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Brain & Spinal Cord Care

We have assembled a multidisciplinary team of surgical, radiation and medical oncologists who work together to develop an optimal treatment plan for you. This spectrum of care ensures that you have access to every possible treatment, procedure and clinical trial best suited for your situation.
 
Our extensive treatment options include:
 

Surgery

The Cancer Institute’s skilled surgeons, who utilize the latest techniques and technologies, are among the most experienced in the country. Their expertise ensures the best possible outcome from your treatment.
 

Our advanced surgical options include:

Craniotomy is the surgical removal of part of the bone from your skull to expose the brain and remove a brain tumor. The bone is replaced after the brain surgery has been performed.

Awake craniotomy is performed in the same fashion as a conventional craniotomy, but you are awakened during surgery to make sure that critical parts of your brain are spared from being damaged by the surgery. For instance, because brain tumors are often located in areas of the brain that control speech, they need to be removed without harming such areas. This can be performed by identifying these areas, using electrical stimulation and monitoring your responses.

Cortical mapping is an advanced technology that our neurosurgeons use prior to removing tumors located near areas that control movement. You are asleep under anesthesia, but the procedure is performed in such a way that allows the surgeon to electrically stimulate brain areas and monitor responses while identifying critical tissue related to motor movement. With this sophisticated technology, the surgeon can remove as much of the tumor as possible while preserving all critical brain functions.

Endoscopic pituitary surgery is a minimally invasive technique that requires no incisions for removing tumors in the pituitary gland. Neurosurgeons remove the tumor by inserting an endoscope – with a microscope, light and camera built into it – through your nose and to the pituitary gland.

Endoscopic eyelid surgery allows the neurosurgeon to approach eyelid tumors without leaving a noticeable incision, allowing quicker recovery and less side effects.

Novocure portable device is a unique non-invasive instrument that uses electrical fields to slow, and possibly reverse, tumor growth. It involves placing electrodes on your scalp to deliver low-intensity electrical fields to the tumor site.

Stereotactic radiosurgery (SRS) involves a one-day outpatient procedure that delivers a single, focused high dose of radiation to a tumor. Our highly sophisticated and precise dosing and targeting system allows our surgeons to irradiate not only round and defined tumors, but also tumors of irregular shapes and sizes.

Stereotactic radiotherapy (SRT) involves giving you a series of radiation treatments (typically 3 to 5) over several days with your head placed in a removable head frame. Keeping your head positioned the same way during each treatment allows our doctors to accurately target the radiation toward the tumor while allowing minimal radiation exposure to surrounding normal brain structures. This fractionated method is an exceptional therapy for cases where the tumor is adjacent to critical structures, such as the brain stem, eyes or optical nerves. We also utilize this approach for acoustic neuromas.

5-aminolevunilic acid (5-ALA) is an orally administered drug given right before surgery to enhance the removal of primary brain tumors. It aids surgeons with identifying the tumor and surrounding healthy tissue by tagging the tumor with a fluorescent dye that can be visualized during the operation.

Radiation Oncology

With state-of-the-art technology and advanced computer software and imaging, our radiation oncologists can administer high-dose radiation beams directly to a tumor while minimizing exposure to surrounding healthy tissue and organs.

You can feel reassured that you are receiving the highest quality and safest radiation oncology care, as we are the country’s largest – and western Pennsylvania’s only – radiation oncology network accredited by both the American Society for Radiation Oncology and American College of Radiology. This means that the Cancer Institute meets specific practice guidelines and technical standards when it comes to patient care and treatment, patient safety, personnel qualifications, adequacy of facility equipment, quality-control procedures and quality assurance programs.

Our advanced radiation treatments include:

Image-guided radiotherapy (IGRT) is the use of daily imaging to deliver precise and accurate radiation treatment. With this technology, physicians can image the tumor immediately before or during radiation treatment, making necessary adjustments as needed for pinpoint accuracy and minimal harm to surrounding healthy tissue.

Intensity-modulated radiation therapy (IMRT) requires the use of sophisticated computer technology to map the precise dimensions and density of cancerous tumors. Then virtual treatment simulations are performed, and the radiation dose's shape and intensity is conformed to the simulation's exact parameters with minimal harm to surrounding healthy tissue. IMRT is often used together with IGRT.

Stereotactic radiotherapy (SRT) involves giving you a series of radiation treatments over several days (typically three to five) with your head placed in a removable head frame. Keeping your head positioned the same way at each treatment allows our doctors to accurately target the radiation toward the tumor while allowing minimal radiation exposure to surrounding normal brain structures. This fractionated method is an exceptional therapy for cases where the tumor is adjacent to critical structures, such as the brain stem, eyes or optical nerves. We also utilize this approach for acoustic neuromas.

Stereotactic radiosurgery involves a one-day outpatient procedure that delivers a single, focused high dose of radiation to a tumor. Our highly sophisticated and precise dosing and targeting system allows our surgeons to irradiate not only round and defined tumors but also tumors of irregular shapes and sizes.

Medical Oncology

Medical oncologists treat patients with systemic drugs that are designed to kill cancer throughout your body. They can be administered either by mouth (oral) or by vein (intravenous).

Our advanced therapies include:

Chemotherapy is the use of medicines that directly kill cancer cells, much like antibiotics kill bacteria. Side effects may occur, such as hair loss, nausea or lowered blood counts because these medicines can damage normal cells as well. Fortunately, your body’s normal cells are more resilient and recover much better than cancer cells. You are monitored carefully and the dose of chemotherapy is calculated to maximize effectiveness and minimize side effects. One example of a chemotherapy designed specifically for brain cancers is Gliadel® Wafer therapy. This treatment is an FDA-approved chemotherapeutic implant that is inserted directly into the area of the brain tumor during surgery.

Targeted therapy is the use of medicines that kill cancer cells in a different way. They attack specific genes within the tumor cells or in the surrounding blood vessels that help the tumor grow. Targeted therapies are much less toxic than chemotherapy and, in some cases, more effective. One example of targeted therapy used in central nervous system cancers is Bevacizumab. This is an Angiogenesis inhibitor medicine that works by attacking the blood supply to the tumor. This medicine reduces the swelling around a tumor and improves the ability of chemotherapeutic drugs to penetrate the tumor, which, in turn, shrinks the tumor.

Immunotherapy is a form of biological therapy designed to stimulate your own immune system to fight cancer. This therapy includes cancer vaccines, genetically engineered human immune stimulatory molecules, and monoclonal antibodies that enhance cellular immune function.

Neoadjuvant therapy is treatment given before surgery, including chemotherapy, hormonal therapy or targeted therapy. This may reduce the amount of tumor remaining at the time of surgery, allowing for a more conservative operation.

Adjuvant therapy is treatment given after surgery to reduce the chance of residual microscopic cancer cells remaining in the body. This may include chemotherapy, hormonal therapy, targeted therapy and/or radiation therapy.