The Brain and Spine CenTer

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1 The Br ain and Spine Center

2 Choosing the right treatment partner is important for patients facing tumors involving the brain, spine or skull base. The Brain and Spine Center at The University of Texas M. D. Anderson Cancer Center is committed to providing the most comprehensive care available for patients with tumors affecting the central nervous system.

3 Cancer Focus The Brain and Spine Center at The University of Texas M. D. Anderson Cancer Center is one of the largest of its kind in the world, with more than 70 physicians and scientists in nine specialty areas dedicated to diagnosing and treating cancers of the brain and spine. It s what we do; it s all we do. Performing more surgeries on patients with brain tumors than any hospital in the nation, and providing a wide range of drug therapies that target abnormalities in tumor cells, M. D. Anderson continues to set the quality standard for neuro-oncology treatment and research. We have ranked among the top two cancer hospitals in U.S. News and World Report s America s Best Hospitals since the rankings began in This depth of experience guides every aspect of patient care at the Brain and Spine Center, where we are dedicated to extending lives and improving quality of life. Included in the Brain and Spine Center are the disciplines of neurosurgery, neuro-oncology, neuropathology, neuroradiology, radiation oncology, clinical neuropsychology, psychiatry, and neurophysiology testing. Complemented by state-of-the-art technologies such as intraoperative magnetic resonance imaging (imri), stereotactic radiosurgery and proton therapy, the Brain and Spine Center is committed to providing comprehensive treatment and achieving the best outcomes possible. Through the combined efforts of clinical and research staff, clinical nurses, social workers, and nutritionists, patients are afforded the benefits of new advances improving cancer treatment, care and survival. Working closely with scientists who research anti-cancer drug development, molecular biology, immunology and the genetics of tumors, the Brain and Spine Center also offers clinical trials that give patients access to the latest weapons to fight their cancers.

4 Our team of cancer experts In addition to technological innovations not available at other hospitals, the Brain and Spine Center is home to a team of cancer experts, including surgeons experienced in the latest minimally invasive procedures, as well as new techniques for reconstructing the spine and reversing tumor damage. Neuro-oncologists offer research-based chemotherapy treatment regimens that exploit weaknesses in the cancer cell or block the abnormal signals that drive a tumor s growth. Neuroradiation oncologists provide the first- or second-line defense against brain and spinal tumors by using advanced technologies, such as proton therapy, which target tumors and minimize damage to normal tissue. Precise new imaging technologies allow the team to pinpoint areas of tumor growth, to avoid critical structures in the brain during surgery and radiation. Imaging specialists are developing agents that will quickly and painlessly disclose tumor response to therapy. Specialists in neurology, neuropsychology and cognitive rehabilitation treat other problems experienced by brain and spinal tumor patients. This unique team effort gives patients at M. D. Anderson the most comprehensive approach to neuro-oncology care.

5 Neurosurgery The Department of Neurosurgery provides the highest quality care in a multidisciplinary environment for patients with benign or malignant tumors affecting the central nervous system. Neurosurgeons work collaboratively with neuro-oncologists, neuroradiologists, radiation oncologists, neuropathologists and anesthesiologists to ensure that each patient receives comprehensive treatment. Highly skilled in performing complex operations involving the brain, spine, cranial base and sacrum, our neurosurgeons specialize in spinal reconstruction, intraoperative administration of cancer drugs, pediatric neurosurgery, surgical treatment of pain and the collaborative delivery of radiation using stereotactic technology. Skull Base Tumor Program M. D. Anderson is one of the few cancer centers in the United States with a specialized program for tumors of the skull base. Because treatment of these relatively rare tumors requires a unique approach, experts from many departments join together to provide each skull base tumor patient with individualized, comprehensive care. Surgeons from the skull base tumor program, in connection with those from the Head and Neck Center, have extensive experience in using the latest technologies and are respected internationally for their ability to treat tumors in this delicate and complex area. Treatment can involve open or minimally invasive surgery, radiation therapy, chemotherapy, or a combination of these therapies. Some patients with skull base tumors may be treated at the Proton Therapy Center at M. D. Anderson.

6

7 Brainsuite imri For some tumors that are aggressive or located close to critical brain functions, a patient s outcome is directly related to the amount of cancerous tissue that can be safely removed. BrainSUITE is an advanced neurosurgical operating room, fully equipped with a large-bore Siemens Espree (1.5-tesla magnet) magnetic resonance imaging system and imageguided data management system, which give surgeons a better perspective on the progress of complex neurological surgeries. These advanced tools maximize the completeness of surgery, helping to prevent damage to critical structures and reducing complications and the need for further surgeries. For most neurosurgery patients, BrainSUITE is particularly useful for: Primary brain tumors (gliomas) Metastatic brain tumors Meningiomas P ituitary tumors and craniopharyngiomas Pediatric tumors Skull base tumors

8 Neuro-oncology One of the largest programs of its kind in the world, the Department of Neuro-Oncology provides leading chemotherapeutic and biological therapies for patients with cancers involving the central nervous system. Because many of the new agents are designed to work against tumor cells, damage to normal cells is avoided and side effects are minimized. In addition to developing new combination strategies that boost the effectiveness of traditional treatments, the department is researching other approaches to killing cancer cells and controlling tumor growth, such as gene therapy, immunotherapy and signal transduction. Following proven safety and effectiveness in the laboratory, these promising treatments bring new hope to patients in the clinical setting. Neurology, Neuropsychology Consultative neurology physicians diagnose and treat various neurological problems, including metastatic brain disease, meningeal carcinomatosis, cognitive dysfunction and peripheral neuropathy. This service uses the latest neurophysiology resources, which allow precise measurement of neurological function to identify neurological problems and provide intraoperative monitoring. Such monitoring allows the neurosurgeon to remove as much of the tumor as possible without harming important functional centers of the brain. Neuropsychologists also are available to assess and treat cognitive and behavioral effects of cancer and cancer treatment. Clinical assessment includes objective evaluation of brain functions, including memory, speech and language, visual perception, attention, intellectual function, executive function, and motor function, as well as mood and personality, quality of life, and more. They also provide cognitive rehabilitation strategies and training, cognitive behavioral therapy, self-hypnosis and relaxation therapy for symptom management, and even evaluations of a patient s ability to drive a car safely.

9 Radiation Oncology Radiation oncologists work as part of a team that includes neuro-oncologists, neurosurgeons, diagnostic neuroradiologists, neuro-pathologists, radiation physicists and nurses, all of whom are specialists in treating brain and spinal cord cancers. Patients are consulted in the Brain and Spine Center, and see all the specialists there. This multidisciplinary approach toward treating central nervous system tumors produces well-considered treatment options based on the collective experience of all the specialists. Together these physicians recommend to patients which therapies surgery, radiation therapy, chemotherapy should be used. Neurosurgeons work closely with radiation oncologists to deliver high doses of radiation to brain and spine tumors while sparing normal tissue. Jointly run by specialists in radiation oncology and neurosurgery, the stereotactic radiosurgery program features pencil-shaped beams of radiation that are used to treat the disease site in a single session. M. D. Anderson researchers are testing a combination of stereotactic guided radiation and computed tomography guidance for administering the highest possible therapeutic dose while minimizing harmful side effects. Proton Therapy Proton therapy is the most advanced form of radiation treatment available. Its advantage over traditional forms of radiation treatment derives from its ability to deliver maximum doses of radiation to a targeted tumor with remarkable precision, leaving healthy tissue virtually unharmed. This results in fewer side effects. The Proton Therapy Center at M. D. Anderson is the only center of its kind in the Southwest. Along with other promising new treatment modalities, it is fully integrated into the Brain and Spine Center s broad range of expertise.

10 clinical Trials Although surgery remains the cornerstone treatment of tumors affecting the nervous system, other innovative therapeutic interventions under development, such as gene therapy and immunotherapy, should revolutionize the practice of neuro-oncology in the near future. Physicians and scientists in the Brain and Spine Center translate basic science and translational research, which aim to understand biological and molecular mechanisms of central nervous system tumors, and then rapidly incorporate the findings into the development of new and improved therapies. Research increasingly plays an important role in determining the future direction of neuro-oncology. Surgery, in combination with other standard cancer therapies, such as chemotherapy and radiation therapy, gives patients with brain or spinal tumors their best hope for survival. In some cases, however, these therapies do not cure the cancer completely. In the years ahead, gains made in the laboratory will provide new ways of treating these tumors. Clinical trials are monitored closely to ensure patient safety while offering innovative treatments that combine the latest findings from clinical and laboratory research. Molecular advances will allow therapy to become individualized; increasingly clinical trials incorporate monitoring patient response at the cellular level, through molecular imaging and pharmacokinetic studies. Working with a multidisciplinary team of specialists at M. D. Anderson, the Brain and Spine Center is well-positioned to further develop and advance surgical technology for treating nervous-system-based tumors, to provide unsurpassed expertise in diagnosis and treatment, and to contribute to important breakthroughs in the laboratory that can be brought quickly to clinical application.

11 A clear choice With a team dedicated to personalized care, treating the physical, emotional, social, and cognitive needs of brain, spine, and skull base tumor patients, the Brain and Spine Center offers patients the best hope for the most effective treatment. It s just one reason why M. D. Anderson has been Making Cancer History for more than 60 years. For more information about M. D. Anderson, contact askmdanderson at MDA-6789 or More information about the Brain and Spine Center at M. D. Anderson is available at

12 Produced by M. D. Anderson Publications and Creative Services 12/06 Contributing photographers: F. Carter Smith Photos and Medical Graphics and Photography

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