|
The American Brain Tumor Association estimates that approximately 350,000 people in the United States were living with a primary brain tumor (a tumor that starts in the brain) during the year 2000 and many thousands more with metastatic tumors to the brain from lung, breast or other malignant tumors. Neuro oncology services at Texas Health Presbyterian Hospital Dallas include advanced technology and procedures for the care of brain tumors. Neuro oncologists work with neurologists, neurosurgeons, neuroradiologists, anesthesiologists and pathologists on the medical staff to provide comprehensive patient care.
What is a brain tumor? The American Brain Tumor Association defines a brain tumor as a mass or growth that arises within the brain. Brain tumors are usually benign or malignant. Benign brain tumors are usually slow-growing, have a fibrous covering (encapsulation), do not usually invade the brain and can often be removed by surgery, depending on location. Malignant brain tumors are more rapidly growing, usually lack a covering (no encapsulation), usually invade the brain with "tentacles" that reach out into the brain and often cannot be entirely removed surgically.
Brain tumors cause symptoms by pressing on, or invading, the brain. Symptoms can result from increased pressure on the brain or destruction of normal nervous tissue. Symptoms can include headache (usually worse in the morning), nausea, vomiting, seizure, and weakness or numbness in the arms and/or legs. None of the symptoms are specific to brain tumors, and they can all be caused by other medical problems.
Diagnosis: Advanced diagnostic testing is available to assist medical staff physicians in determining the type, location and extent of tumors. Diagnostic radiology services include magnetic resonance imaging (MRI) and computerized axial tomography (CAT or CT scans). Also available is single photon emission computed tomography (SPECT scans), offered through the hospital's nuclear medicine department. All these tools are used to assist physicians on the medical staff with diagnosis and treatment.
Care options: Treatment for a brain tumor is managed by medical staff physicians and depends on the location, rate of growth and pattern of spread within the central nervous system. Inpatient and outpatient care options are available for a variety of brain tumors. These options include surgery, Gamma Knife treatment, radiation therapy, traditional intravenous chemotherapy and intra-arterial chemotherapy. Texas Health Dallas is one of only a few facilities in the country with medical staff physicians who offer intra-arterial chemotherapy.
- Download a brochure containing continuing medical education information on intra-arterial chemotherapy.
Surgery performed by medical staff neurosurgeons is the most common treatment for accessible brain tumors. Accessible tumors are those that can be surgically removed without causing severe neurological damage. Many benign tumors are treated with surgery only, but most malignant tumors require additional treatment. Surgery can help physicians on the medical staff establish the diagnosis, relieve pressure on the brain caused by the tumor and provide access for other treatments, such as chemotherapy wafers. Texas Health Dallas has two types of image-guided neurosurgery systems, a dedicated neuro ICU and an inpatient neuroscience patient care unit.
Radiation therapy: Radiation is a very strong local treatment administered by physicians on the medical staff for tumors of many kinds. With some tumors there is a high likelihood of residual cells in the surrounding brain tissue following surgery, and radiation therapy is often recommended as a means of treatment.
Radiation therapy is performed with a machine called a linear accelerator. This machine produces high-energy X-rays. By using the type of radiation best suited to the location of the patient's tumor and often treating from several directions, the treatment can be concentrated in the area at risk while sparing as much of the normal brain tissue as possible. In addition, special radiation-planning computers can use the information from CT and MRI scanners to plan the radiation and the optimal number of treatment directions and angles for each patient.
Physicians on the medical staff often prescribe radiation treatments that are divided into small daily doses. Normal tissue has the ability to repair the damage done by radiation, but tumor cells lose some of this ability. Spacing out radiation sessions allows time for the normal tissues to heal, thereby reducing side effects. At the same time, the cancer cells damaged by radiation diminish and die from the exposure.
Traditional chemotherapy: Chemotherapy drugs are derived from plant or synthetic toxins that stop the growth or division of tumor cells. With traditional chemotherapy, anticancer drugs may be given orally or intravenously, or may be administered directly into the cerebral spinal fluid. Because not all tumors are vulnerable to the same anticancer drugs, physicians on the medical staff often use a combination of drugs for chemotherapy.
Intra-arterial chemotherapy (IAC): The arteries that supply blood to the brain, and to a brain tumor, carry oxygenated blood from the heart and lungs. Although all drugs are, in fact, delivered to the brain by the arteries, IAC involves the placement of a catheter directly into the artery feeding the tumor by a medical staff physician. This provides a higher concentration of the drug closer to the tumor.
IAC can treat recurring, localized malignant tumors in the brain and/or tumors that are not candidates for surgery or other types of chemotherapy. Patients first have a diagnostic angiography or a contrasting die is used in the cerebral arteries to determine the placement of catheters that will be used to administer chemotherapy. This procedure is performed by a medical staff physician and is done under anesthesia. Patients are observed closely the evening following the procedure. Intra-arterial chemotherapy is usually administered in sessions four to six weeks apart.
Texas Health Dallas has a Hamon Intra-operative MRI (iMRI) Neurosurgical Suite featuring BrainSUITETM technology and Siemens' MAGNETOMTM 1.5 Tesla high-field MRI system. Among the first of its kind, the BrainSUITETM surgical suite employs technology which provides neurosurgeons with real-time, decision-making information to treat complicated brain tumor and other neurosurgical cases.
For more information, call 1-877-THR-WELL (1-877-847-9355).
Links
|
