Our Treatment Approach

Brain and Spinal Cord Tumors

Highly Skilled, Multidisciplinary Care
Gamma Knife Treatment
Neurosurgery Expertise
State-of-the-Art Techniques
Cutting-Edge Research

Highly Skilled, Multidisciplinary Care
At the Siteman Cancer Center, our brain and spinal tumor care team provides state-of-the-art diagnostic and treatment strategies for adults and children with newly diagnosed and recurrent tumors. Among these strategies are the very latest chemotherapy drugs, which are available through clinical trials. Many of our physicians also perform laboratory research that can be rapidly translated into new avenues of treatment.

Every week, the members of our team meet to discuss patient cases. Through this multidisciplinary approach, physicians in a number of clinical areas work together to provide patients with the best individualized care. Our group offers expertise in neuro-oncology, neurosurgery, neurology, neuropathology, neuroradiology, nuclear medicine and radiation oncology.

Gamma Knife Treatment
One special tool available to Siteman patients is the Gamma Knife, an advanced piece of equipment used to treat tumors and other abnormalities within the brain without an incision and with minimal effect on surrounding healthy tissue. For patients whose age or medical condition rules out surgery, the Gamma Knife can be a lifesaving tool. Siteman is the only cancer center in the St. Louis area to offer this innovative equipment.

The Gamma Knife works by focusing 201 beams of precisely targeted radiation on malignant or benign tumors. Some of these tumors cannot be reached through surgery. Others are resistant to radiation therapy or are multiple in number. Gamma Knife treatment is highly effective for smaller brain lesions and those that are near critical structures in the head, such as the brain stem and cranial nerves.

Gamma Knife procedures typically are performed on an outpatient basis, significantly reducing hospital stays and costs. Another benefit is fewer complications. Because this outpatient treatment is minimally invasive, most patients can resume normal activities the day after their procedure.

Neurosurgery Expertise
In 1999, Siteman neurosurgeons performed the first human magnetic surgery, which is a new and safer way of manipulating surgical tools within the brain. This technology allows surgeons to use computer-controlled superconducting magnets to direct instruments on a curved pathway around sensitive structures, such as those that control speech or vision.

In the past, neurosurgeons have used images of the brain to see a tumor, but they have not had any way to automatically navigate tools through the brain along an optimal path. To obtain a biopsy, for example, they have manually pushed a rigid needle toward a tumor, passing through unaffected brain structures. The magnetic surgery system directs a catheter to a predetermined part of the brain along a pathway planned by the surgeon.

Siteman neurosurgeons also are skilled at other sophisticated techniques for patients with brain and spinal cancers, including:

  • Measuring electrical activity in the brain to aid in surgery
  • Functional mapping protect important areas of the brain
  • Frameless stereotactic surgical guidance
  • Implantation of chemotherapeutic agents and radioactive seeds

State-of-the-Art Techniques
Radiation oncologists at Siteman work closely with neurosurgeons to provide patient care. They are expert at 3-D treatment planning, and they participate in current Radiation Therapy Oncology Group (RTOG) clinical trials, which test the latest treatment options.

Neuro-oncologists also are an integral part of the treatment team. These specialists treat brain and spinal cord cancer with chemotherapy agents and a variety of unique drug delivery methods, including intra-arterial chemotherapy, which involves injecting drugs directly into the artery feeding a tumor to increase the concentration of the drug where it is needed and decrease exposure to other areas.

Our state-of-the-art imaging capabilities include unique clinical trials of magnetic resonance imaging (MRI), which is used to view specific brain regions. We also use MRI to assess, in a noninvasive way, a tumor’s location with respect to functional brain areas. In addition, MR spectroscopy helps physicians differentiate tumor lesions from nontumor lesions. Finally, positron emission tomography (PET), an imaging capability developed by Siteman researchers, is used for locating and defining brain lesions.

Cutting-Edge Research
Our team includes clinical and basic science researchers who are studying the molecular biology and genetics of adult and childhood brain cancer and other nervous system tumors. The goal of these scientists is to improve diagnosis and treatment for patients with these diseases. Focus areas include:

  • Analysis of tumor samples to identify genes related to cancer formation and progression
  • Understanding how normal genes function in an effort to develop strategies to reduce tumor growth
  • Identifying new therapies and evaluating their effectiveness through testing on animal models

Siteman researchers at Washington University’s Neurofibromatosis Center are focusing their efforts on neurofibromatosis, a common hereditary disorder in which affected individuals develop brain and nervous system tumors. The work of this interdisciplinary, collaborative group has led to several significant discoveries.