Chemotherapy may be used systemically or targeted directly to the cancerous cells. Radiation is typically used if the tumor can't be completely removed or is in a very dangerous part of the brain.

The brain has one big benefit when it comes to radiation treatment. "It doesn't move. We can be very, very accurate and fine with radiation," said Sause, a radiation specialist. "The advantage of all the fancy equipment is you use the geometry of stereotactic delivery and go in through multiple angles so beams converge on the target. As software and hardware get more sophisticated — which has been going on for 30 years — our accuracy is more sophisticated. There've been no dramatic breakthroughs, just the steady pounding over decades of software and hardware development. It just keeps getting a little better, steadily."

The ability to deliver focused radiation has greatly reduced side effects..

Where big advances have come is in understanding brain cancers at a molecular level, Sause said. The next step is to design drugs that can take advantage of what has been learned about how brain cancer develops.

Treatment involves teamwork. "They are teams that see a lot of brain tumors and put a lot of people on clinical trials — people who think about this a lot. That lends itself to improved quality of care," Sause said.

And though improvement has been slow, Choucair said there's a lot of research on the horizon and hope for more effective treatments.

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E-mail: lois@desnews.com