The UK Neuro-oncology clinic offers an integrated, multispecialty program for the diagnosis and treatment of patients with primary and secondary central nervous system tumors.
The clinic allows quick evaluation, treatment expertise and access to new therapies and clinical trials all under one roof. The multispecialty program allows for a neurosurgeon, a neuro-oncologist and radiation medicine experts to see patients in one visit, creating more time for the patient as well as the doctors.
The clinical programs and services of the neuro-oncology program are integrated with the Markey Cancer Center. The Markey specialty teams work together with UK Chandler Hospital departments and divisions to provide primary patient care and support services as well as advanced specialty care with applicable clinical trials. All diagnostic services, clinical and pathology laboratories, operating rooms, emergent and intensive care, and radiation therapy services are also provided to cancer patients through UK Chandler Hospital.
Due to the complexity of cancer, the Markey Cancer Center takes a team approach to cancer treatment. Our teams include a dedicated primary nurse, an oncology nurse care manager, a dietitian, a social worker, a pharmacist, a chaplain, volunteers and a physical or enterostomal therapist if necessary. However, the most important members of our teams are our patients and their families.
The specific neurological abnormalities that a person with a brain tumor experiences vary from person to person and depend on where in the brain the tumor is located. For example, if the tumor invades the motor regions of the brain (areas responsible for movement of the skeletal muscles, such as those in the arms and legs), patients can show signs of motor weakness on the opposite side of the body (one side of the brain controls the opposite side of the body). The arms and legs on the opposite side of the body may be stiff or move awkwardly.
When the areas of the brain responsible for sensing the environment - the sensory structures - are damaged, a person may feel tingling, numbness or other odd sensations.
People may not be able to recognize parts of their environment. For example, if the tumor obstructs the visual pathways, in addition to vision loss, patients may not be able to recognize objects by looking at them. If the tumor is in the temporal lobe of the brain, a person may see hallucinations or experience other unusual perceptions. If the tumor is in the frontal lobe, a patient may have bowel and bladder problems.
Different types of treatments are available for patients with brain tumors. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials.
Surgery is used, when possible, to treat adult brain tumor. The tumor is first diagnosed and next removed in surgery. If a brain tumor is suspected, a biopsy is done by removing part of the skull and using a needle to remove a sample of the brain tissue. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are found, the doctor will remove as much tumor as safely possible during the same surgery. An MRI may then be done to determine if any cancer cells remain after surgery. Tests are also done to find out the grade of the tumor.
Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy:
- External radiation therapy uses a machine outside the body to send radiation toward the cancer.
- Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires or catheters that are placed directly into or near the cancer. How the radiation therapy is given depends on the type and stage of the cancer being treated.
There are also several newer methods of delivering radiation therapy, including:
- Radiosensitizers: Drugs that make tumor cells more sensitive to radiation. Combining radiation with radiosensitizers may kill more tumor cells.
- Hyperfractionation: Radiation therapy given in smaller-than-usual doses two or three times a day instead of once a day.
- Stereotactic radiosurgery: A radiation therapy technique that delivers radiation directly to the tumor with less damage to healthy tissue. The doctor uses a CT scan or MRI to find the exact location of the tumor. A rigid head frame is attached to the skull and a high dose of radiation is directed to the tumor through openings in the head frame, reducing the amount of radiation given to normal brain tissue. This procedure does not involve surgery. This is also known as stereotaxic radiosurgery or Gamma Knife therapy.
Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). A dissolving wafer may be used to deliver an anticancer drug directly into the brain tumor site after the tumor has been removed by surgery. How the chemotherapy is given depends on the type and stage of the cancer being treated.
With Gamma Knife radiosurgery, our neuroscience team can treat neurological (brain) disorders and diseases without invasive surgery. The system's leading-edge technology allows our specialists to operate on the brain without general anesthesia or incisions.
Hyperthermia therapy exposes body tissue to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs.
Biologic therapy uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
Treatment in a Clinical Trial
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from coming back or reduce the side effects of cancer treatment.
Tumors that have spread to the brain from somewhere else in the body are usually treated with radiation therapy and/or surgery. Chemotherapy may be used if the primary tumor is the kind that responds well to chemotherapy. Clinical trials are under way to study new treatments.