Chemotherapy for cancer

Chemotherapy, the use of drugs to kill cancer cells, is sometimes used to treat brain tumors. Drugs may be given in the following ways:

By mouth or vein (intravenous): Chemotherapy may be given during and after radiation therapy. The drugs enter the bloodstream and travel throughout the body. They may be given in an outpatient part of the hospital, at the doctor’s office, or at home. Rarely, you may need to stay in the hospital.

The side effects of chemotherapy depend mainly on which drugs are given and how much. Common side effects include nausea and vomiting, loss of appetite, headache, fever and chills, and weakness. If the drugs lower the levels of healthy blood cells, you’re more likely to get infections, bruise or bleed easily, and feel very weak and tired. Your health care team will check for low levels of blood cells. Some side effects may be relieved with medicine.


In wafers that are put into the brain: For some adults with high-grade glioma, the surgeon implants several wafers into the brain. Each wafer is about the size of a dime. Over several weeks, the wafers dissolve, releasing the drug into the brain. The drug kills cancer cells. It may help prevent the tumor from returning in the brain after surgery to remove the tumor.

People 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.

You may wish to read the NCI booklet Chemotherapy and You.

You may want to ask your doctor these questions about chemotherapy:
  • Why do I need this treatment? 
  • What will it do? 
  • Will I have side effects? What can I do about them? 
  • When will treatment start? When will it end? 
  • How will treatment affect my normal activities?
Second Opinion

Before starting treatment, you might want a second opinion about your diagnosis and treatment plan. Some people worry that the doctor will be offended if they ask for a second opinion. Usually the opposite is true. Most doctors welcome a second opinion. And many health insurance companies will pay for a second opinion if you or your doctor requests it. Some companies require a second opinion.

If you get a second opinion, the doctor may agree with your first doctor’s diagnosis and treatment plan. Or the second doctor may suggest another approach. Either way, you’ll have more information and perhaps a greater sense of control. You can feel more confident about the decisions you make, knowing that you’ve looked at your options.

Chemotherapy


It may take some time and effort to gather your medical records and see another doctor. In many cases, it’s not a problem to take several weeks to get a second opinion. The delay in starting treatment usually won’t make treatment less effective. To make sure, you should discuss this delay with your doctor. Some people with a brain tumor need treatment right away.

There are many ways to find a doctor for a second opinion. You can ask your doctor, a local or state medical society, a nearby hospital, or a medical school for names of specialists.

Also, you can request a consultation with specialists at the National Institutes of Health Clinical Center in Bethesda, Maryland.

Adults and children with a brain tumor: Specialists in the NCI Neuro-Oncology Branch provide consultations. The telephone number is 301–594–6767 or 866–251–9686.

Children with a brain tumor: Specialists in the NCI Pediatric Neuro-Oncology Section of the Pediatric Oncology Branch provide consultations. The telephone number is 301–496–8009 or 877–624–4878.

The NCI Contact Center at 1–800–4–CANCER (1–800–422–6237) can tell you about nearby treatment centers. Other sources can be found in NCI’s fact sheet How To Find a Doctor or Treatment Facility If You Have Cancer.

Nonprofit groups with an interest in brain tumors may be of help. Many such groups are listed in the NCI fact sheet National Organizations That Offer Services to People With Cancer and Their Families.

Nutrition

It’s important for you to take care of yourself by eating well. You need the right amount of calories to maintain a good weight. You also need enough protein to keep up your strength. Eating well may help you feel better and have more energy.

Sometimes, especially during or soon after treatment, you may not feel like eating. You may be uncomfortable or tired. You may find that foods don’t taste as good as they used to. In addition, the side effects of treatment (such as poor appetite, nausea, vomiting, or mouth blisters) can make it hard to eat well. Your doctor, a registered dietitian, or another health care provider can suggest ways to deal with these problems. Also, the NCI booklet Eating Hints has many useful ideas and recipes.

Supportive Care

A brain tumor and its treatment can lead to other health problems. You may receive supportive care to prevent or control these problems.

You can have supportive care before, during, and after cancer treatment. It can improve your comfort and quality of life during treatment.

Your health care team can help you with the following problems:
  • Swelling of the brain: Many people with brain tumors need steroids to help relieve swelling of the brain. 
  • Seizures: Brain tumors can cause seizures (convulsions). Certain drugs can help prevent or control seizures.
  • Fluid buildup in the skull: If fluid builds up in the skull, the surgeon may place a shunt to drain the fluid. Information about shunts is in the Surgery part of the Treatment section (page 17).
  • Sadness and other feelings: It’s normal to feel sad, anxious, or confused after a diagnosis of a serious illness. Some people find it helpful to talk about their feelings. See the Sources of Support section on page 28 for more information. 
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.

by: Meyda Azzahra