Brain Tumors: Chemotherapy

Chemotherapy (or chemo) uses strong medicines to kill cancer cells. The medicines attack and kill cells that divide quickly. Cancer cells divide quickly. But so do some normal cells, like those in your mouth, digestive tract, skin, and hair. Because of this, chemo can also affect those normal cells in the body. This can lead to side effects.

Because it works best on quickly dividing cells, chemotherapy tends to work better on fast-growing tumors. It's often used along with other treatments. These can include surgery or radiation therapy.

Chemotherapy can be given in several ways:

• As pills taken by mouth

• Into the blood through a vein (IV)

• Right into the cerebrospinal fluid that bathes the brain. This is called intrathecal chemotherapy.

• As a wafer in the skull cavity. The dissolving wafers contain the medicine carmustine. The wafers are placed on the lining of the cavity (or hole) left after brain surgery.

Chemotherapy is given in cycles. This means you take the medicines for a certain amount of time. Then you have time off to recover. Each cycle usually lasts a few weeks. This pattern will continue over the course of the treatment. You may have treatment in any of these places:

• The outpatient part of your hospital

• Your healthcare provider’s office

• A chemotherapy clinic

• An infusion center

• At home

Temozolomide is the medicine most often used. It's used for many types of brain tumors.

Some of the other chemo medicines that might be used are:

• Carboplatin

• Carmustine

• Cisplatin

• Etoposide

• Irinotecan

• Lomustine

• Methotrexate

• Procarbazine

• Vincristine

In many cases, a person may get more than one of these medicines for treatment.

Side effects depend on the type and dose of chemo medicine, as well as the length of your treatment. Because the medicines kill cells that divide quickly, they also damage healthy cells that divide quickly. They may harm cells in the bone marrow where new blood cells are made. This can cause low numbers of blood cells, leading to problems such as:

• Higher risk of infection, due to low levels of white blood cells

• Bruising or bleeding easily, due to low levels of platelets

• Extreme tiredness, due to low levels of red blood cells

Other possible side effects include:                                                                                                                                                                              

• Hair loss

• Loss of appetite

• Mouth sores

• Nausea and vomiting

• Diarrhea

• Constipation

• Skin sensitivity to the sun

It's important to know which medicines you're taking. Write down the names of your medicines. Ask your healthcare team how they work, what they're for, and what side effects they might have.

Keep a written journal of your treatment schedule and any signs or symptoms you have. Write down physical, mental, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.

Talk with your healthcare providers about what signs to look for and when to call them. Know what number to call if you have problems after office hours and on weekends and holidays.