Neuro Oncology Program Conditions and Treatments

Gliomas are the most common primary malignant tumor of the brain, meaning cancers that start in the brain. Gliomas include glioblastoma, astrocytoma, oligodendroglioma, ependymoma, and other similar tumors. Gliomas can occur in any area of the brain. Gliomas can cause different symptoms depending on where they are located in the brain.

Treatment options for gliomas include surgery, laser ablation therapy (LITT), radiation, chemotherapy, targeted drugs, and tumor treating fields. Gliomas range from very slow growing to very fast growing. Optimizing treatment requires knowing the type of glioma, the molecular features of the glioma, the location in the brain, and the attributes of the person.

Meningiomas are benign tumors of the lining of the brain or spinal cord. In many cases they can be cured with surgery and/or radiation. Small meningiomas may even be watched and not require treatment. In some cases meningiomas can come back or become more aggressive and may be treated with drugs.

Many types of brain and spine tumors are rare and effect only a few thousand people in the US every year. Some examples of rare tumors of the brain and spine are primary CNS lymphomas, CNS germ cell tumors, adult medulloblastoma, or ependymoma. Most cancer doctors who do not specialize in neuro-oncology see maybe one person in their career with these tumors.

Treatment and follow up requires knowing the most up to date testing and protocols.

Metastatic brain tumors are cancers that start somewhere else in the body, such as lung cancer or breast cancer, and then spread to the brain. Metastatic brain tumors may cause symptoms or may be found during routine staging scans. Metastatic brain tumors may be treated with surgery, laser therapy (LITT), radiation, or drugs.

The treatment depends on the type of cancer, the symptoms, the location in the brain, and how the cancer is affecting the rest of a person’s body.

Pituitary tumors, also called adenomas, are benign growths in the pituitary gland. The pituitary gland hangs down from the brain, behind the nose, and produces hormones that regulate metabolism, sexual function, salt balance, and growth. Pituitary tumors may be found on imaging for something else, because of vision problems from pressure on the nerves from the eyes that run just above the pituitary gland, or from effects of having too much or too little of hormones.

Pituitary tumors may be treated by hormone treatment by endocrinologists or may require surgery or radiation. Pituitary tumors are rarely life threatening, but appropriate monitoring and correction of hormone imbalances is important to optimize quality of life.

Any of the brain tumors, including gliomas, meningiomas, or metastatic tumors, can also start in the spinal cord or vertebras surrounding the spinal cord. Ependymoma also commonly occurs in the spinal cord. Tumors of the spinal cord and the surrounding vertebra that protect the spinal cord can affect strength, sensation, bowel or bladder function, or cause pain.

Treatment of spinal tumors can involve surgery sometimes with special monitoring, radiation, or drugs.

For the majority of brain and spine tumors, surgery is the first-line of treatment. Surgical intervention is intended either as curative or part of the treatment algorithm together with other treatment modalities depending on the type of the tumor and location within the brain and spine. Sometime the surgery is needed only to remove tissue for the pathologist to be able to make the accurate diagnosis.

Our neurosurgeons specialized in treatment of brain and spine tumors have extensive experience in using the most advanced techniques to treat patients with all type of tumors. Some of these techniques are Awake craniotomy with brain mapping, use of Laser Interstitial Thermal Therapy (LITT) for ablation of brain tumors, use of various mini-invasive techniques such as Mini-invasive Pathway Surgery, use of 5-ALA, endoscopic techniques and many others.

Radiation therapy uses high energy radiation to destroy cancer cells or slow their growth. Not all tumors have to be treated with radiation therapy. There are various modalities of radiation therapy that our Radiation Oncology experts will implement depending on the type and location of the tumor. Such modalities available for our patient here at Inova include Cyberknife radiation, Proton Beam radiation, 3D conformal Radiation Therapy, etc.

Proton Therapy is a highly advanced form of radiation therapy that treats tumors with high precision, conforming to the shape of the tumor and reducing the risk of side effects and damage to surrounding healthy tissues. The main difference between Proton Therapy and standard radiation is that protons have the unique property of delivering the majority of their energy or “dose” directly in the tumor, without going beyond it, into normal tissues. This special behavior allows tumors to receive more targeted doses, while reducing damage to the healthy tissues that surround the tumor, decreasing side effects.

Please visit the proton therapy page for more information:

Proton Therapy

Medical therapy is used for many of the brain and spine tumors. It consists in using various drugs that will slow down or destroy cancer cells. Depending on the tumor location and type the chemotherapy can be deployed alone or in combination with radiation therapy. Many times medical therapy is used together with surgical intervention to treat residual tumors or prevent recurrence of these tumors.

This is a specific type of medical therapy that takes advantage of differences in genetic profile of various cells within the tumor. With this modality the medical oncologist after evaluating the genetic markers of the specific tumor, will implement a strategy with various drugs that specifically target that specific tumor.

Please visit the clinical trials page for more information:

Clinical Trials

GammaTile® Therapy is an FDA-cleared, Surgically Targeted Radiation Therapy (STaRT) designed to delay tumor regrowth for patients with brain tumors while protecting healthy brain tissue. This radiation oncology treatment is for patients with newly diagnosed malignant brain tumors and recurrent brain tumors, including gliomas, glioblastomas, meningiomas, and brain metastases