Brain tumor treatment is advancing quickly. New options ranging from immunotherapy to tumor treating fields mean more patients can put their brain tumor experience behind them and move on to live full lives.
The board-certified and fellowship-trained specialists at the Brain Tumor Center have the training and experience to know which emerging or established treatments to employ against a comprehensive range of brain tumor types. The Brain Tumor Center is a collaboration of Norton Neuroscience Institute and Norton Cancer Institute. The center’s specialists are actively involved as principle investigators in clinical trials of new and experimental treatments.
A full range of treatment options for each case is reviewed weekly by the brain Tumor Board, a gathering of all the center’s specialists to review each patient’s progress and next steps. Sharing their expertise and experience, physicians specializing in neuro-oncology, neurosurgery, radiation oncology, behavioral oncology, neuropathology, neuroradiology and neuropsychology collaborate to create a customized approach for each patient and their family.
The pros and cons of various options are discussed and weighed before the team determines a customized, coordinated treatment plan for your case.
The Brain Tumor Center allows scheduling a single appointment for the same day at the same location where you are able to meet with all specialties needed for your care to minimize travel.
A brain tumor treatment plan may include surgery, chemotherapy, immunotherapy, radiation, tumor treating fields or combinations of various treatment plans.
With same-day appointments for newly diagnosed patients, more people in Louisville and Southern Indiana trust their care to Norton Cancer Institute and Norton Neuroscience Institute than any other providers.
Brain Tumor Surgery
Brain surgery by opening the skull — craniotomy — is a common procedure for removing a brain tumor. If possible, the entire tumor is removed, but your neurosurgeon will be careful not to damage vital brain tissue. If only part of the tumor can be removed, the remaining part can be targeted with chemotherapy, radiation or other advanced treatments.
Increasingly, brain tumors are treated with minimally invasive surgery that involves small holes in the skull where precise tools are inserted for biopsy or precise robot-assisted treatment. Advances in radiation therapy, which targets high-energy X-rays at the tumor while sparing nearby healthy tissue, also have allowed some patients to avoid a craniotomy.
Minimally Invasive Technology
Laser interstitial thermal therapy (LITT) is a new technique used at the Brain Tumor Center to kill the tumor precisely with heat. Using advanced imaging, including a 3D map of the brain, your physician uses the NeuroBlate LITT device to plot a path to the tumor that avoids vital brain functions and delivers treatment only to the tumor, sparing surrounding healthy tissue.
The ROSA robotic system provides our surgeons with even greater precision by helping guide the LITT tool to the tumor.
The 3D imaging helps surgeons use ROSA’s robotic arm to thread tiny tools through holes the width of a spaghetti noodle to the source of the tumor. ROSA often allows surgeons to avoid a craniotomy to access the tumor.
Brain Tumor Radiation
Using high-energy X-rays, our radiation oncologists can target your tumor precisely from the outside. Radiation therapy typically is used after surgery and sometimes in combination with chemotherapy.
The Brain Tumor Center uses a complete range of tools to deliver radiation directly to the tumor while sparing surrounding healthy tissue.
TrueBeam STx equipment is a radiosurgery system that allows radiation oncologists to target tumors that may be hard to reach in surgery. Images that capture the shape and location of your tumor — as well as your natural breathing movements — allow the radiation beams to target your tumor without the need to attach a halo to your skull to hold you steady.
Stereotactic radiosurgery — A high dose of radiation administered, usually in a single treatment, to the tumor while sparing healthy tissue. The radiation damages the tumor cells’ DNA, making them incapable of reproducing, and closes off the blood vessels to the tumor. Eventually, the tumor withers.
To avoid harming healthy tissue, the procedure aims multiple beams of radiation at the tumor from multiple directions. Each beam by itself isn’t harmful, but when all the beams meet at the site of the tumor, their effect is significant.
Intensity-modulated radiation therapy (IMRT) — Higher doses of radiation are delivered to the tumor, and surrounding tissue gets lower doses. The intensity of individual beams is changed, or modulated, to put the most intense dosage on the tumor.
Brain Tumor Chemotherapy
Chemotherapy uses drugs to destroy cancer cells. Chemotherapy, possibly in combination with radiation therapy, typically is used after surgery if the tumor couldn’t be removed completely or if it returns.
Chemotherapy can be taken orally in pill form or injected into a vein (intravenously), depending on the specific drug or treatment plan.
The body’s natural blood-brain barrier protects the brain from possible toxins in the blood while allowing nutrients in. Some chemotherapy drugs are better than others at crossing this barrier. Some chemotherapy treatments involve implanting small wafers at the site of the tumor’s surgical removal to deliver medication.
During treatment, you will have regular magnetic resonance imaging (MRI) scans to monitor whether the tumor is responding to the treatment. Chemotherapy side effects depend on the patient and the dosage, but usually go away after treatment is finished.
Brain Tumor Treating Fields
Tumor treating fields (TTF) deliver an electric field to the outside of the patient’s head intended to disrupt tumor cells’ ability to grow and spread.
Also known as alternating electrical field therapy, brain tumor treating fields have been shown to be an alternative to chemotherapy for patients with glioblastoma. Newly diagnosed glioblastoma patients appear to benefit if the tumor treating fields are combined with chemotherapy treatments and radiation therapy.
Small transducers are attached with adhesive to the patient’s head. The TTF device is about the size of a book and delivers continual therapy. TTF have been approved for glioblastoma treatment.
Immunotherapy for Brain Cancer
The Brain Tumor Center team is regularly involved in clinical trials to evaluate new treatments, including immunotherapy.
Immunotherapy treatment takes advantage of a patient’s own immune system to help kill cancer cells. Immunotherapy has been proven to extend the lives of patients with certain types of cancer.
Immunotherapy agents have been approved for metastatic brain tumors — cancer that has spread to the brain from other parts of the body.
Immunotherapy is showing promise in the treatment of brain cancer, but currently, there are no FDA-approved immunotherapy agents to treat primary brain tumors. Immunotherapy trials for brain cancer are ongoing.