In the UK alone at least 88,000 children and adults are estimated to be living with a brain tumour and, as March is Brain Tumour Awareness Month, we thought we’d take this opportunity to raise awareness of the treatments that are currently available for brain tumours, and why the availability of proton beam therapy is an important factor in treating this devastating condition which is biggest cancer killer of children and adults under 40.
Brain tumours can affect people of all ages, genders and ethnicities. Patients may be treated with surgery, proton beam therapy, conventional radiotherapy, chemotherapy or other drugs – often in some combination. What treatments depends on a number of factors including the type of cancer, location, size and your general age and health.
In this blog article, we aim to help raise awareness of the treatment options available for brain cancers.
Surgery
Surgery is often the first treatment for a brain tumour. It involves removing as much of the tumour as safely possible to alleviate symptoms such as headaches and seizures. It also provides a sample for analysis to confirm the type of tumour and direct further treatment decisions.
In some cases, surgery may be followed by proton beam therapy, radiation therapy or chemotherapy to further target any remaining tumour cells or to reduce the risk of tumour recurrence.
While surgery can be effective in treating brain tumours, it is not always possible or appropriate for all patients, and other treatments may be needed in combination with or instead of surgery.
Proton Beam Therapy
Proton beam therapy (PBT) is an advanced form of radiation therapy. Proton beam therapy uses high-energy protons, which are positively charged particles, to target and destroy cancer cells, unlike conventional radiotherapy, which uses high-energy X-rays (photons).
Proton beam therapy is not widely available as a treatment, indeed there are currently just two PBT centres in the UK linked to NHS hospitals, but research shows that proton beam therapy is considered an advantageous treatment option for certain types of tumours, including those in the brain for several reasons:
- Precise targeting: Proton beams can be very precisely aimed and controlled to deliver radiation to a brain tumour while sparing surrounding healthy brain tissue.
- Reduced side effects: PBT avoids exposing surrounding brain tissue to unnecessary radiation, particularly beyond the tumour – called an exit dose. This precision can potentially reduce the risk of side effects and improve patient outcomes.
- High dose delivery: PBT can deliver more radiation to a tumour than traditional radiotherapy, which can be particularly effective for certain tumours of the brain or bony skull that require high radiation doses to achieve the best outcomes.
Radiation therapy
Standard x-ray-based radiotherapy is often used to treat brain tumours effectively, and technological advances in these treatments have made them safer.
However, these treatments are not able to match the dose-sparing effect in the healthy normal brain tissue around the tumour that can be achieved with proton beam therapy. This is particularly important in patients who have a more promising outlook with their type of brain tumour.
Drug treatments
Systemic Anti-Cancer Therapy (SACT) is a term that describes the use of medications such as chemotherapy, immunotherapy or targeted drug therapies to treat cancer throughout the body.
Chemotherapy is the most common form of SACT used to treat some types of brain tumours. It can be used alone or in combination with other treatments, such as surgery or radiotherapy.
Targeted drug therapies are designed to specifically target and kill cancer cells which contain the specific target while sparing healthy cells. Immunotherapy drugs help the body’s immune system to recognise and attack cancer cells.
How will I know which treatment option is best for me?
If you are diagnosed with a brain tumour, a multidisciplinary team of healthcare professionals will work together to determine the best course of action for your individual case.
A brain tumour can be either categorised as a primary or secondary brain tumour. A primary brain tumour originates in the brain itself and is the result of abnormal growth and division of cells within the brain.
A secondary brain tumour, which is more common, also known as a metastatic brain tumour, is a tumour that has spread to the brain from cancer in another part of the body.
Treatment depends on a number of factors, including:
1. Whether the tumour is malignant or not
Non-malignant brain tumours are not cancerous, but they may cause problems if they grow large enough or if they press on sensitive areas of the brain. Rarely they can secrete hormones that can cause other medical problems.
Treatment, including surgery and radiotherapy, may be required to relieve symptoms such as headaches, and vision impairment, prevent seizures, or control excess hormone levels.
A malignant brain tumour (also called brain cancer), is made up of cancerous cells that usually grow and divide more quickly. These tumours can invade nearby tissues and can spread to other parts of the central nervous system (brain and spine)..
For malignant brain tumours, treatment may involve a combination of surgery, radiation therapy, and chemotherapy. The goal of treatment is to remove as much of the tumour as possible and slow down its growth and spread and provide symptom palliation.
2. The size of the tumour
Brain tumours can range considerably in size.
3. The grade of the tumour
Brain tumours are graded between 1-4. The more aggressive a tumour is, the higher the grade:
- Grade 1 and 2 brain tumours are non-cancerous (benign) tumours that tend to grow quite slowly.
- Grade 3 and 4 brain tumours are cancerous (malignant) tumours that grow more quickly and for which the outlook may be poorer.
4. The location of the tumour
Brain tumours can develop in any part of the brain or skull, including the membranes lining the brain (meninges), the bony base of the skull, the pituitary gland and the substance of the brain itself.
Tumours can also infiltrate from nearby structures, including the sinuses and the nasal cavity.
5. Your age and general health
Decisions regarding the best treatment strategy for a brain tumour will also take into account any underlying medical conditions that you may have as well as your overall age, general health and fitness levels.
Where can I have proton beam therapy for brain tumours in the UK?
There is a mix of both private and NHS-funded proton therapy treatment available in the UK:
NHS patients can be treated at The Christie Hospital in Manchester and at University College Hospital London (UCLH).
At Proton International London, we specialise in Proton Beam therapy to treat a wide range of cancers, including malignant and benign brain tumours. In conjunction with our first-class clinical colleagues at UCLH and UCLH Private Healthcare, we are proud to be able to offer PBT privately to adults and children from the UK and abroad, in London.
Conclusion
In recognition of Brain Tumour Awareness Month, we highlight the different treatments available for treating cancers and tumours of the brain.
Proton International London is pleased to be able to offer proton beam therapy, an advantageous yet widely unavailable treatment to insured or self-pay brain tumour patients here in the UK as well as overseas.
If you, or someone close to you, has been diagnosed with a brain tumour, speak to your consultant about whether proton beam therapy might be a good treatment option, or contact us.
Book a consultation or seek a second opinion with Proton International London.
This article has been clinically reviewed by Consultant Clinical Oncologist, Dr Michael Kosmin. Dr Kosmin specialises in the use of radiotherapy (including proton beam therapy and chemotherapy for the management of tumours of the central nervous system. He has a particular interest in advanced radiotherapy techniques including stereotactic radiotherapy and proton beam therapy.
