When diagnosing and classifying a brain tumor, the physician assesses many factors, including the location, size, and aggressiveness of the tumor. These factors help the physician decide if the tumor is operable or inoperable.
What is an inoperable brain tumor?
Operable tumors are those that the surgeon feels confident can be removed completely or partially. Inoperable tumors are those located in an inaccessible place in the brain, or those that are composed of multiple tumors that cannot all be removed. Surgeons cannot always access every corner of the brain, and there may be some concern about damaging nearby tissues. There is not one type of brain tumor that is operable and another that is inoperable. Inoperable tumors can be of any type or size. The key issue is the location of the tumor(s) and whether or not the surgeon feels he or she can access it without damaging critical brain areas around it, such as those needed for speech, movement, and other essential functions of the body.
Another possible problem is vascularization. An inoperable brain tumor may be so entangled with blood vessels that it would be too dangerous to the life of the patient to try to remove the tumor. Finally, the state of the patient’s general health is also a concern. If the patient suffers additional illnesses, they may be in a weakened state that would make performing surgery to risky for the patient.
The surgeon may consider whether part of the tumor can be removed. However, the problem with removing only part of a tumor is that it is likely to recur because the remaining tissue multiplies. Thus it is best, when possible, to remove the entire tumor. It is important to note that a tumor that one surgeon believe is inoperable may seem treatable to another. You may wish to visit more than one surgeon before accepting the conclusion that the tumor is inoperable.
What are the treatment options for inoperable brain tumors?
The first thing your physician will consider is radiation therapy to treat the tumor. The objective of radiation therapy is to selectively killing tumor cells while avoiding damaging healthy brain tissue nearby. To accomplish this goal, standard external beam radiation is administered in “fractions”, or doses, to the brain. You may receive between 10 and 30 treatments, depending on the size and type of tumor(s) you have. There are several types of radiotherapy, such as external beam radiation therapy, brachytherapy, and stereotactic radio surgery. Your physician will explain these treatments to you and help you decide which is the best approach for your particular brain tumor.
What about chemotherapy?
Chemotherapy is the administration of drugs that kill cancer cells. While chemotherapy can extend survival in patients with malignant tumors, there is a low rate of success with such treatments. In fact, only about 20 percent of patients receiving chemotherapy have a significantly improved outcome. This is due in part to the difficulty of the drugs passing the blood-brain barrier and affecting the tumor itself. The other problem is the high toxicity and severe side effects of chemotherapy, and these combined with the low rate of success place chemotherapy lower on the priority list of treatments for brain tumors.
There are many treatments being researched for inoperable brain tumors. One is the use of a laser to kill brain cancer cells with heat. Laser treatment of cancer is not new, but only recently has the technology evolved enough to allow more precise targeting of the laser beam to directly treat cancer cells without harming nearby tissues. It is a possible treatment for patients whose tumors are considered too risky to remove, or whose tumors have not responded to other methods of treatment.
Before making any decisions about inoperable brain tumor treatment, it is important to consult with your entire medical team, and get second and third opinions. You’ll also want to consult with your family and choose an approach together, as whatever route you choose, it will require a team effort from everyone involved.