Tests, Treatments & Therapies for Brain Cancer at the University of Colorado Cancer Center

At the University of Colorado Cancer Center, we use the most minimally invasive approach possible for both diagnosis and treatment of brain tumors. We recognize that both work-up and management requires a multidisciplinary approach with numerous specialists working closely together.

We use both standard treatments and those being tested in clinical trials. You might consider participating in a trial, which are designed to improve current treatments or get information on new treatments. If a new treatment is proven better than the standard treatment, the new treatment may become the standard treatment.

Staging and Detection Tests

Tests are only as good as the doctors who report and interpret them. That’s why our doctors-who work together as a patient’s care team-are the highest trained specialists in the state.

Once a cancer has been diagnosed, it is very important for doctors to find out where the cancer may have spread (the “stage” of the cancer) to determine the best possible treatment plan for you. To find out, doctors use staging tests, which include:

• Different types of scans
• Different ways to take tissue samples to look for tumor cells microscopically (biopsy tests)

Scans and other tests may also be used:

• In a “surveillance program” looking for any signs of relapse after treatment
• In a “screening program” to detect cancer early in individuals at high-risk
• To monitor responses to treatment

Diagnostic Tests

The following tests and procedures may be used to find (diagnose) brain tumors:

Neurological examination – Helps doctors diagnose or find the cause of a patient’s symptoms and provides a standard way of monitoring any change in function throughout treatment. A neurological examination may include the following:

A medical history – questions concerning symptoms and condition.

An examination – complete screening of neurological function.

• Diagnostic tests
• Electrodiagnostic tests
• Blood tests

CT scan (computed tomography) – An X-ray procedure that creates detailed, highly accurate cross-sectional body images.

PET scan (positron emission tomography) – An imaging test used to light up cancer in different parts of the body. You get an injection of a short-lived radioactive substance before having the scan. Cancerous tissue will build up more of the substance and appear brighter than normal tissue on the PET images. Other non-cancerous tissues, such as areas of inflammation, can also sometimes “light up.”

Magnetic Resonance Imaging (MRI) – An imaging technique that provides detailed images of body structures. It uses a radio waves and a powerful magnet linked to a computer. These pictures can show the differences between normal and diseased tissues. It is especially useful in showing the inside of bones.

Biopsy – Part of the skull is removed by a neurosurgeon and a needle is used to remove a sample of the brain tissue. A doctor, called a neuro-pathologist, views the tissue under a microscope to look for cancer cells.

Angiography and MRI angiography (MRA) – Both done to map blood vessels in the brain. The angiography involves injecting dye into an artery. The MRA does not require an intra-arterial injection.

Single photon emission tomography (SPECT) – Similar to a PET. A camera measures the rate of radioactive material as it is emitted through the brain. This allows doctors to:

• Detect brain tumors
• Find the location of brain tumors
• Determine the recurrences of brain tumors after therapy

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Treatment & Therapy for Brain Cancers

The following treatments may be used alone or in combination to treat brain cancer.

Surgery

Operations to remove tumors are done by doctors who have specialized training on operating on the brain and neural systems, called neurosurgeons.

Craniotomy – A neurosurgeon opens the skull to remove a tumor. If cancer cells are found during the biopsy, the doctor will remove as much tumor as safely possible during the same surgery. An MRI may then be used to determine if any cancer cells remain after surgery.

Radiation Therapy (“Radiotherapy”):

Radiation therapy involves using X-rays and other types of medical radiation aimed at specific parts of the body to:

• Kill cancer cells
• Prevent cancer cells from developing or recurring
• Improve many of the symptoms caused by cancer

Radiation therapy can be:

• Used before surgery to make the operation easier (this is called “neoadjuvant” treatment).
• Used after surgery to reduce the chances of the cancer coming back (this is called “adjuvant treatment”).
• Almost as effective as surgery in people who are not fit enough for an operation.
• Better than surgery when used together with chemotherapy for certain cancers (this is called “chemo-radiotherapy”).

Chemotherapy and other drug-based treatments:

Anti-cancer drug treatments: Chemotherapy-and new “targeted therapies”-involve using drugs that kill, slow down or damage cancer cells. Many new drugs are being developed.

View current brain cancer clinical trials available at UCCC.

Anti-cancer drug treatments may involve:

• Single drugs or combinations of drugs
• Intravenous injections or tablets/capsules
• Taking the drugs in repeating patterns, called “cycles”, that usually last three to four weeks
• Taking some drugs every day or only on a few days within the cycles
• Taking other medicines to reduce or eliminate side effects associated with chemotherapy
• Taking targeted therapies, often with very little side effects, on their own or in combination with standard chemotherapy
• Access to new drugs or vaccines on their own, or added into standard treatments, in clinical trials  

Chemotherapy and targeted therapies can:

• Be given before surgery to make the operation easier
• Be given in combination with radiotherapy to make both treatments more effective
• Be given after surgery to reduce the chances of cancer coming back
• Successfully control advanced cancer and many cancer-related symptoms

Clinical Trials

The goal of clinical research is to improve treatment outcomes and reduce treatment side effects or long-term toxicities. Clinical trials provide the latest treatments because they evaluate:

• New drugs
• New combinations of therapies
• New treatment delivery methods

Because we’re the Rocky Mountain region's only National Cancer Institute (NCI)-designated Comprehensive Cancer Center-one of only 39 in the United States-your treatment will always include the latest and most comprehensive care options.

Learn more about clinical trials at UCCC.

Other therapies being tested through clinical trials:

Biologic therapy (biotherapy or immunotherapy) – A treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct or restore the body’s natural defenses against cancer.

Radiosensitizers – Drugs that make tumor cells more sensitive to radiation. Combining radiation with radiosensitizers may kill more tumor cells.

Hypofractionated radiation therapy – Radiation therapy given in higher-than-usual doses over a shorter number of days.

Stereotactic radiosurgery – A radiation therapy technique that delivers radiation directly to the tumor with less damage to healthy tissue. This procedure does not involve surgery.