Fighting Brain Tumors and Cancer with Today’s Most Advanced Techniques

March 9, 2009

Experts at Floyd Memorial Hospital and the Cancer Center of Indiana bring together the latest advances in neurosurgery, radiation and chemotherapy to provide powerful treatment for patients who are faced withbrain tumors and/or cancer. Neurosurgeon Michael Doyle, MD, Radiation Oncologist John Bechtel, MD, and Medical Oncologist and Hematologist Aftab Chaudhry, MD, provided information on some of the latestadvancements in the treatment of brain tumors and cancer.

Stereotactic Neurosurgery and Biopsies

As Dr. Doyle explained, “Stereotactic navigation in neurosurgery is a dramatic advancement that offers significant advantages. By showing us the exact location of a tiny probe within the brain, it makes
surgery much more straightforward. We can make a very small incision, come right down on the tumor,
avoid delicate structures in the brain and see the full extent of the lesion.” “This remarkable technology also allows us to perform minimally invasive biopsies,” said Dr. Doyle. “Many times we don’t know
whether the lesion in the brain is benign or malignant or something infectious like an abscess. If it’s too deep to remove, in a bad location or we are unsure of the diagnosis, we can make a small incision and use
stereotactic navigation to guide a tiny needle into the lesion. We can then send tissue to the lab and get feedback while the patient is still in surgery.”

Radiation Therapy

“At the Cancer Center of Indiana,” said Dr. Bechtel, “we treat brain tumors of all types, including benign tumors, malignancies that metastasize from the lung or breast as well as primary brain tumors. Therapy ranges from external beam radiation to IMRT to stereotactic radiosurgery for tumors in critical
locations. In developing our programs of treatment for patients, we work closely with medical oncologists and neurosurgeons.” According to Dr. Bechtel, “IMRT, or Intensity Modulated Radiation Therapy, allows us to shape our radiation dose with extreme accuracy. We can deliver powerful radiation to the tumor while sparing critical structures such as the brain stem or the nerves that go to the eyes or ears.”

Chemotherapy

“The survival rate for brain cancer is not as good as with many types of cancer,” said Dr. Chaudhry. “We are constantly searching for more effective ways to treat it, and we participate in many clinical trials.” As Dr. Chaudhry explained, “One recent advancement in chemotherapy for certain brain cancers is the Gliadel® wafer. It is a dime-sized wafer that delivers a chemotherapy drug directly into the surgical cavity created
when a brain tumor is removed. The wafers are implanted along the walls of the cavity and difuse the medication slowly as they dissolve.” “Currently we use Temozolomide orally along with radiation therapy after surgical resection of the Glioma. Another approach involves new drugs such as Avastin®,” said Dr. Chaudhry. “Avastin inhibits the growth of the vascular system in the tumor, restricting its blood supply. Used in combination with chemotherapy drugs, it is improving the response rate by as much as 30 percent.”