Cancer Treatment Centers of America


"My overall goal for my patients is to deliver excellent care and treatment using advanced and innovative technologies in order to achieve the best possible outcome for patients with brain and spinal tumors."

-Dr. Juan Alzate, Neurosurgeon

Our department

The Neurosurgery Services Department at Cancer Treatment Centers of America (CTCA) provides innovative treatment options for neurological cancers and neurologic problems resulting from other cancers or treatments.

The Neurosurgery Services Department treats the following:

Understanding neurological cancers

The brain and spinal cord together make up the central nervous system (CNS). Cancer can begin in the CNS or, more commonly, it can spread there.

Primary brain tumors are tumors that form from cells within the brain. Some types of primary brain tumors include: glioblastoma, astrocytoma, oligodendroglioima, oligoastrocytoma, ependymoma and medulloblastoma.

Metastatic brain tumors are tumors that spread (metastasize) to the brain from another location in the body, such as the lung, colon, breast or kidney. Metastatic brain tumors are more common than primary brain tumors.

Primary spinal cord or column tumors are tumors that form from cells within the spinal cord itself or from its surrounding structures. Most tumors of the spine are metastatic tumors, which spread to the spine from another location in the body.

Experienced neurosurgical team

Our neurosurgical team includes: a neurosurgeon, radiation oncologist, medical oncologist, pathologist, psychologist, rehabilitation therapist and other cancer experts across a variety of disciplines.

When you arrive at CTCA, your team will review your symptoms with you and obtain a health history. We use advanced imaging technology to evaluate the tumor(s), such as MRI, PET scans and/or CT scans. We may also obtain tissue in the form of a biopsy or, sometimes, perform full surgical resection of the tumor. Once we determine the location, type and grade of the tumor, we can plan your individualized, fully integrated treatment.

Advances in treatments & technologies

Our comprehensive neurosurgical treatment program provides a full range of options for primary and metastatic cancers of the brain, spinal cord and peripheral nerves, as well as neurological problems resulting from other cancers.

Your treatment plan may include: traditional surgical approaches (e.g., resection of the tumor), radiation therapy, chemotherapy, and/or immunotherapies.


Brain surgery and spinal surgery typically focuses on removing the tumor in its entirety. In the past, the surgeon would make large incisions to remove the tumor. Today, we’re often able to use more minimally invasive surgical techniques.

Where possible, endoscopy, which positions a camera next to the brain tumor, may allow for smaller surgical incisions while still allowing for complete tumor resection. The following are some potential advantages:

  • Improves speed of recovery
  • Lessens pain during recovery process
  • Allows other cancer treatments to resume sooner
  • Helps patients return to normal activities more quickly

In addition, we use some of the most sophisticated tools for intraoperative electrophysiology "brain mapping" and intraoperative neuronavigation. Both tools help enhance the safety of brain tumor treatment.

Minimally invasive neurosurgery

CTCA at Midwestern is among the first hospitals in the country to offer a new minimally invasive surgery for patients with deep subcortical tumors and cysts, using the 6 Pillar Approach. The new approach integrates several advancements in neurosurgery, allowing doctors to resect tumors that were often previously deemed inoperable due to factors such as location within the brain and tumor size.

During the procedure, surgeons access the brain through an opening the size of a dime, and use brain mapping, GPS navigation technology and a tool called the BrainPath® to safely move through the natural folds and delicate fibers of the brain to reach the tumor. This allows surgeons to displace tissue rather than cutting it, thereby helping to lower the risk of damage to healthy brain tissue and to lower the risk of complications from surgery. Once in place, the BrainPath creates a clear passageway for surgeons to maintain access to the tumor. They then use a tool the size of a pencil to resect or remove the mass.


Significant advancements have been made in both the delivery of local chemotherapy and chemotherapy that's given orally or intravenously. Our doctors can deliver chemotherapy locally to the brain (also known as Gliadel®, or BCNU, wafers) at the time of surgical resection. Since chemotherapy is administered as close as possible to the brain tumor edges at the resection area rather than systemically (through the veins), this technique may help to reduce typical chemotherapy-related side effects.

Radiation therapy

Our doctors also use intraoperative radiation therapy (IORT), presently under investigational use, to deliver radiation directly to the area of the tumor resection. This may help avoid damage to surrounding normal structures, particularly the scalp and the skin on the scalp. It may also allow for higher doses of radiation to be delivered along the edges of the tumor while sparing areas of the brain without the tumor.

Stereotactic radiation therapy (SRT) may be used to treat metastatic brain cancer, particularly for tumors in more than one location. This may help to avoid the pain, discomfort and recovery time associated with surgery.

Preserving mobility & controlling pain

Tumors in the brain and spine, or neurological problems caused by other cancers, can present unique challenges. Spinal cord compression can cause pain and make it difficult to walk or move the legs. Neurological dysfunction can also interfere with your ability to communicate with others and cause depression.

We recognize the importance of helping you control pain and maintain your mobility so you can continue treatment without complications like pneumonia, other infections or paralysis. With therapies like surgery and radiation, the neurosurgical team can alleviate pain and help you maintain your mobility.

The neurosurgery team at Midwestern

If you have primary or metastatic brain or spinal cord cancer, it’s important to be seen by an integrated team of physicians with expertise in performing cancer-related surgical procedures on the nervous system and its supporting structures, including the brain, spinal cord, nerves, and spinal column.

At CTCA at Midwestern Regional Medical Center, you’ll find an expert multidisciplinary neurosurgical team. Led by neurosurgeon Dr. Juan Alzate, the neurosurgical team works together to understand your individual needs and provide advanced, fully integrated treatments.

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