Treatment usually begins with trying to surgically remove as much of the tumor as possible. Some tumors may be cured by surgical removal alone or by surgery combined with radiation therapy. These tumors include meningiomas, some ependymomas, gangliogliomas, and cerebellar astrocytomas.
Tumors such as anaplastic astrocytomas or glioblastomas cannot be cured by surgery because their cells invade too far into the normal surrounding brain tissue. However, surgery reduces the amount of tumor that needs to be treated by radiation or chemotherapy and increases the effectiveness of those treatments.
There are two main types of operations:
- Craniotomy: A craniotomy is surgically opening the cranium (the part of the skull that surrounds the brain). The craniotomy is usually large enough for the surgeon to insert multiple instruments and look at various parts of the brain.
- Stereotactic surgery: Stereotactic surgery involves using a needle through a small opening in the skull. The direction of the needle is calculated in advance from 3-dimensional (3D) measurements obtained by CT or MRI scans. The 3-D images show the tumor's location. The surgeon can apply the 3-D coordinates to the frame and precisely locate the tumor.
- Radiation Therapy
If a brain tumor cannot be cured by surgery, it is treated with radiation therapy - either externally or internally.
Radiation therapy can cure up to half of medulloblastomas and virtually all germinomas. However, this treatment does little to help astrocytomas, oligodendrogliomas, and ependymomas.
One promising new treatment for head and neck cancer is called stereotactic radiosurgery. The John Stoddard Cancer Center was the first facility in central Iowa to offer stereotactic radiosurgery.
The John Stoddard Cancer Center also was the first central Iowa facility to use Intensity Modulated Radiation Therapy (IMRT).