Brain cancer treatment at GenesisCare

A brain tumour is a mass or growth of abnormal cells in your brain.

There are many different types of brain tumours, some are benign (non-cancerous), and some are malignant (cancerous). Brain tumours can begin in your brain (primary), or spread to your brain from other parts of your body (metastatic or secondary).^1,2

How quickly a brain tumour grows varies greatly, and both the growth rate and position of the tumour determines how it may affect the function of your nervous system.

Primary brain tumours are named by the types of cells involved, e.g.^3,4

• Gliomas: these tumours begin in the brain and include astrocytomas, ependymomas, glioblastomas, oligoastrocytomas, and oligodendrogliomas.
• Meningiomas: a tumour that arises in the membranes surrounding the brain (the meninges). Most meningiomas are non-cancerous.
• Acoustic neuromas (schwannomas): these are benign tumours that develop on the nerves that control balance and hearing leading from the inner ear to the brain.
• Pituitary adenomas: these develop in the pituitary gland at the base of the brain (see image below). These tumours can affect the pituitary hormones (inc. thyroid, fertility, and growth hormones) and thereby having an effect throughout the body.

Secondary brain tumours behave similar to their site of origin and are named accordingly e.g. brain metastases from a lung cancer primary.^3,4

Some factors that increase the risk of primary brain cancer include:¹

• some brain tumours are more common in people with certain inherited or genetic conditions
• people exposed to very high doses of radiation to the head such as with radiation therapy used to treat another cancer (rare)

Symptoms of brain cancer

Brain tumours can cause many different symptoms including (but not exclusively):^1,3

• Seizures (fits)
• Headaches
• Reduction in function of arm or leg
• Loss of balance
• Inability or change in speech
• Decreased or double vision, disturbed hearing , smell or taste
• Confusion and/or brain fog
• General irritability, drowsiness or a change in personality.

Your doctor will discuss your specific symptoms with you. Tests to diagnose brain cancer include:^1,4

A neurological examination – this may include checking your vision, hearing, balance, coordination, strength, and reflexes. Difficulty in one or more areas may provide insight into the part of the brain affected by a tumour.

CT scan – takes three-dimensional pictures of blood flow in the brain in areas with higher blood flow, such as a tumour, will be brighter on the scan.

MRI scan – provides high resolution cross-sectional images of the brain and spinal cord.

MRS (magnetic resonance spectroscopy) – measures the chemical differences within tissues.

PET scan – produces three-dimensional colour images that show where any cancers are in the body.

Lumbar puncture – this test is occasionally necessary. A needle is used to collect cerebrospinal fluid which is then examined for the presence of cancerous cells.

Biopsy – depending on the position of the tumour, for more definitive diagnosis of the type of tumour, a biopsy will be undertaken. This may be done separate to, or at the same time as surgery to remove the tumour.

Treatment for brain cancer will depend on the location and extent of the cancer, whether the cancer can be removed with surgery, likely side effects of treatment and your overall health. Your doctors will discuss the treatment options with you. They may include one or a combination of:^1,3

• Surgery
• Systemic therapies including chemotherapy, targeted drug therapies and immunotherapy
• Radiation therapy
• Steroid therapy

Radiation therapy

Radiation is most often used after surgery for brain tumours. It can also be used as an alternative to surgery if tumours are inoperable due to location or a patient is not well enough to undergo surgery.

Radiation is aimed at shrinking or producing local destruction within tumours. With careful planning and advancements in technology, the ability to minimize side effects and damage to surrounding normal tissues is greatly improved.
At GenesisCare we are able to offer the latest-generation stereotactic radiosurgery (SRS) including systems to improve image-guided radiation therapy, and surface-guided radiation therapy technologies.

SRS is a highly focused, non-surgical brain radiation therapy often used to treat smaller tumours within the brain. It delivers high doses of precisely targeted radiation therapy whilst minimising dose to surrounding normal tissues.5 SRS can be delivered on a linear accelerator (radiation therapy machine) or using a Gamma Knife

Your doctor can advise which is most suitable for you.
Chemotherapy may be delivered alongside your radiation therapy to enhance the effect of radiation.

Chemotherapy

Chemotherapy is medication that treats your cancer by disrupting the cell cycle. The drugs kill cancer cells, preventing them from dividing and spreading further.

Chemotherapy, targeted drug therapies and immunotherapies are all called systemic therapies. These drug therapies can be used to enhance the effect of radiation. They are also used in the case of metastatic disease, to limit further spread.

A cancer diagnosis is life changing. Even before your initial encounter with us you will experience a wave of emotions. It’s natural to feel disbelief, anxiety, sadness, anger and loneliness. At GenesisCare we understand these emotions and strive to strengthen your confidence, settle your emotions, and create care experiences for the best possible outcomes.

Our care team know your name and get to know who you are as a person. We don’t want you to feel alone when you’re at GenesisCare. Your nursing team and oncology team are here to support you before, during and after your cancer treatment. We are here to guide you to get the support you need which may include a psychologist, exercise physiologist, physiotherapist and dietitian.

Please contact your local GenesisCare centre for more details on services available. View a list of our centres here.

Radiation therapy

General side effects:⁶

• Fatigue/ lethargy which typically improves within a few weeks
• Nausea/ vomiting
• Headaches
• Alopecia/ hair loss
• Skin irritation

Your doctor may discuss specific side effects depending on where radiation is aimed.

Specific side effects (depending on the area being treated):

• Hair loss in the treatment area
• Headaches
• Skin changes around the area being treated
• Possible hearing changes
• Digestive issues – reduced appetite, pain, discomfort, or bloating
• Nausea or vomiting.

Most of these side effects will ease shortly after treatment is finished. Your team will discuss any long-term considerations with you depending on the tumour type.

Chemotherapy

Side effects⁷

Whether you experience side effects and how severe they are, depends on the type and dose of drugs you are given and your reaction from one treatment cycle to the next.

• Most side-effects are short-term and can be managed.
• They tend to gradually improve once treatment stops and the normal, healthy cells recover.

You may worry about the side effects of chemotherapy. If you feel upset or anxious about how long treatment is taking or the impact of side effects, let your doctor or nurse know.

What can I do to help my treatment go smoothly?

• Get as much rest as possible
• Eat a wholefood, varied diet
  • Appetite changes are common, and you may experience taste changes or nausea – help manage this by eating small, frequent snacks, avoiding smells that make you feel nauseous, eating foods that interest you rather than what you think you ‘should’ eat
• Keep up your water intake
• Reach out to support groups and others who have had
• Ask your team about topical treatments for skin if you are getting irritation or pain
• Stay out of the sun as much as possible throughout your treatment
• Record your side effects in a diary or journal
• Take some gentle exercise, such as walking, if you feel up to it. Light to moderate exercise can reduce treatment-related fatigue and improve mood.
  • It is important to acknowledge when you are fatigued, and rest when you need to. Plan your exercise for times in the day when you know you have more energy
• Ask for, and accept, help from family, friends and neighbours
• Be open with employers about your treatment and discuss flexible working options where need.

Other brain cancer information, resources and support services are available to assist you during your cancer journey. These include:

Cancer Council
T: 13 11 20
cancer.org.au

Brain Foundation Australia
T: 1300 886 660
brainfoundation.org.au

Brain Tumour Alliance Australia
T: 1800 857 221
btaa.org.au

EviQ
www.eviq.org.au/

1. Cancer Council. Brain cancer. Available at: www.cancer.org.au/cancer-information/types-of-cancer/brain-cancer. Accessed on: 16/07/21.

2. Brain Tumour Alliance Australia. The Brain – Tumour information. Available at: www.btaa.org.au/sites/default/files/2019-04/FS4.pdf. Accessed on: 16/07/21.

3. Brain Foundation. Brain tumour/cancer. Available at: brainfoundation.org.au/disorders/brain-tumour-cancer/. Accessed on 16/07/21.

4. American Cancer Society. What are adult brain and spinal cord tumours? Available at: www.cancer.org/cancer/brain-spinal-cord-tumors-adults/about/what-are-brain-spinal-tumors.html. Accessed on: 16/07/21.

5. Li D, et al. Cancer Biol Med 2014; 11(4):217-236.

6. Cancer Council Australia. Radiation therapy. Available at: https://www.cancer.org.au/cancer-information/treatment/radiation-therapy. Accessed on: 15/07/21.

7. Cancer Council Victoria. Chemotherapy side effects. Available at: https://www.cancervic.org.au/cancer-information/treatments/treatments-types/chemotherapy/side_effects_of_chemotherapy.html. Accessed on: 15/07/21.