A glioma is a brain tumor originating in the glial cells, the support cells of the brain. Many gliomas are highly aggressive and respond poorly to treatment or require multiple treatments to deal with recurrences or regrowth of the tumor. According to Massachusets General Hospital, the three goals of treatment for tumors in the brain are to remove tumor cells, kill any tumor cells left behind after removal of the primary tumor mass and prevent any remaining tumor cells from further dividing or growing.
Surgery
Surgery is typically the first choice of treatment for a glioma. Even if the doctor plans on using other forms of treatments, he will likely recommend surgery first to remove as much of the primary tumor as possible before starting other treatments. The size and location of the tumor determine the feasibility of surgery as a treatment, since some tumors may be located in sensitive areas and cannot be cut out without damaging the brain itself. Surgery is usually done as a craniotomy, which opens the skull to expose the portion of the brain to be operated on. A surgeon may also use microsurgery, which threads a tiny microscope into the brain to view the surgery area. Sometimes, instead of a traditional scalpel, the surgeon will use ultrasonic waves or a tightly focused beam of radiation to destroy the tumor, explains the International Radiosurgery Association. Because gliomas tend to spread out into nearby areas, surgery rarely removes the entire tumor.
Radiation
Radiation therapy, or radiotherapy, often begins between two to four weeks after surgery to remove the glioma, according to Massachusets General Hospital. A patient receiving radiation therapy will visit the hospital daily for treatment, which will last four to six weeks. Radiation treatment itself typically lasts only a few minutes. Because radiotherapy is not precise, nearby normal tissues are often damaged by the radiation in addition to the cancer cells. Modern radiotherapy often uses the assistance of computer imaging to aim the radioactivity directly at the tumor site.
Chemotherapy
Chemotherapy attacks dividing cells using specific drugs, causing these cells within the tumor to die. Unfortunately, major side effects can also result, since other rapidly dividing tissues in the body, such as the cells lining the gastrointestinal tract, may also die. Many different chemotherapy drugs exist, each aimed at a particular molecular or biochemical mechanism used by cancer cells. Chemotherapy drugs can be used singly or administered in combination, depending on tumor activity. Chemotherapy may be given before or after radiation therapy, depending on the preferences of the physician and patient as well as the characteristics of the particular tumor. According to the University of Maryland Medical Center, chemotherapy drugs may have difficulty passing from the bloodstream to the brain so in addition intravenous delivery of the drugs into the bloodstream, they may sometimes be injected directly into the brain near the tumor site, injected into the spinal fluid to travel from there to the brain or placed in a slow-release capsule directly into the brain at the end of surgical tumor removal.
