Central nervous system
cancers

A brain tumor can cause various symptoms that may appear suddenly or develop gradually. The nature of the initial symptoms and the development of tumors depend on the size of the tumor, how fast it grows, and where it is located. In some areas of the brain, even a small tumor can have significant consequences. In other areas of the brain, tumors can grow to a relatively large size before symptoms become noticeable.

Many symptoms are the result of increased intracranial pressure:

• Headaches are the most common and often the earliest symptom. The frequency of headaches caused by a brain tumor increases over time.
• Nausea and vomiting
• Increased intracranial pressure impairs the patient's cognitive function and mood. Personality changes may be observed (drowsiness, confusion, concentration problems, mood swings, depression, unusual behavior, severe balance disorders, etc.). These symptoms are often more obvious to those around the patient than to the patient themselves.

Depending on the area of the brain affected, a tumor can have the following consequences:

• Weakness or paralysis of an arm, leg, or one side of the body
• Reduced ability to feel heat, cold, pressure, light touch, or sharp objects
• Inability to speak or understand language
• Increased or decreased heart rate and breathing rate if the tumor compresses the brain stem
• Reduced alertness
• Reduced ability to hear, smell, or see
• Other common symptoms of a brain tumor include dizziness, loss of balance, and lack of coordination. Some brain tumors, usually primitive tumors, cause seizures.

Several treatments and combinations of treatments are available at the CFB. Treatments are specific to each patient and each tumor and depend on potential prior surgical treatment, the location of the tumor, the stage of development, the patient's age, medical history, and general condition.

External radiotherapy

Radiotherapy is recommended exclusively, either alone or in combination with chemotherapy. It can also be used as an adjuvant after surgery to eliminate any microscopic cancer cells that were not removed during the procedure . Radiotherapy may target the tumor or the tumor bed (the area where the tumor was located before surgery).

This treatment uses X-rays directed through the skin to the area to be treated. These rays are produced by a linear accelerator and gradually destroy the cancer cells.

Your treatment will begin with a scanning session (called virtual simulation) to identify the areas to be treated (target volumes) and the healthy organs around them that must be preserved as much as possible.

Your treatment plan will be tailored to your individual needs (taking into account your specific characteristics and those of your disease) and scheduled over several weeks. Sessions take place from Monday to Friday and last approximately 15 minutes.

The radiation is invisible and painless and does not make you radioactive.

Stereotactic radiotherapy

Stereotactic body radiation therapy (SBRT) delivers high doses to very small areas with millimeter precision. It is a special type of high-precision radiation therapy that is usually performed in a very small number of sessions. This type of treatment is offered to certain patients based on specific criteria.

Chemotherapy in combination with radiotherapy

Chemotherapy is a treatment based on drugs that act on the mechanisms of cell division.

It is a general treatment (called systemic treatment) that acts throughout the body. This allows cancer cells to be reached regardless of their location in the body, even if they are isolated and cannot be detected by diagnostic tests.

At Centre François Baclesse, chemotherapy drugs for the treatment of brain tumors are administered exclusively by mouth. The tablets are taken on an empty stomach before the radiotherapy session in order to maximize the effect of the radiation on the areas to be treated.

Side effects are predictable but not systematic; each situation is unique and each patient reacts differently. We invite patients to report any adverse effects to their referring physician at the CFB during weekly follow-up consultations. Nowadays, the most common acute side effects are very well managed with symptomatic treatments. These will be prescribed by your radiation oncologist if necessary.

During radiotherapy

• Onset or worsening of headaches
• Nausea and/or vomiting
• Seizures: These may occur, especially if the patient has had them before diagnosis. It is essential to tell the radiation oncologist. A seizure usually subsides within one to two minutes without treatment, after which the patient will feel drowsy for 15 to 30 minutes. The patient should be allowed to rest. If this is the first seizure, the attending physician or oncologist should be called.
• Hair loss or alopecia: This only affects the area within the radiation field. It occurs two to three weeks after the start of radiation therapy. It is usually reversible, but the hair may not grow back, depending on the dose received by the scalp.
• Fatigue: Fatigue is a common side effect.

During chemotherapy

Side effects will depend on the choice of drugs and the doses required to treat the tumor.

However, it is important to know that a number of chemotherapy drugs do not cause hair loss and that nausea after chemotherapy is increasingly well controlled.

The combination of radiotherapy and chemotherapy can increase side effects such as fatigue and nausea.

The effects observed during treatment generally fade a few months after the end of treatment. Some signs may appear after several months or years; these are known as "late effects." In rare cases, they may be related to the treatments received. We encourage you to report any side effects, even late ones, to your radiation oncologist.

• Persistent headaches: If headaches, nausea, or other symptoms that have already occurred reappear and/or worsen, it is important to consult a doctor, especially if these signs persist for several days.
• Changes in certain neurological functions, such as sensations, motor skills, or personality.
• Loss of working memory or short-term memory
• Difficulty concentrating
• Persistent fatigue