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University of Chicago neuro-oncologists (specialists in cancerous brain tumors) work with neurosurgeons, radiation oncologists and medical oncologists to treat primary brain tumors and spinal cord tumors in adults and children. Neuropsychiatrists also provide support as needed.
About Brain Tumors
Brain tumors may be either malignant (cancerous) or benign (non-cancerous). Because they are a cancer affecting the brain, malignant brain tumors usually are life-threatening. Benign tumors in the brain also can be life-threatening, depending on the tumor's location. For example, a benign tumor may grow and increase pressure on an important blood vessel or a vital area of the brain.
A primary brain tumor originates in the brain. A secondary brain tumor (also called a "metastatic" brain tumor) is one which develops when cancer cells spread to the brain from a primary tumor in another part of the body, such as the breast, prostate or lungs.
Symptoms
Brain tumors can produce symptoms that are similar to other neurologic disorders, so accurate diagnosis by a trained physician is critical. Symptoms can include seizure, severe headache often accompanied by double vision or nausea, gradual loss of movement or sensation in an arm or leg, loss of balance, loss of vision in one eye or both, loss of hearing, or gradual difficulty with speaking. Stroke or a dramatic change of behavior also may suggest a brain tumor.
Diagnosis
Physical examination by the physician, followed by a CT scan or MRI, can help to identify the presence of a brain tumor. Highly sophisticated diagnostic techniques enable physicians to pinpoint the precise location and shape of the brain tumor.
Treatment
Treatment choices are guided, in part, by the location of the tumor. Standard treatments include surgery, radiation therapy or medications. These therapies may be combined or used individually. University of Chicago neurologists coordinate care with nationally recognized neurosurgeons and oncologists at the University of Chicago Hospitals.
Surgery: A tumor located close to vital centers of the brain or spinal column, or embedded deep within the brain, may not be eligible for surgery because of the risk to nearby brain tissue and functions. Today, innovative, high-precision surgical techniques and tools enable University of Chicago neurosurgeons to operate on deep brain tumors which were previously considered inoperable. These newer techniques and tools include stereotaxis three-dimensional computer imaging of the brain's interior, microscope-guided microsurgery, laser surgery, and other newer techniques. Skull-base surgical techniques enable University of Chicago neurosurgeons to operate on some tumors located near the base of the skull without destroying vital brain-stem functions.
When surgery is possible, it is often the first step in treatment. Neurosurgeons will remove as much of the tumor as possible. Sometimes, a small amount of the brain tumor remains. After surgery, the remaining brain tumor may be destroyed through radiation.
Radiation therapy: Most brain tumors are treated with radiation therapy, either alone or in combination with surgery or medication. Radiation therapy targets tumor tissue remaining after surgery, or the tumor itself if surgery was not possible. Even when surgery appears to have removed the entire malignant tumor, University of Chicago neurosurgeons often recommend radiation therapy to ensure destruction of any stray cancer cells that might remain. For benign tumors, radiation therapy may be used to slow or halt the growth, or to treat a tumor that recurs after initial treatment.
At the University of Chicago Hospitals, adults and children with brain tumors have access to the most sophisticated radiation therapy technologies. These systems are designed to destroy as much of the tumor as possible, while causing minimal damage to surrounding health brain tissue. Stereotaxis (or "stereotactic") radiosurgery provides three-dimensional imaging of the tumor, without surgically opening the skull. Then, a high-dose radiation beam is precisely focused on the tumor. Stereotactic radiotherapy uses fractionated external beam radiation to deliver multiple smaller doses of radiation directly to the tumor. Fractionated stereotactic technology adds precision to standard radiation therapy techniques.
Interstitial brachytherapy: A form of radiation therapy, interstitial brachytherapy involves implanting tiny radioactive seeds directly into the tumor. These seeds remain in the tumor for a while and can target tumor cells in various stages of growth. University of Chicago specialists use stereotactic techniques to precisely position the radioactive seeds.
Medication: Chemotherapy may be used to inhibit growth of the brain tumor. Chemotherapy targets cells as they are dividing and reproducing, and are most appropriate for malignant tumors. Different types of brain tumors respond to specific types of chemotherapeutic drugs. University of Chicago physicians have the expertise to select the proper drug and determine the appropriate dosage.
The brain itself acts as an obstacle to treating cancerous brain tumors with chemotherapy. In the healthy person, the blood-brain barrier is a network of blood vessels that protects the brain and blocks foreign chemical substances from reaching the brain. Hence, the brain-blood barrier also blocks chemotherapeutic agents from reaching the brain. Physicians at the University of Chicago Hospitals are testing new drugs which will help the chemotherapeutic agents to pass through the blood-brain barrier.
Clinical Trials for Brain Tumors
Clinical trials are open to patients who meet specific criteria. Patients must provide signed, informed consent before participating in a trial. Clinical trials are strictly voluntary; at any time, patients are permitted to leave the trial.
O-6 Benzylguanine: Working in tandem with standard chemotherapy drugs, O-6 benzylguanine may help to overcome the blood-brain barrier so chemotherapeutic drugs can penetrate the brain and reach the tumor. This agent may help overcome the brain's natural protective resistance to certain drugs. Combining O-6 benzylguanine with conventional tumor-fighting drugs such as BCNU may make the BCNU more effective.
Gadolinum Texaphrin: This radiation sensitizing agent may enhance the effectiveness of radiation therapy. The agent accumulates within the tumor, then can be traced on a MRI to help radiation oncologists precisely focus the radiation beam. Finetuning the focus of radiation more effectively destroys the tumor, while limiting damage to surrounding healthy tissue.
Brain Tumors in Children
Brain tumors in children can be quite different than tumors in adults, and respond differently to therapies. In fact, children with certain neuro-oncologic conditions tend to respond better to therapies. At times, children are eligible for clinical trials.
Whether using medications, radiation or surgery to treat pediatric brain tumors, the physician team is highly sensitive to issues concerning the child's growth and development.
Related Websites
The Brain Tumor Society
U of C Pediatric Brain Tumor Hotline |
