Chemotherapy (adults)

If you're 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 as a treatment on its own, or it may be used with or after surgery or radiotherapy.

Download our fact sheet about chemotherapy for adults.

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.

Why is chemotherapy given?

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 within the brain
  • your general health and fitness
  • your age.

Chemotherapy may be given:

  • during or after surgery to control cells that haven't been removed, in order to delay or reduce the chance of the tumour returning
  • with or after radiotherapy, to reduce the risk of tumour regrowth
  • to treat a tumour that has returned
  • to shrink or control a tumour that cannot be operated on
  • to prevent or slow further growth of a tumour.

How is chemotherapy given?

You'll be given chemotherapy 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're absorbed and carried around your body in the bloodstream to reach the tumour cells.

You'll be able to take the tablets at home, but should take care not to touch them and should wash your hands straight afterwards. You should not crush them, unless you're advised to.

There can be an after-taste to these drugs - chewing flavoured gum afterwards can help to disguise this taste.

As with all medication, tablets should be kept out of the reach of children.

​Injection or drip

Chemotherapy drugs can be injected into a vein (intravenously) or into the spinal fluid (intrathecally). When given intravenously, they may be given via a drip into the veins over 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. (This means they break down in the body). The wafers gradually dissolve over 2-3 weeks, releasing the chemotherapy drug directly into the brain, getting round the blood-brain barrier. Wafers are used to target cells which couldn't be removed by surgery. You may also hear these implants called Gliadel® wafers.

They're only licensed for high grade gliomas where at least 90% of the tumour has been removed by surgery. Their suitability for use also depends on where the tumour is in your brain.

​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.However, giving chemotherapy this way can be complicated and difficult, so doesn't form part of routine treatment for most patients.

How long will chemotherapy last?

Individual treatment plans vary and yours will be carefully planned specifically for you.

Typically a course of treatment may last 6-12 months, consisting of 6-12 cycles. You may have chemotherapy for a few days every few weeks.

Do I need to stay in hospital during the chemotherapy?

Chemotherapy is generally given as an outpatient treatment, which means that you don't have to stay in hospital overnight, although in certain circumstances you will need to. A member of your health team will talk to you about this before you start your treatment.

What side-effects can I expect?

Side-effects vary from person to person and according to the drugs you have been given. As chemotherapy (temporarily) acts on healthy cells as well as tumour cells though, it may cause some unpleasant short-term side-effects, which commonly include:

  • Lowered immunity (increased risk of infection)
  • Increased risk of bruising/bleeding, e.g, nosebleeds, heavy periods, bleeding gums
  • Tiredness - be patient with yourself and rest as you need to
  • Anaemia
  • Nausea - anti-sickness tablets can help
  • Hair thinning - this should grow back after treatment has finished, but may be a different texture of colour
  • Sore mouth ('oral mucositis') or mouth ulcers - sucking on ice cubes or ice lollies can help, as can some medicines
  • Changes in taste, appetite and digestion - try small, frequent meals
  • Effects on nails and skin, including sensitivity to sunlight and chlorine - use a sunscreen that blocks UVA and UVB rays with an SPF of at least 30-50, and avoid going out in the hottest part of the day
  • Numbness or tingling hands or feet
  • Reaction with alcohol, even non-alcoholic beer & wine, and some foods, such as nature cheeses, Marmite®, salami - can cause dizziness, sickness or breathlessness

Side-effects tend to gradually disappear over time once the treatment is complete, but if you are concerned about any of your side-effects, please remember to speak to your health team.

If you experience shortness of breath, an irregular heartbeat, increased bruising/bleeding, numb hands or feet, or a temperature over 38 degrees C, tell your health team as soon as possible.

How will this affect my work?

While you will not need to stay in hospital to receive treatment, if you work, you will need to arrange time off for hospital appointments. Side-effects, such as tiredness and nausea, may mean you need a longer period of time off work.

Our Employment resources provide help and information on how to approach your employer about your diagnosis and how they can support you through this time.

How will I know if chemotherapy has worked?

You will be monitored for any changes to the tumour, sometimes during and sometimes following treatment. This can be through the use of scans (MRI and CT scans) to see whether the tumour is shrinking.

What happens after treatment has finished?

You will have check-up appointments following treatment, which will sometimes include scans. These appointments may continue for a number of years after your chemotherapy has finished.

Download our fact sheet for more information about chemotherapy.

Page last reviewed: 06/2018

Next review due: 06/2021

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