Brain and Spine Tumor Treatment
Several treatment options may be required to remove a brain or spinal tumor, depending on the type and location of the tumor in the nervous system. There have been significant advances in treating brain and spine tumors, meaning success rates have improved in the last two decades.
Treating Nervous System Tumors
Below we list some of the treatment options for brain and spine tumors in adults and children.
Any type of biopsy refers to the removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue.
Biopsies can be used to diagnose as well as treat tumors, depending on how much of the tumor is removed. There are many different types of biopsy procedures.
The most common types include:
- Incisional biopsy, in which only a sample of tissue is removed;
- Excisional biopsy, in which an entire lump or suspicious area is removed;
- Needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.
Stereotactical Biopsy maps the brain in a 3-dimensional coordinate system. In conjunction with MRI and CT scans, the neurosurgeon is better equipped to accurately target the area of the brain in question. This allows the neurosurgeon to easily and safely remove small pieces of the tumor to determine what it is and how best to treat it.
Adjunctive Tumor Treatments
In some cases, an adjunctive or secondary treatment can increase the effect of the primary treatment, such as surgery or a biopsy.
Radiation is a localized, painless therapy to eradicate cancer cells by destroying them and/or by keeping them from reproducing.
Two types of radiation treatment include:
- External radiation therapy is a beam directed at the cancer from outside the body.
- Internal radiation therapy (called brachytherapy or implant therapy) is from a source placed inside the body at the site of the cancer.
Radiation has come a long way, and can be delivered with more precision and effectiveness largely due to advanced imaging techniques.
At ANA, our expert neurosurgeons, in consultation with radiation oncologists, determine and recommend the best possible treatment plans—with explanations and support designed to inform and assure you.
Stereotactic Radiation (Radiosurgery)
Stereotactic radiation, which uses high-powered x-rays on a small part of the body, is used to treat certain types of nervous system tumors. It is a specialized type of external beam radiation therapy, delivered with accuracy and minimal exposure time, both of which are designed to provide results while limiting the effect of the therapy on healthy tissue.
Proton Beam Therapy
Proton Beam Therapy is a type of radiation delivery system that uses protons rather than x-rays. Depending on the location of the tumor, proton beam therapy can treat it with lower radiation doses to surrounding normal tissue.
Protons (the positively charged parts of an atom) delivered at high energy destroy cancer cells. This type of radiation therapy is particularly desirable for pediatric or adult tumors in critical structures, such as the brain and spine.
Chemotherapy (chemo) uses anti-cancer drugs that are usually given into a vein (IV) or taken by mouth. These drugs are distributed throughout the body via the bloodstream.
Since chemo drugs are unable to enter certain parts of the brain or spine via the above methods, some brain or spine tumors may be treated with drugs administered directly to the cerebrospinal fluid (CSF) or to the spinal canal. In this case, a member of the ANA specialized team will insert a thin tube, called a ventricular access catheter, into the skull via a small hole.
In general, chemotherapy is used for faster growing tumors. Some types of brain tumors, such as medulloblastoma, are frequently treated with chemotherapy.
Advanced Treatment and Research
Doctors are continually working to learn more about brain and spine tumors. They study how to prevent them, treat them and provide the best care to their patients.
The following areas of investigative research may include new options for patients through clinical trials:
- Enhanced imaging tests: These are new techniques for imaging scans.
- Biomarkers: Using blood or other tests to determine the presence of a brain tumor before symptoms begin.
- Immunotherapy: Also called biological response modifier (BRM) therapy, this technique is meant to fight the cancer by fortifying the body’s natural defenses, such as dendritic cells (the main function of which is to process and present antigens, causing an immune response), or vaccines. Several methods are being tested in clinical trials.
- Targeted therapy: Treatment that targets faulty genes or proteins that contribute to cancer growth and development.
- Blood-brain barrier disruption: A system to allow chemotherapy to more easily enter the brain via the bloodstream by temporarily disrupting the brain’s natural protective barrier.
- New drugs and combinations of drugs: New drugs and combinations of drugs are being developed. And since tumors can develop resistance to chemotherapy, another approach is to use a treatment that targets how tumor cells develop resistance.
- Gene therapy: Therapy that seeks to replace or repair abnormal genes that are causing or helping tumor growth.
- Genetic research: Seeking to learn more about mutations of specific genes and how they relate to the risk and growth of brain tumors. This includes discovering more on the link between genetics and glioblastoma.
Tumor Clinical Trials
For many patients with brain or spine tumors, clinical trials offer the best treatment options. Clinical trials are studies designed to test the most promising new treatments.
People participate in clinical trials for a variety of reasons. They want to:
- Try a new and promising treatment method
- Contribute to the development of future treatments
- Help find a cure
Most clinical trials require certain medical criteria in order for a patient to qualify. Some trials can be joined before surgery, others during radiation, or even in the event of recurrence. At ANA, we determine whether a patient is eligible and best served by a number of clinical trials.
Collaboration also extends to organizations that serve as hubs for experts to share their knowledge and research. Dr. Arno Fried explains that memberships in these organizations allow patients “to get the best treatment available—whether they are at Hackensack, Morristown or a hospital in any other part of the country.”
Our neurosurgeons will discuss clinical trials based on your unique case and current trials (clinicaltrials.gov).
Should You Join a Clinical Trial?
ANA has access to a wide range of clinical trials and our experts will guide a patient whenever beneficial and relevant. Clinical trials are rigorously controlled tests of new drugs, medical devices or procedures.
Besides helping to develop future treatments, the benefit of participating in clinical trials with ANA is that patients gain access to treatments that are not yet widely available. Moreover, in the case of pediatric tumors, clinical trials are a key factor in improving both treatments and prognosis.
Our team will explain Phase 1, 2 and 3 clinical trials as well as the benefits and risks of participating in one of them. As always, our goal is to build patient trust by way of information and inclusion in the process.
At Advanced Neurosurgery Associates (ANA), we are on the cutting edge of brain tumor diagnosis and treatment for both children and adults. The brain is a complex organ, and thus so are brain tumors. That is why a crucial focus for any brain or spine tumor treatment entails a collaborative approach.
A collaborative approach means working as a team to ensure an accurate diagnosis with the most effective treatment possible, keeping side effects to a minimum. At ANA, we not only understand the complicated medical aspect of brain and spinal tumors, but the profound effect they have on both patients and families.
This complex task requires a group of specialists that include but are not limited to experts in:
- Radiation oncology
- Rehabilitation therapy
In addition to the medical needs of patients, other specialists such as psychologists and psychiatrists contribute to the psychological and emotional welfare of both patients and their families.
For advice on the best treatment options for your individual case, contact our expert neurosurgeons.