These warning signs may indicate brain cancer.Learn more »
You may undergo the following tests if your doctor thinks you have brain cancer.Learn more »
Learn how we fight brain cancer.Learn more »
Learn about follow-up care for brain cancer.Learn more »
The neuro-oncology team at Lehigh Valley Health Network’s Cancer Center includes specialists in neurosurgery, neurology, chemotherapy, radiation therapy, pathology and psychiatry who are skilled in determining the best brain cancer treatment. Depending on the stage of your cancer, treatment could vary greatly from someone else’s path. You may have some or all of these treatments during your cancer journey.
Have you been diagnosed with a brain tumor, brain cancer or other neurological condition?
Arm yourself with knowledge.
Chemotherapy is the use of anti-cancer drugs to treat cancerous cells. Chemotherapy has been used for many years and is one of the most common treatments for cancer. In most cases, chemotherapy works by interfering with the cancer cell's ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. Chemotherapy may be used alone for some types of cancer or in combination with other treatments such as radiation or surgery. Often, a combination of chemotherapy drugs is used to fight a specific cancer. Certain chemotherapy drugs may be given in a specific order depending on the type of cancer they are being used to treat.
While chemotherapy can be quite effective in treating certain cancers, chemotherapy drugs reach all parts of the body, not just the cancer cells. Because of this, there can be many side effects during treatment. Being able to anticipate these side effects can help you and your caregivers prepare and in some cases prevent these symptoms from occurring.
Clinical trials are medical research studies that enlist volunteers to learn whether new medications, practices or devices are safe and effective. They are designed to find better ways to prevent or treat illness or disease.
For more than 30 years, Gamma Knife® has been the gold standard in radiosurgery, offering a safe, precise option for treating malignant and benign conditions of the brain. Gamma Knife® Perfexion™ can treat even more – and harder to reach – tumors, and we are the first in the area to offer the faster, more precise Gamma Knife® Perfexion™ for brain and spine tumors. Our treatment teams – a neurosurgeon, radiation oncologist and medical physicist – have offered Gamma Knife surgery since 2004. Radiosurgery with Gamma Knife Perfexion does not actually involve a knife. It’s an exceptionally precise treatment method that delivers extremely focused radiation beams to selected targets, sparing healthy tissue. In addition to targeting brain tumors and lesions, Perfexion is capable of treating vascular malformations, as well as lesions in the sinuses, eye sockets, and upper spine and neck. The Gamma Knife reduces surgical risk and patient discomfort, and usually is performed as an outpatient procedure due to the low risk for complications.
Intensity-modulated radiation therapy is a specialized, precisely targeted form of external beam radiation therapy (EBRT). While traditional EBRT distributes the same strength of radiation across the whole tumor, IMRT is capable of varying the intensity of the radiation beam as it is delivered. This results in better shaping of the radiation dose and significant sparing of normal, sensitive tissue in the brain and surrounding structures. When treating the brain with IMRT, treatments are precise to within millimeters because daily setup imaging is performed to verify precise targeting.
During this procedure a surgeon performs surgery via a small incision through which an endoscope is inserted into the ventricles, which contain cerebrospinal fluid. It is within the ventricles that the intracranial neuroendoscopy is performed. All procedures are performed under general anesthesia. The patient’s head is shaved, usually only along the incision site, hidden behind the hairline. The standard incision is approximately 1-2 inches, accompanied by a small half-inch opening in the skull. The surgeon inserts the endoscope into the ventricles, where he can see the tumor or cyst, then uses a variety of very small instruments to perform the procedure. Depending on the goal, surgery can range from 15 minutes to one hour for colloid cyst tumor removal. Most patients are discharged from the hospital the day after surgery.
If you have a type of brain tumor called glioblastoma multiforme (GBM), you may benefit from a leading-edge device called NovoTTF. It generates an electrical field that disrupts molecules and prevents cancer cells from dividing. Studies show NovoTTF increases glioblastoma multiforme survival by an average of four months. The Food and Drug Administration approved NovoTTF for use in October 2015.
Radiation therapy uses X-rays, electrons and other types of radiation to treat cancerous and some noncancerous areas of the body in a variety of ways. It usually involves focusing beams of radiation on cancerous cells. Radiation, by itself or in conjunction with other kinds of treatment, often can cure cancer. If a cure is not possible, palliative care may help relieve the symptoms of cancer, such as pain.
Radiation therapy may be the only treatment necessary, or it may be used in combination with surgery or chemotherapy (drugs). For example, radiation therapy may help shrink a cancerous tumor before surgery or stop the growth of remaining cancer cells after surgery. When used with chemotherapy, it may help destroy cancer or prevent its reappearance. If you are receiving radiation therapy and chemotherapy at Lehigh Valley Health Network, your doctors will work as a team to ensure that you receive the most appropriate care.
At Lehigh Valley Health Network, we use advanced linear accelerators such as Varian Trilogy and True Beam to provide radiation therapy with IMRT (see above). Our linear accelerators target radiation in a highly focused beam, destroying cancer cells while sparing the surrounding normal tissue.
Before your radiation therapy begins, we must plan a program to deal specifically with your type of cancer. We do this with the help of a CT simulator. At the time of simulation, we will take your photograph for identification purposes. During simulation, special devices are made to help you hold still during treatment. Scans are taken to determine the precise location of the cancer area and fused to diagnostic imaging (usually MRI) for localization. Since radiation affects all cells, both normal and abnormal, it is important to ensure as little as possible of the normal tissue is treated. The skin over that area will be outlined with a special marking pen to identify exactly where the radiation will be directed. These marks will wash off easily, but since they may rub off, you might want to wear older undergarments and clothing for this visit. You will not need to keep these marks on for the treatment.
When treating the brain, we create a customized aquaplast mask during the simulation. This helps us reproduce precisely the treatment we have designed for you each time you receive your therapy. Once this setup has been performed, pictures are taken of the area that will receive treatment to further ensure accuracy and safety.
An appointment will be made for your next visit, usually within one to two weeks after this simulation. This time allows our staff and your doctor to make accurate computer calculations for the radiation treatment. It also gives us time to design shields to protect other areas of your body from receiving unnecessary radiation.
Because each patient is different, treatment plans will vary. The number or frequency of your appointments does not imply anything about the expected results of your care. Your schedule is planned specifically for you, to help you achieve the best results, so we ask for your help by maintaining that schedule.
During the progress of your therapy, we may find it appropriate to use more than one type of radiation treatment machine because each one performs different functions in the course of therapy. Also, you may have a simulation more than once to make adjustments in your treatment plan as your cancer shrinks.
“Neurosurgery is the first line of treatment for many brain tumors, whatever the type,” says Lehigh Valley Health Network neurosurgeon Mei Wong, MD. Surgeons like Wong use smaller incisions today and sometimes even can remove a brain tumor transphenoidally (through the nose). Advanced procedures such as awake craniotomy and brain mapping help the surgeon remove as much of the tumor as possible without disturbing areas of the brain that control speech and movement.