Non-surgical treatment of brain tumors
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Surgery remains the mainstay of treatment for most cancers. Neurosurgery in Germany can often be a curative measure in patients with brain neoplasms. However, brain tumors can also be treated with non-surgical methods. They not only complement the operation, but can completely replace it. Let's discuss how to treat a brain tumor with conservative methods.
Content
- Is a brain tumor treatable?
- Radiation therapy for brain tumor treatment
- Chemotherapy for brain tumor treatment
- Target therapy for brain tumor treatment
- Electro-Field Therapy for brain tumor treatment
- Symptomatic treatment of brain tumor
- Specialized hospitals and cost of treatment for brain tumor
- Treatment of brain tumor in Germany
Is a brain tumor treatable?
Non-surgical methods as a therapeutic agent for tumors of intracranial localization often play a leading role in the treatment process, since it is not always possible to treat a brain tumor by surgery. Often, the tumor is located in functionally active areas, and its surgical removal can be life-threatening for the patient.
Is brain tumor treatment without surgery possible? Yes, there are many other effective treatments that can significantly extend a patient's life span.
Whether a brain tumor can be cured depends on the degree of its malignancy. There are 4 such degrees in total.
As a rule, a brain tumor can be completely cured if it is benign (grade 1). The risk of recurrence is very low.
Grade 2 tumors are also considered benign, but their prognosis is worse. The chances of a second-degree brain tumor curing depend largely on the therapeutic methods used and the age of the patient. On average, the relapse-free period after the treatment program lasts 3-5 years.
Starting from stage 3, the tumor is considered malignant. Unfortunately, in most cases, even surgery does not lead to a complete cure. The risk of recurrence depends on whether the tumor is completely removed. Since it is impossible to remove a grade 3 brain tumor without surgery, a relapse occurs on average after 2-3 years.
Finally, a grade 4 tumor is characterized by the greatest malignancy. The most common type of this stage is glioblastoma. The life expectancy of patients who have not undergone surgery is only 4-12 months. In recent years, new methods of treatment have appeared in developed countries that allow a patient's life to be extended up to several years without the use of surgical methods.
Radiation therapy for brain tumor treatment
The main non-surgical treatment for a brain tumor is radiation therapy. Both radiosurgical and radiation methods of treatment are used. The radiosurgical method involves the introduction of radioactive substances into the brain. The radiation therapy method includes external irradiation.
A brain tumor is treated with radiation therapy if:
- After surgery, to reduce or delay the risk of recurrence
- As a palliative treatment to reduce the size of the tumor and relieve the symptoms
- As an independent method of treatment, if the operation is not performed for any reason
The most common contraindication for surgery is tumor localization. It is often localized in hard-to-reach or functionally active areas of the brain. Consequently, surgical removal carries a risk to the patient's life or creates a significant neurological deficit.
There are other reasons:
- Patient's refusal from surgery
- Identification of medical contraindications during examination
- Low life expectancy
- Financial reasons (the operation is expensive)
In many cases, due to the large size of the tumor and the high grade of malignancy, doctors refuse such an operation. Treatment of a brain tumor with surgery and radiation therapy leads to the same prognosis for the patient. In this case, radiation provides a similar lifespan, but does not carry the same risks and is better tolerated.
Radiation methods are distinguished by their accuracy, efficiency, and the degree of impact on the surrounding tissues. Developed countries have developed and applied new methods of irradiation. They act on the tumor tissue with a large dose of radiation, practically without affecting healthy tissue.
The following types of radiation therapy are currently used to treat brain tumors:
- Remote radiation therapy. The same as X-ray, only the radiation dose is much higher. Before radiation therapy, diagnostics (MRI or CT) are performed to determine the exact location of the tumor. This is the simplest radiation method that has long been used in oncology. It has a big drawback: the surrounding tissues also receive a rather high dose of radiation.
- Three-dimensional conformal radiation therapy. A more advanced method of radiation that minimizes the radiation dose to healthy tissue. MRI is used to accurately localize the tumor. Multiple rays of gamma rays are then sent to the tumor from different directions.
- Modulated intensity radiotherapy. A dose-controlled 3D radiation therapy method. With this technique, the doctor can increase the radiation dose to the tumor and decrease it for healthy tissues that are most sensitive.
- Stereotactic radiosurgery. Stereotactic radiosurgery makes it possible to cure a brain tumor in a hard-to-reach location in one or several sessions of high-precision and high-dose radiation. The Gamma Knife or Cyberknife settings are used. Today, this type of treatment has become more comfortable for the patient, thanks to the precise adjustment of the beam, therapy can be carried out without the use of stereotaxic frames.
- Proton therapy of brain tumor. Instead of X-rays, it uses positively charged particles. It is highly safe because healthy tissue is minimally damaged. In this case, the tumor receives a large dose of radiation. The disadvantage of this method is the high cost of treatment.
Whether a brain tumor can be cured with radiation therapy alone depends on the degree of its malignancy. With benign tumors, it is usually possible to achieve a sufficiently long life expectancy of the patient. Tumors may not recur after treatment, or the relapse-free period may last 5-10 years or more. However, in the case of malignant tumors, the disease does not go away forever, because it is almost impossible to stop the growth of a brain tumor without the risk of recurrence with radiation therapy alone. This method is less effective than surgical treatment. Its advantage is a higher level of safety and better treatment tolerance.
Chemotherapy for brain tumor treatment
Chemotherapy in the treatment of brain tumors is much less important than in the treatment of other types of cancer. The reason is that the brain is separated from other organs and systems by the blood-brain barrier. Most chemotherapy drugs cannot overcome it. Therefore, after injection into a vein or when taken orally, the drugs simply do not reach the tumor tissue and, therefore, cannot affect it.
Chemotherapy is used to treat brain tumors in the following cases:
- If the tumor grows very quickly
- If no surgery has been done, chemotherapy can be used in combination with radiation therapy.
- If surgery has been performed, chemotherapy drugs are injected through a catheter directly into the ventricle of the brain, thereby overcoming the blood-brain barrier.
- If a patient is diagnosed with lymphoma or medulloblastoma, these types of neoplasms respond better to chemotherapy.
However, more often the treatment is carried out without the use of chemotherapy. Often, chemotherapy is poorly tolerated by the patient, while it does not increase life expectancy and has minimal effect on tumor growth.
Target therapy for brain tumor treatment
For some types of tumors, targeted therapy drugs are used. Among them:
Angiogenesis inhibitors. Monoclonal antibodies are used to block vascular endothelial growth factor. The tumor is constantly growing and must receive nutrients from the blood vessels. Without this, its growth slows down significantly.
Research has shown that angiogenesis inhibitors can be used in the treatment of glioblastoma after surgery to delay relapse. These drugs do not have a significant effect on life expectancy, but they can reduce the doses of steroid hormones (a medicine that prevents brain edema) used that are not always well tolerated by patients. Treatment of glioblastoma in Germany often includes this additional benefit for the patients option.
Protein inhibitors mTOR. It is a protein that helps tumors gain weight. Drugs that block this protein are used to treat astrocytomas. Treatment of brain tumors with mTOR inhibitors increases the patient's life expectancy.
Electro-Field Therapy for brain tumor treatment
Studies have shown that electric field therapy suppresses the growth of tumor cells with minimal damage to healthy tissue. Such treatment for a brain tumor prolongs the patient's life. At the same time, it is safe and has no serious side effects.
Electro-field therapy is used to treat glioblastoma. Because the treatment of a malignant brain tumor with chemotherapy alone is not always successful, adding electric field therapy to chemotherapy can be effective.
The essence of the method is that four electrodes are attached to the patient's head. The batteries are in a backpack that a person always carries with him. This treatment of a brain tumor in combination with chemotherapy prolongs life by an average of more than 20 months.
Symptomatic treatment of brain tumor
Not every brain tumor is curable. Sometimes the goal of therapy is not the patient's recovery, but the elimination of the main symptoms in order to improve the patient's quality of life. Symptomatic medications always complement the basic treatment for a brain tumor.
These medicines include:
- Corticosteroids - relieve headaches, eliminate inflammation after radiation therapy, prevent cerebral edema.
- Anticonvulsants - reduce seizures in people with brain tumors.
- Hormonal treatment - used for hormone-producing tumors (for example, with pituitary neoplasms) to correct metabolic disorders.
Specialized hospitals and cost of treatment for brain tumor
Non-surgical treatment of brain tumors is usually carried out in the departments of neurosurgery or interventional neuroradiology. The patient remains under the supervision of neurologists and neurosurgeons during his stay in the hospital. Leading hospitals that offer minimally invasive and non-surgical treatment of brain neoplasms are:
- University Hospital Frankfurt am Main, Department of Adult and Pediatric Neurosurgery
- University Hospital Rechts der Isar Munich, Department of Adult and Pediatric Neurosurgery
- University Hospital Muenster, Department of Neurosurgery
- Charite University Hospital Berlin, Department of Adult and Pediatric Neurosurgery
- Beta Klinik Bonn, Department of Neurosurgery and Interventional Neuroradiology
- University Hospital Freiburg, Department of Adult and Pediatric Neurosurgery
The cost of non-surgical treatment of brain tumors depends on the diagnosis, the chosen therapeutic technique, and the hospital itself. Average prices for various treatment methods are:
- Non-invasive removal of neoplasms with the Gamma knife system – €16,140
- MRI-guided laser ablation – €88,800
- Proton therapy – €87,730
- Chemotherapy and radiation therapy – €56,090
- Neurological rehabilitation after completion of the main course of treatment – €1,160 per day
Treatment of brain tumor in Germany
Each person decides where to treat a brain tumor, based on their financial capabilities. Oncology and neurosurgery are highly academic and therefore expensive branches of medicine.
Obviously, it is better to be treated in clinics in developed countries, such as Germany. In the best hospitals in Germany, the most modern methods of treatment are available: the latest types of radiation therapy, stereotactic radiosurgery, targeted therapy and others.
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Authors:
The article was edited by medical experts, board certified doctors Dr. Vadim Zhiliuk, Dr. Nadezhda Ivanisova. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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