course of treatment for you. This will depend on the type of tumour you have and whether it has spread, your general health and fitness, and your age.

Chemotherapy may be given:

  • before surgery to shrink a tumour to make it easier to operate on
  • during or after surgery to kill small amounts of cells that haven't been removed, in order to reduce the chance of the tumour returning
  • to treat a tumour that has returned
  • to shrink a tumour that cannot be operated on
  • to prevent further growth of a tumour
  • prior to radiotherapy

How is treatment given?

Chemotherapy will be given to you in a series of treatments separated by rest periods. One treatment session and rest period is called a 'cycle' and a number of cycles make up the 'course' of treatment. There are various ways that chemotherapy can be given.

Tablets

Some chemotherapy drugs can be taken in tablet or capsule form like any other tablet. They are absorbed and carried around your body in the bloodstream to reach the tumour cells. You will be able to take the tablets at home, but will need to take care to touch them as little as possible and should wash your hands straight afterwards. There can be an after-taste to these drugs - chewing flavoured gum afterwards can help to disguise this taste.

Injection or drip

Chemotherapy drugs can be injected into a vein ('intravenously') or into the spinal fluid ('intrathecally'). They can also be given via a drip to the veins over a time period of half an hour to a few hours. As with tablets, the drugs are absorbed and carried around your body in the bloodstream to reach the tumour cells.

Wafers

Chemotherapy drugs are sometimes put inside a polymer wafer and inserted into the brain during surgery. The polymer wafers are made from a biodegradable material (i.e. one that breaks down in the body). Wafers are used to target cells which couldn't be removed by surgery.

Ommaya reservoir / Ventricular access device (VAD)

This is a dome-shaped device that sits underneath the scalp and delivers chemotherapy directly into the cerebrospinal fluid (CSF), the clear fluid within the brain and spinal cord. By doing this, chemotherapy is delivered directly to the brain, which increases its effectiveness.

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