All of the varied treatment options for brain cancer carry with them important questions related to delivery of the therapy and the spread of the disease beyond the visible enhancing area. Going into surgery, the surgeon must have a plan for the extent of the surgery and placement of local therapies. A radiation therapist similarly plans the margins of the radiation therapy based on imaging data. Chemotherapies may be administered systemically or locally, with very different ease of entry into and residence in the brain. A neurooncologist, along with the others, must consider the alleviation of symptoms like edema in conjunction with its effect on the other therapeutic treatments. More effective therapies must consider the likely routes of tumor dissemination.