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Brain Tumors

We are national leaders in treating brain tumors with the most innovative and successful techniques and treatments. Patients travel from across the country to receive treatment from our world-class surgeons and highly experienced healthcare team. These surgeries are performed in AHN’s state-of-the-art operating suites that incorporate sophisticated imaging technology with advanced instrumentation and monitoring for superior outcomes. 

Our experts from neurosurgery, neurology, radiation oncology and medical oncology coordinate your individualized treatment plan that results in eliminating or managing your brain tumor, including:

Benign and skull base tumors​

  • Acoustic neuroma
  • Arachnoid cyst
  • Chordoma
  • Colloid cyst
  • Dermoid and epidermoid tumor
  • Glomus jugulare tumor
  • Hemangioblastoma
  • Meningioma
  • Pinealoma
  • Vestibular schwannoma

 

Malignant tumors

  • Astrocytoma
  • Cognitive disorders due to brain tumor
  • Ependymoma
  • Esthesioneuroblastoma
  • Germinoma
  • Gliosarcoma
  • Glioblastoma multiforme
  • Metastatic brain tumor
  • Mixed-malignant glioma
  • Oligodendroglioma
  • Para-neoplastic syndromes due to systemic cancer
  • Pineal region tumors
  • Primary central nervous system lymphoma
  • Primitive neuroectodermal tumors (medulloblastoma, neuroblastoma)

 

Symptoms

Brain tumor symptoms depend on the type, size and location of the tumor. They symptoms can be general – caused by the pressure of the tumor on the brain or spinal cord – or they can be specific – caused when a particular part of the brain is not working properly because of the tumor. Sometimes, people with brain tumors experience no symptoms, but generally people experience one or more of these symptoms:

  • Headaches
  • Seizures
  • Changes in your vision, smell and hearing 
  • Personality or memory changes
  • Motor and balance problems
  • Nausea or vomiting
  • Fatigue

Diagnosis

At the AHN Neuroscience Institute, we will schedule your appointment with a neurosurgeon or neuro-oncologist quickly and efficiently to begin testing your condition. Our multidisciplinary team from various medical specialties will evaluate your test results and collaborate to develop an accurate diagnosis and most effective treatment plan.

Our highly specialized and advanced testing includes:

Computed tomography scan (CT or CAT scan) uses a combination of X-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of your body. A CT scan is more detailed than general X-rays and shows detailed images of any part of the body, including the bones, muscles, fat and organs.

Magnetic resonance imaging (MRI) uses powerful magnets and radio waves to produce detailed images of organs and structures within your body.

Positron emission tomography (PET) scan is a test where a radioactive-tagged glucose (sugar) is injected into your bloodstream and then a scanner takes images of your body. Tissues that use the glucose more than most normal tissues (such as tumors) can be detected by the scanning machine and will show up on the images.

Cerebral arteriogram is an X-ray, or series of x-rays, of the head that shows the arteries in the brain. X-rays are taken after a contrast medium is injected into the main arteries of your head.

Lumbar puncture or spinal tap is a procedure where a doctor uses a needle to take a sample of cerebrospinal fluid to look for tumor cells, blood or tumor markers. Tumor markers or biomarkers are substances found in higher than normal amounts in the blood, urine, spinal fluid, plasma or other bodily fluids of people with certain types of cancer. Typically a local anesthetic is given to numb your lower back before the procedure.

Biopsy is the removal of a small amount of tissue for examination under a microscope and is the only definitive way a brain tumor can be diagnosed. The sample removed during the biopsy is analyzed by a pathologist. A biopsy can be done as part of surgery to remove the entire tumor or as a separate procedure if surgical removal of the tumor is not possible because of its location or a patient’s health.

Molecular testing involves typing a tumor sample to identify specific genes, proteins and other factors, such as tumor markers, unique to the tumor. Researchers are examining biomarkers to find ways to diagnose a brain tumor before symptoms begin. Results of these tests may help decide your treatment options.

Neurocognitive assessment is a detailed evaluation of all major functions of the brain, such as storage and retrieval of memory, expressive and receptive language abilities, calculation, dexterity, and your overall well-being. The results are used for comparison with future assessments or to identify specific problems that can be helped through treatment.

Electroencephalography (EEG) is a noninvasive test in which electrodes are attached to the outside of a person's head to measure electrical activity of the brain. It is used to monitor for possible seizures.

Evoked potentials involve the use of electrodes to measure the electrical activity of nerves and can often detect acoustic schwannoma, a noncancerous brain tumor. This test can be used as a guide when removing a tumor that is growing around important nerves.

Treatments

To treat a brain tumor, we unite various doctors who specialize in different areas of medicine to create a comprehensive treatment plan that will address every aspect of your condition. Our multidisciplinary team includes neurosurgeons, neuro-oncologists, medical oncologists, radiation oncologists, nurses, social workers, rehabilitation therapists, neuropsychologists and other healthcare specialists.

Our extensive treatment options include:

Surgery

AHN surgeons are among the most skilled in the country and perform procedures that are being done at only a handful of medical facilities. We utilize the latest techniques and technologies, including minimally invasive and endoscopic surgeries where patients experience minimal impact to their body and a rapid recovery.

Our advanced surgical options include:

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

Awake craniotomy is performed in the same fashion as a conventional craniotomy, but you are awake 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.

Skull base surgery involves drilling bone located at the bottom of the brain. Requiring many years of training because much of the brain’s vessels and important nerves are located here, the surgeon is able to access lesions through safe corridors with minimal trauma to the brain. We are a major referral center with many surgeons from around the world visiting our network to learn of the latest techniques, and we are actively developing minimally invasive skull base techniques.  Our eyelid incision technique is being utilized throughout the neurosurgical community.

Endoscopic minimally invasive surgery is a procedure that can be performed to remove tumors with little impact to your body. The AHN Neuroscience Institute is one of only a few medical facilities in the country with the expertise to perform these surgeries. By inserting a device smaller than a pencil with a light and camera built into it, surgeons can access corridors of the brain with minimal trauma.

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 in order to identify 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 involving the pituitary gland. Neurosurgeons remove the tumor by inserting an endoscope – a device smaller than a pencil with a light and camera built into it – through your nose and to the pituitary gland.

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 without surgery. 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.

Laser ablation is a minimally invasive technique where a laser probe is inserted inside the tumor, and the laser is directed toward the tumor to destroy it. Using live MRI, surgeons are able to visualize the tumor ablation in real time. The incision is typically a small nick in the skin.

Ultrasound can be utilized during brain surgery to break up brain tumors so they can be removed easily. Ultrasound can also be used to localize tumors for targeting.

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. This drug is being used at AHN as part of a clinical trial study.

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.