Brain Tumors: Chemotherapy

What is chemotherapy?

Chemotherapy uses anticancer medicines to kill cancer cells. The medicines are made to attack and kill cancer cells that divide rapidly. Cancer cells divide rapidly, but so do some normal cells. Because of this, chemotherapy can also affect those rapidly dividing normal cells in the body. This can lead to side effects.

Chemotherapy tends to work better on fast-growing tumors. It is often used along with other treatments, like surgery or radiation therapy.

How is chemotherapy given for brain tumors?

Chemotherapy medicine can be given in several ways:

  • As pills taken by mouth

  • Into a vein in the arm (IV)

  • Directly into the cerebrospinal fluid (CSF) that bathes the brain (intrathecal chemotherapy)

  • As a dissolvable wafer with the medicine carmustine placed on or next to a tumor during surgery

Doctors usually give chemotherapy in cycles. That means you take chemotherapy medicines for a certain amount of time. Then you have time off to recover from the treatment. This pattern of treatment and recovery will continue over the course of the chemotherapy. You may have treatment in one of these places:

  • The outpatient part of your hospital

  • A doctor’s office

  • A chemotherapy clinic

  • Your home

What are the types of medicines used to treat brain tumors?

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

You may also be given any of these medicines:

  • Carmustine

  • Irinotecan

  • Lomustine

  • Procarbazine

  • Vincristine

  • Carboplatin

  • Cisplatin

  • Etoposide

In some cases, a person may use more than one of these medicines for treatment.

Possible side effects of chemotherapy

Side effects depend on the type and amount of medicines you take, and the length of your treatment. Because chemotherapy medicines kill rapidly dividing cells, the medicines can also damage healthy cells that divide quickly. This includes cells in the bone marrow where new blood cells are made. This can result in low number of blood cells. This can cause 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

  • Fatigue, due to low levels of red blood cells

Chemotherapy can affect other rapidly dividing cells of the mouth, skin, and digestive tract. This can cause other side effects such as:                                                                                                                                                                                

  • Hair loss

  • Loss of appetite

  • Mouth sores

  • Nausea and vomiting

  • Diarrhea

  • Pain

  • Constipation

You may want to ask your doctor or nurse in advance about the specific side effects of the medicines and how best to prevent or manage them. Most of these side effects go away after treatment is done. Your doctor may prescribe medicines to help reduce the side effects so that you can recover from them more quickly. 

Some chemotherapy medicines also affect fertility. They may also damage hearing, and organs such as the kidneys or lungs. Your doctor and chemotherapy nurse will review the medicines and their side effects with you.

It's helpful to keep a log of side effects and share them with your medical team. This information can help you and your team manage symptoms more quickly. 

Working with your healthcare provider

It's important to know which medicines you're taking. Write your medicines down, ask your healthcare team how they work, and what side effects they might have. Keep a written diary of your treatment schedule and any signs or symptoms you have.

Talk with your healthcare providers about what signs to look for, and when to call them. Chemotherapy can make you more likely to get infections.

It may be helpful to keep a diary of your side effects. Write down physical, thinking, 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 medical team to make a plan to manage your side effects.