Treatment for brain and spinal cord tumours
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy brain tumour cells. The drugs circulate throughout your body in the bloodstream.
You might have chemotherapy after surgery or if your brain tumour comes back. Common chemotherapy drugs for brain tumours are a drug called temozolomide. And a combination of drugs called procarbazine, lomustine and vincristine (PCV).
It can be difficult to treat brain tumours with some chemotherapy drugs because the brain is protected by the blood brain barrier. This is a natural filter between the blood and the brain which protects the brain from harmful substances.
You might have chemotherapy:
after surgery for some types of brain tumour such as gliomas
with radiotherapy and for some months afterwards
for a brain tumour that has come back after treatment
Find out more about the different types of brain tumours
Common types of chemotherapy drugs for brain tumours include:
temozolomide
procarbazine
carmustine (BCNU)
lomustine (CCNU)
vincristine
a combination of drugs called PCV (procarbazine, lomustine and vincristine)
The type of chemotherapy you have depends on which type of brain tumour you have. You might have other chemotherapy drugs if you have a less common type of brain tumour. You might have:
methotrexate if you have lymphoma of the brain or CNS
cisplatin or carboplatin if you have a germ cell tumour
Choose a chemotherapy drug on our A-Z list to find out more
You usually have chemotherapy in cycles of treatment. This means that you have the drugs for a few days every few weeks. There is a time with no treatment when you recover from the side effects.
How often you have treatment depends on the particular drug or drugs that you are having.
There are different ways of having chemotherapy for a brain or spinal cord tumour.
You might have it:
as a drip into your bloodstream (intravenously)
into your spine (intrathecal chemotherapy)
directly into your brain (for example, chemotherapy wafers)
as tablets or capsules that you swallow (oral chemotherapy)
You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.
Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment.
Your surgeon might put chemotherapy drugs into the brain tissue as a wafer. The chemotherapy drug is inside a gel wafer, which slowly dissolves over 2 to 3 weeks.
As the gel wafer dissolves, the chemotherapy is slowly released into the brain tissue. One example is a Gliadel wafer that contains carmustine (BCNU).
This isn't a very common treatment. Ask your doctor or nurse if you want to know more about this treatment.
Find out more about carmustine wafers
During surgery, your treatment team might put a small plastic dome under the skin of your scalp. It's called a ventricular access device or an Ommaya reservoir. This is less common than chemotherapy wafers.
Your doctor or nurse gently puts a small needle through your skin into the reservoir. They then give the chemotherapy straight into the fluid filled spaces in your brain. So it goes straight into your cerebrospinal fluid (CSF). This bypasses the blood brain barrier, which means that doctors can give smaller doses of chemotherapy.
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.
You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take newspapers, books or electronic devices to help to pass the time. You can usually bring a friend or family member with you.
For some types of chemotherapy, or if you have chemotherapy into your brain or spinal cord, you usually have to stay in a hospital ward. This could be overnight or for a couple of days.
You need to have blood tests to make sure it’s safe to start treatment. You usually have these a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.
Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test.
Between 2 and 8 out of 100 people (2 to 8%) have low levels of an enzyme called dihydropyrimidine dehydrogenase (DPD) in their bodies. A lack of DPD can mean you’re more likely to have severe side effects from capecitabine or fluorouracil. It might take you a bit longer to recover from the chemotherapy. These side effects can rarely be life threatening.
Before starting treatment with capecitabine or fluorouracil you have a blood test to check levels of DPD. So you may start treatment with a lower amount (dose) of the drug or have a different treatment. Your doctor or nurse will talk to you about this.
The side effects vary from one person to another. It is difficult to predict how you will feel and what side effects you will have.
Common side effects of chemotherapy include feeling sick and a drop in the levels of white blood cells causing an increased risk of infection.
Find out more about the possible side effects of each chemotherapy drug
Chemotherapy for a brain tumour can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.
Last reviewed: 04 Apr 2023
Next review due: 04 Apr 2026
There are many cancer drugs, cancer drug combinations and they have individual side effects.
Treatment for a brain or spinal cord tumour depends on the type of tumour you have, where it is and your general health.
There are many different types of brain tumours. They are usually named after the type of cell they develop from.
Practical and emotional support is available to help you cope with a brain or spinal cord tumour.
Primary brain tumours are cancers that start in the brain.
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