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Treating Brain Tumors at the Cancer Center

April 20, 2017

Brain tumors, a growth of abnormal cells in the brain, can be either benign or malignant.

At the Brain and Spine Tumor Center at UF Health Cancer Center - Orlando Health, we treat all types of tumors, including primary brain tumors, which begin in the brain, and secondary brain tumors, which begin in another part of the body but spread to the brain.

As one of the country’s largest and most advanced centers for treating cancers of the brain and spine, we’ve helped thousands of patients. We use a multidisciplinary team approach and create individualized treatment plans for patients, leading to improved outcomes and improved quality of life for many people.

Understanding Brain Tumors

On average, there are 25,000 new cases of primary tumors every year in the U.S. The most common type of primary tumors in people up under age 70 are called gliomas, which are diffuse and infiltrated tumors that have various grading systems ascribed to them. The second most common type of primary tumors are meningiomas (nearly 37 percent of all primary tumors)  and pituitary angiomas, which account for about 16 percent of all primary tumors.

There are dozens of other types of primary brain and spine tumors, as well.

Secondary brain and spine tumors outnumber primary tumors, with an estimated 200,000 to 250,000 cases a year. Secondary tumors, also called metastatic brain tumors, often spread from the lung to brain, the breast to brain or from the colon to the brain. In recent years, a disproportionately larger number of melanomas (skin cancer) have spread to the brain.

At the Cancer Center, we see people at all stages of the condition. However, we often see patients after they come to the emergency room with an onset of symptoms that was initially considered a stroke. In other cases, a neurological specialist may find something that suggests a lesion in the brain or an imaging scan may show a lesion or sign that requires further assessment.

Treatment for Brain Tumors

After a tumor is found, we then try to determine whether it’s primary or secondary, so we can decide on a treatment approach. With brain and spine tumors, treatment decisions are quite complex and the gravity of the decision-making is quite intense because some of these tumors are disproportionately disabling and lethal.

When we discover a brain tumor in a patient, we have to consider all the risks and benefits of the next steps in treatment. The brain is a very sensitive organ and is responsible for many of the body’s core functions, so the difficult balancing act for any doctor is to pursue a treatment approach that will remove the tumor or reduce its effects without adversely affecting other parts of the brain.

Whether treatment involves surgery, radiation therapy, chemotherapy or targeted therapies, we put together a sequenced treatment plan that is individualized for every patient. We’re also unique in our multidisciplinary team approach to care. I work with several sub-specialists who are experts in their field, including a neuropathologist who provides the diagnosis, a neuroradiologist who evaluates the characteristics of the tumor, a neuro-radiation oncologist who manages the treatment and ancillary support teams like physical and occupational therapy, speech therapy, medicine and rehabilitation. We also have a multidisciplinary Brain & Spine Tumor conference, where we do decision making and treatment planning together and always advocate for the most beneficial treatment for patients. Working together in this way provides comprehensive management of a patient’s condition.

Our ultimate goal with every patient we treat is to remove the tumor, but sometimes this isn’t possible without a high risk for things like brain swelling, bleeding, a blood clot, memory problems or impaired speech, vision or movement issues. We often make a decision about further treatment recommendations after we remove most or all of the tumor during surgery, or if that’s not possible, then radiation or biochemotherapy will be considered for the patient.

We may screen patients for clinical research studies or use advanced treatment approaches like radiosurgery, which treats small, localized tumors, or proton therapy, a new form of targeted radiation therapy that treats tumors while minimizing harm to the healthy tissue that surrounds them.

A tumor is a shocking diagnosis for many patients, and figuring out the next steps can be difficult. However, it’s important for patients and their advocates to ask for second opinions after an initial diagnosis and seek collaborative approaches when it comes to their care. Also, not every hospital will offer advanced treatment options. There only are certain prescribing sites where a patient can gain access to particular interventions, whether that’s in the context of a clinical research study or newly FDA-approved, best-in-class interventions like tumor treatment fields or electromagnetic waves that disrupt the growth of cancer cells.

Thousands of people will be diagnosed with primary and secondary brain tumors this year, but we strive to help them with advanced treatments and a collaborative approach that gives patients the best possible care. Working together — through diagnosis, treatment and recovery — gives patients more support throughout this difficult process and drives better treatment outcomes. And at the end of the day, that is our ultimate goal.

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