From the Body to the Brain: Treating Metastatic Brain Tumors
By Alain C.J. de Lotbinière MD, CM, FRCSC, FACS, Medical Director of the Gamma Knife Center at Northern Westchester Hospital
Most brain tumors begin elsewhere in the body. Although there is a great deal of awareness around Breast Cancer and Lung Cancer, what most people don’t realize is that these two cancers are the most common source of aggressive, metastatic brain tumors, according to the American Brain Tumor Association. Cancers of the colon, kidneys, and skin can also spread cancer cells to the brain. That’s grim news, but neurosurgeons are finding new ways to treat brain cancer.
Between 20 and 40 percent of patients with a cancer diagnosis elsewhere in the body develop metastatic brain cancer. The symptoms often show up as headaches, seizures, muddled thinking, a loss of balance, changes in vision and weakness in the limbs. If an oncologist suspects a patient is at risk, he or she may suggest a CT scan or a MRI to check for tumors in the brain.
Surgery is sometimes an option: If the tumor is easily accessible and the patient is in good health, a brain surgeon may remove as much of the cancer as possible. However, with a metastatic tumor, neurosurgeons may opt to do something called stereotactic radiosurgery. This technique doesn’t involve scalpels, despite the name: Instead, surgeons deliver a concentrated dose of gamma radiation to the cancerous growth. The device they use is called a Gamma Knife, and research suggests that the procedure is much safer for the patient and more effective than older methods. What’s more, neurosurgeons are now able to target multiple tumors with the Gamma Knife; in the past, such patients would get radiation treatment to the entire brain, raising the risk of dementia and other side effects.
Northern Westchester Hospital (NWH) is home to the only Gamma Knife in Westchester County, and has been treating patients using this technology since 2005. The patients are able to go back to their normal life within hours of the procedure. Gamma Knife Perfexion, currently being used at NWH, is the most advanced model to-date.
The Gamma Knife can also reach tumors in the head and neck that were previously untreatable. One 30-minute treatment can shrink a tumor and prevent future growth, Dr. de Lotbinière says. Because there’s no incision, patients are able to go back to their normal life within hours of the procedure. Gamma Knife Perfexion is the gold standard for radiosurgery. The machine is easier to use, more precise, and safer for the patient.
Editor’s Note: Dr. de Lotbinière has been treating patients with a multitude of intracranial disorders using stereotactic radiosurgery since 1991. He has performed over 1,000 stereotactic radiosurgical interventions and is recognized worldwide as a leading authority in the field. He was the first director of the Gamma Knife Center at Yale, having introduced the technology there in 1998.