Surgery to remove the tumor is often among our first treatment tactics, but in some cases doctors cannot reach deep-seated tumors without damaging critical parts of the brain. Moreover, surgery is too often unable to remove every part of a tumor. Because treating brain cancer is so intertwined with the location, type and size of the tumor, no two cases are identical.
Surgery to remove the tumor is often among our first treatment tactics, but in some cases doctors cannot reach deep-seated tumors without damaging critical parts of the brain. Moreover, surgery is too often unable to remove every part of a tumor.
Fortunately, we have a series of tools to shrink these tumors without brain surgery, explains Herbert Newton, MD, FAAN, a board-certified Neuro-Oncologist with AdventHealth who has over 30 years of experience in his field.
AdventHealth is the only health care provider in Central Florida to offer three innovative technologies: the Gamma Knife, Laser Interstitial Thermal Therapy (LITT), and the Optune Electrical Array Device.
They each work in different ways but have the same strategy: Hit tumors that are hard-to-reach using minimally invasive or non-invasive means.
Even with the best treatment, brain cancer is still a devastating illness. A typical patient diagnosed with a glioblastoma, the single most common form of brain cancer, will survive for 15 to 18 months after their diagnosis.
When patients have an incurable cancer, we communicate with them upfront, Dr. Newton says. In these cases, our treatment is aimed at maximizing survival time and maintaining quality of life.
This makes kindling life-sustaining hope even more critical for these patients. In cases where a cure is unlikely, he says these technologies can create a space for hope to reduce the size of a tumor and give patients more time with family and friends.
Radiation, Targeted to the Millimeter
Whole-brain radiation therapy has long been a mainstay of brain cancer treatment, but it is something of a blunt tool that can cause serious side effects many months afterward.
In recent years, a more precise form of radiation therapy called stereotactic radiosurgery has been used to limit the damage to where it belongs: the tumor itself.
At AdventHealth, we use magnetic resonance imaging, or MRI, scans to guide a tool called the Gamma Knife to the tumor site.
Its very, very targeted, down to the millimeter tolerance, Dr. Newton says.
It is sometimes used in patients with smaller tumors that are difficult to reach with conventional surgery.
Boiling the Tumor
Another relatively new technology, Laser Interstitial Thermal Therapy, or LITT, does require surgery, but it uses a much smaller incision than typical brain surgery. It works like this:
A small hole is drilled into the skull, into which a thin laser probe is inserted. This probe is guided by MRI imaging to the tumor, where it applies a blast of heat.
Its basically boiling the tumor tissue, Dr. Newton says.
Like other technological approaches, it is sometimes used for patients whose tumors have not responded to other therapy.
Electric Fields Disrupt Tumor Cells
AdventHealth is also a center for the Optune device, which directs electric fields to a tumor site through four electrode arrays placed on the head. These electric fields are thought to prevent tumor cells from reproducing or kill them outright.
It is used to treat glioblastomas, which are tumors that arise from astrocytes, a star-shaped cell with tendrils that branch out in all directions. These tendrils make this a particularly difficult type of tumor to eradicate, so treatment more often focuses on slowing it down.
AdventHealth is one of only a few hospitals to have three health care providers Dr. Newton, Sherif Makar, MD, and nurse practitioner Gage Gwyn, Ph.D., ARNP actively prescribing this therapy.
Like the other two technologies, this approach has the added benefit of targeting only the tumor site, helping it avoid the side effects of whole-body treatment like chemotherapy. One downside is that the device must be worn at home, so patients often must adapt to wearing it.
Striking a Balance
One important benefit of these technological tools is that they tend not to impose a major cost on patients quality of life.
Newton says the treatment of brain cancer is often a balance between aggressive treatment and the side effects this treatment can cause.
Sometimes, its a fine line, he says.
A Personalized Future
The use of targeted therapies that key in on a tumors specific genetic makeup has shown promise in treating other forms of cancer, especially lung cancer, Dr. Newton says. Learning the DNA sequence of a tumor can allow doctors to develop a plan that exploits the tumors individual vulnerabilities.
Researchers are exploring promising new avenues to apply this strategy to treat brain cancer, but there are no treatments yet available, he says. Genetic testing of a brain tumor can help doctors predict the course of a disease, including the likelihood of survival, but does not yet guide treatment decisions.
The Chance for Hope
In addition to shrinking tumors, these technologies also offer something less tangible: hope. They give patients the knowledge that they're doing all they can to fight their cancer and give them all the time they can.
AdventHealth's CREATION Life philosophy teaches that choice can help bring us fulfillment and establish control over our lives. A positive outlook, too, can change your health in real and concrete ways.
Dr. Newton says a positive attitude doesn't just improve our mood, it helps strengthen our immune systems ability to fight off cancer and other ailments.
Hope is critical. Once patients lose hope they simply do not do as well, he says.
At the AdventHealth Cancer Institute, technology is just one piece of a whole-person approach to treat patients with brain cancer in body and spirit, along with the mind.