Chemotherapy

Chemotherapy for brain tumours

Navigate chemotherapy: Understanding treatment, side effects and support

Chemotherapy is the use of drugs to destroy cancer cells by targeting the ways in which cells grow and divide. Chemotherapy relies on the fact that cancer cells divide at a faster rate than healthy cells, but it also affects non-cancer cells, which can cause side effects. Chemotherapy can be given as a stand-alone treatment, alongside radiotherapy or on its own after radiotherapy is finished. It may also be used if the brain tumour re-grows.

The chemotherapy treatment depends on the type and grade of tumour and genetic biomarkers that are present. The treatment team will also consider factors such as the patient’s overall health and age. Most chemotherapy is given in cycles, which allow for a rest period to enable recovery. Most cycles are four to six weeks long.

There are a number of different chemotherapy drugs which are used to treat brain cancer: Temozolomide, Lomustine and Procarbazine which are given as tablets to take at home, Vincristine, which is given intravenously (into a vein) in hospitals and Carmustine, which is sometimes administered directly into the brain during surgery.

The treatment team will discuss side effects with the patient; they may give drugs to combat these,  such as anti-sickness drugs to treat nausea.

How and where you have chemotherapy

Chemotherapy can be given after surgery for some types of brain tumour, with radiotherapy and for some months after radiotherapy, or for a brain tumour that has come back after treatment.

If you have a high-grade glioma, you may have chemotherapy and radiotherapy together. The radiotherapy usually lasts 3 to 6 weeks, then the chemotherapy stops for a while, then starts again for up to 6 cycles. Having both treatments can cause more side effects, so you need to be physically well enough to cope.

Types of treatments include

• Tablets or capsules (oral) you usually take at home, though you will still visit the hospital outpatients regularly for blood tests and checkups.
• You might have chemotherapy at home if your hospital or private healthcare company has homecare chemotherapy nurses or if you are having low-dose, continuous chemotherapy through a pump that you can wear at home 
• A liquid given into a vein (intravenous) through a cannula will be done in a chemotherapy day unit as one or more sessions of treatment in a cycle of treatment/rest, most cycles being 4 to 6 weeks long 
• Very rarely, as an implant or ‘wafer’ directly into the brain during surgery. This is sometimes used for people having surgery to remove a high-grade glioma.

Lower dose chemotherapy

This treatment is given at a cancer day clinic. It can take anything from a few minutes to a few hours through a drip, sitting in a chair. You might want to take something to help you pass the time – a book, tablet etc. You can usually bring a friend or family member with you.

You will have a blood test before you start, be reviewed by the oncologist and you might need to take some anti-sickness medication. The amount of chemotherapy you receive will be based on your weight, height and general health.

Chemotherapy is sometimes given every day for a few days in a row and doesn’t require you to stay in the hospital. This is called an ambulatory clinic or Ambi-care. Your oncology team will talk to you about accommodation if you need this.

Higher dose chemotherapy

With a high dose, more intense chemotherapy you might need to stay in the hospital overnight or few a few days or even weeks because it’s administered more slowly, you might need a fluid drip, monitoring in case of a reaction and because treatment may have more side effects and you’ll be more at risk of picking up infections.

After chemotherapy

Chemotherapy, low or high doses, is an intense treatment for the body. When you go home, make sure you tell your oncologist or nurse about any problems or side effects that you have. Your team will give you numbers to call.

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Cancer Research | Chemotherapy treatment