Cancer Treatment Centers of America

Neurosurgery

neurosurgery alzate

What is neurosurgery?

Neurosurgery is surgery performed on parts of the nervous system, such as the brain and spinal cord. The Neurosurgery Services Program at Cancer Treatment Centers of America® (CTCA) provides a wide range of innovative treatment options for:

Experienced care team

If you have a neurological cancer, it's important to be seen by a multidisciplinary team of physicians with expertise in performing cancer-related surgical procedures on the nervous system and its supporting structures.

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

Learn about our neurosurgery programs at our hospitals in Philadelphia, Tulsa and suburban Chicago.

Individualized treatment approach

When you arrive at our hospital, the neurosurgical 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 a surgical resection of the tumor. Once we determine the location, type and grade of the tumor, we can plan your individualized treatment.

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

Surgery

Brain surgery and spinal surgery typically focus on removing the tumor in its entirety. In the past, the surgeon would make large incisions to remove the tumor. Today, our neurosurgeons are often able to use more minimally invasive surgical techniques. When performing minimally invasive spinal surgery, for example, our neurosurgeons use small incisions and tubes to remove the tumor with fewer impacts on muscle tissue. This technique may help reduce pain and speed up recovery, while still allowing our neurosurgeons to decompress the nerves of the spinal cord and, in some cases, reach intradural spinal tumors, or those located between the membranes of the lining around the spinal cord (dura mater).

Where possible, endoscopy, which positions a camera next to the brain tumor, allows for smaller surgical incisions while still allowing for complete tumor resection. This may shorten recovery time, lessen pain and help patients return to normal activities more quickly.

We also use sophisticated tools that enhance the precision and safety of brain cancer surgery. These tools allow us to remove tumors that may otherwise have been inoperable, while preserving neurologic function:

  • Intraoperative neuronavigation uses an advanced MRI system to map areas of the brain responsible for important functions. The map then allows us to precisely plan surgery to help avoid damage to those important areas.
  • Intraoperative electrophysiology “brain mapping” (also called motor mapping and language mapping) is like GPS for the brain. We use small electrodes placed on the outer layer of the brain to stimulate the brain and areas around the tumor. This helps us locate regions of the brain to avoid, such as those responsible for speech or movement.

Chemotherapy

Our doctors may 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, this technique may help to reduce typical chemotherapy-related side effects.

Radiation therapy

Our doctors also use intraoperative radiation therapy (IORT) 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 helping to spare healthy areas of the brain.

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.

Addressing motor and speech impacts

During brain and spinal surgeries, our neurosurgeons use nerve monitoring technology to help ensure that the patient’s motor function is not being damaged by the procedure.

For patients with lesions in the areas of the brain that control speech and motor function, our neurosurgeons may recommend awake craniotomy procedures as an extra layer of assessment, to help avoid damage to those key functions. During these procedures, patients who meet certain criteria are placed under light sedation. Patients are then woken up while the tumor is being removed, and speech or physical therapists work with them to make sure they have not lost motor or speech function. Once the tumor resection is complete and the care team is confident the patient has not lost function, the patient is placed back under sedation for the remainder of the procedure.

Preserving mobility & controlling pain

Neurologic cancers of the brain and spine, or neurologic problems caused by other cancers, may present unique challenges, including mobility and communication difficulties. Your care team will offer a variety of supportive care services to help address these challenges throughout your care, so you are better able to continue treatment without complications.

Learn more about

Neurosurgery - Dr. Clinton Baird

Neurosurgery - Dr. Juan Alzate