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Brain Tumors: Chemotherapy

What is 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, skin, and hair. Because of this, chemo can also affect those normal cells in the body. This can lead to side effects.

Chemotherapy tends to work better on fast-growing tumors. It's often used along with other treatments. These can include surgery or radiation therapy.

How is chemotherapy given for brain tumors?

Chemotherapy can be given in several ways:

  • As pills taken by mouth

  • Into the blood through a vein (IV)

  • Right into the cerebrospinal fluid (CSF) that bathes the brain (this is called intrathecal chemotherapy)

  • As a dissolvable wafer of the medicine carmustine, which is put on the parts of a tumor that can't be removed during 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 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

What types of medicines are used to treat brain tumors?

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:

  • Carmustine (BCNU)

  • Irinotecan

  • Lomustine (CCNU)

  • Procarbazine

  • Vincristine

  • Carboplatin

  • Cisplatin

  • Etoposide

  • Methotrexate

In some cases, a person may get more than 1 of these medicines for treatment.

Possible side effects 

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

Talk with your healthcare team about the side effects you should watch for and how best to prevent or manage them. Most side effects go away over time after treatment ends. Tell your healthcare team about any side effects you have. There are medicines that can help reduce and even prevent some side effects. 

Chemo can also affect fertility. Some medicines may also damage hearing and other organs, such as the kidneys or lungs. Your healthcare team will review the medicines and their side effects with you.

It's helpful to keep a log of side effects and share it with your healthcare team. This information can help you and your team manage symptoms more quickly and stop them from getting worse. 

Working with your healthcare team

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.

Online Medical Reviewer: Kimberly Stump-Sutliff RN MSN AOCNS
Online Medical Reviewer: Louise Cunningham RN BSN
Online Medical Reviewer: Richard LoCicero MD
Date Last Reviewed: 9/1/2020
© 2020 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare provider's instructions.
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