Metastatic brain tumors are the result of cancer spreading from another part of the body like the breast, lung or colon. Not that long ago these tumors represented a virtual death sentence, and treatment was practically non-existent.
Today, thanks to tremendous advances in care — both for primary cancers and metastatic brain tumors — patients can survive for many years with good quality of life. Endeavor Health pioneering neurosurgeon Amin Kassam, MD, and radiation oncologist Stephen Nigh, MD, highlight advanced treatment options and positive outcomes for patients with metastatic brain tumors.
Immunotherapy has revolutionized treatment for many cancers, essentially converting many advanced cancers into chronic diseases. But the blood-brain barrier prevents immunotherapy drugs from attacking metastatic brain tumors.
Innovative minimally-invasive surgical techniques developed by Dr. Kassam are now used to remove tumors through a tiny port the size of a dime. Remarkably, these procedures are performed while patients are awake and actually able to think and talk throughout the procedure.
“Your quality of life is determined by your brain; your speech, movement, personality, thought,” said Dr. Kassam. “I am trying to protect our patients and conscious surgery, where patients are awake and talking to their family members, helps us do that.”
The brain has no pain receptors, and specially-developed minimal sedation enables patients to converse during surgery, which allows Dr. Kassam and his surgical team to closely monitor their emotions, cognition and personality as he works to resect tumors with sophisticated robotic equipment.
Read Dorothea’s story: An incredible recovery thanks to conscious brain surgery.
Advanced imaging used to map the individual brain before surgery guides the procedure that takes place in an operating suite with eight large screens that allow patients to see what is happening in real time just as the surgeon does.
“Today we can get to most of the brain and the patients, who are participants in the surgery, have just a few stitches in their scalp, have never been intubated and are generally discharged the next day,” explained Dr. Kassam.
Many of these patients will undergo focused beam radiation or “radiosurgery” the day before surgery with specialists like Dr. Nigh to help treat the tumor before surgical resection.
“CyberKnife radiation treatments are highly precise, non-invasive methods that allow us to radiate one or several tumors with decreased toxicity and improved quality of life,” explained Dr. Nigh. These radiation treatments are especially important for patients with multiple brain lesions as they optimize local control and precision, reducing the toxicity that patients can experience with traditional radiation.
Surgically-targeted radiation therapy Gamma tiles are another innovative new technology providing a very good treatment option for patients with recurrent and high-grade brain tumors, said Dr. Nigh.
The absorbable, collagen-based tiles embedded with radiation seeds are placed by neurosurgeons along the area where tumors were resected. The treatments are personalized to each patient and involve collaborative teams of neuro specialists, radiation oncologists and physicists.
As Chairman of Endeavor Health Neurosciences Institute’s Advanced Neurosciences Center, Dr. Kassam leads a multidisciplinary team that has attracted patients from across the globe for these advanced treatment options.
The growing team of specialists and subspecialists is helping to change the paradigm for how patients with metastatic brain tumors are treated.
“We’re seeing referrals from all over the country,” said Dr. Nigh. “These treatments are really extending survival and saving patients from neurological decline.”
