Standard of Care

When facing a brain tumor diagnosis, understanding your treatment options can feel overwhelming. The term standard of care refers to the best available and widely accepted treatments for brain tumors, based on rigorous research and expert consensus. These standard treatments typically include surgery, radiation therapy, and chemotherapy. You may receive one or a combination of these approaches depending on your diagnosis.

Surgery: The First Line of Defense

Surgery, also called a craniotomy when it involves opening the skull, is often the first step when a brain tumor is suspected, based on symptoms and imaging. It plays a critical role in diagnosis, helping doctors determine the exact tumor type and grade. Surgeons also aim to remove as much of the tumor as safely possible, which may reduce pressure in the brain and relieve symptoms. In some cases, removing even part of the tumor can significantly improve quality of life.

Radiation and Chemotherapy

Following surgery, additional treatments such as radiation therapy and chemotherapy may be recommended. This depends on the tumor’s type, grade, location, and other factors like molecular markers or growth behavior.

Optune (Tumor Treating Fields)

Tumor Treating Fields are an innovative and FDA-approved therapy used primarily for glioblastoma, one of the most aggressive forms of brain cancer. This treatment uses low-intensity, alternating electric fields to disrupt cancer cell division and slow tumor growth.

The therapy is delivered through a wearable device called Optune Gio, which includes a set of adhesive electrode arrays placed on the patient’s scalp and connected to a portable power source worn in a shoulder pouch or backpack. The arrays are customized to each patient’s tumor location and are worn continuously—typically at least 18 hours a day—during treatment.

Tumor Treating Fields are most often used in combination with chemotherapy and are considered part of the standard of care for glioblastoma following initial surgery and radiation.

Treatment by Tumor Grade

• Grade I (Low-grade tumors): These are typically non-aggressive and may be effectively treated with surgery alone. Ongoing monitoring is often sufficient afterward.
• Grade II (Low-grade tumors): Treatment beyond surgery varies. Decisions are based on the amount of tumor remaining, tumor behavior, and specific biological features. Radiation and/or chemotherapy may be recommended in some cases.
• Grades III & IV (High-grade tumors): These aggressive, malignant tumors usually require a combination of surgery, radiation, and chemotherapy. Clinical trials may also be a promising option. Because high-grade tumors grow rapidly, a more intensive treatment approach is needed.

In cases where a tumor displays features of multiple grades, treatment is based on the highest-grade characteristics. It’s also important to note that some low-grade tumors can progress into higher grades if they recur.

Challenges in Treating Brain Tumors

Treating brain tumors presents unique challenges. Unlike other cancers, the brain cannot be fully removed or aggressively operated on without risking vital functions. Additionally, the blood-brain barrier—which protects the brain from harmful substances—also limits the effectiveness of some chemotherapy drugs. Radiation therapy, while useful, can damage healthy brain tissue, especially in sensitive areas.

Why Guidelines and Clinical Trials Matter

To support treatment decisions, the National Comprehensive Cancer Network (NCCN) provides expert-developed guidelines for each tumor type and grade. These are updated regularly and available (with a free account) to patients and caregivers.

In some cases, clinical trials offer access to promising new treatments—sometimes even before surgery. If you’re newly diagnosed or facing a recurrence, talk to your care team about clinical trial options.

Moving Forward with Hope

While brain tumors remain one of the more complex cancers to treat, there’s hope. Advances in surgical technology, targeted therapies, and radiation delivery methods are improving outcomes. Researchers and clinicians around the world are working daily to discover more effective treatments and improve quality of life for those affected.