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Central Nervous System Cancer

MR image of a brain following successful tumor therapy.

MR image of a brain following successful tumor therapy.

The neurosurgical team at Virtua Our Lady of Lourdes Hospital is trained and experienced in neurosurgical treatment of cancers of the central nervous system.  Tumors of a variety of types with different growth rates may be located in the brain, spinal cord, nerves, skull or spine, and they may be noncancerous (benign) or cancerous (malignant).   They may be a primary growth from the local tissues or a metastatic spread from a cancer in another part of the body. They are not among the most common types of cancers, and some primary forms are rare.

Types of primary brain tumors include gliomas, meningiomas, acoustic neuromas (schwannomas), pituitary adenomas, medulloblastomas, PNET (primitive neuroectodermal tumors), germ-cell tumor and craniopharyngiomas.

More common in the central nervous system are secondary tumors, which are other types of cancers that have spread from another location.   The most common types of cancers to spread to the brain or other parts of the nervous system are cancers of the breast, colon and lung.

Imaging studies are very important in determining which of these types of cancers a central nervous system tumor is.   Some combination of CT, MR or PET imaging, and sometimes a needle biopsy of the tumor, is key to diagnosing these cancers.   The neurosurgical team may also use imaging during operations to better target brain tumors.

The neurosurgeons work closely with radiation oncologists and medical oncologists to create the most effective and individualized treatment plan, which will depend on the type, size and location of the tumor, as well as other aspects of the patient’s medical status.   If the tumor is accessible, removal to the extent possible, is usually recommended.

In some cases, the team can use endovascular procedures to block blood supply to tumors in the brain, head or neck.   Images produced by the biplane radiology system in the operating room aid these dual-trained neurosurgeons in performing these neurointerventional procedures, which may be used in addition to or instead of surgical removal of the tumor or other forms of treatment.

The team uses radiation therapy and drug and chemotherapy to whatever greatest advantage possible, sometimes sequencing these treatments before and/or after surgical treatment.   The staff may also refer patients for radiosurgery, a type of “surgery” using highly focused radiation beams.  Robotic radiosurgery using the Cyberknife technology is a non-invasive alternative to surgery for tumors anywhere in the body, including the brain and spine.   The treatment delivers beams of high-dose radiation to cancers with extreme accuracy.   It involves no cutting, instead providing a nonsurgical option with minimum pain for patients who have inoperable or surgically complex tumors, or who may be looking for an alternative to surgery.   The team includes Cyberknife-qualified neurosurgeons.

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