Neuro-Oncology Branch: Patient Experience and Expertise
We have more than 20 years of experience working with patients and their physicians to offer a comprehensive approach to patient care. Patients travel from all over the world to be evaluated and treated by our clinical team. The Brain Tumor Clinic sees hundreds of new patients and 2,000–3,000 follow-up patients each year.
Clinical trials. In addition, there is also the potential to participate in a range of clinical studies. Although we are in the process of enhancing the clinical trials portfolio, typically there are between 5-10 trials for primary brain tumors underway at the Neuro-Oncology Branch.
A multidisciplinary approach to patient care. In addition to the neuro-oncologist in the clinical practice, our specialists in neurosurgery, radiation oncology, and imaging bring their expertise to every case, and together we develop a personalized treatment plan for all our patients. Our team meets weekly to review each patient's case to ensure they receive the best care possible.
We want to ensure maximal safe resection while sparing healthy tissue. To this end, there are state-of-the-art surgical techniques and extensive pre-surgical planning that may include:
- Functional MRIs
- MRI perfusion
- MRI tractography
- PET imaging
Intra-operative MRI is available to help guide our neurosurgeons through challenging cases, maximizing tumor removal while minimizing injury to surrounding brain. They also specialize in intra-opertive functional cortical mapping and nerve monitoring to allow the most aggressive—yet safest—surgery to be conducted on some of the most sensitive areas of the brain.
After surgery, the clinical care team works closely with the neurosurgery team to coordinate patient care and follow-up.
Radiation therapy is an important part of treatment for brain tumors. Our radiation oncologists use cutting-edge technologies including:
- intensity-modulated radiation therapy (IMRT)
- rapid arc technology
- stereotactic radiosurgery (SRS)
These various treatments are used to direct targeted beams at the tumor while minimizing the radiation delivered to normal tissues.
Typically, radiation therapy for brain tumors is a daily treatment (about 1-hour) Monday-Friday for about 6 weeks.
SRS is a specialized delivery system that gives precise high-dose radiation in a single treatment and is typically used for benign brain tumors and brain metastases (cancer that has spread to the brain from a systemic [body] cancer, such as lung cancer, breast cancer, or melanoma)
The members of the Neuro-Oncology Branch work closely with the Neuroradiology Section of the Radiology Department at NIH to provide comprehensive neuroimaging evaluations. CT scans, PET imaging, and MRIs are available.
For MRI interpretation, we use a technique called “MRI registration.” Developed at the NIH, this technology allows us to view digitally matching slices of the MRI across different dates to make more exact comparisons. We can now more accurately detect small but potentially clinically significant changes in a tumor.
In addition to MRI registration, all brain tumor MRIs include the generation of physiological data through various techniques (i.e., MR diffusion, MR spectroscopy, MR blood volumes, and perfusion). These give us a detailed understanding of the potential for tumor growth and response to treatment.
PET scans are commonly used to find areas of very active cancer. This often assists in distinguishing a true tumor from areas of brain injury.