Multidisciplinary Neuro-Oncology Clinic
RCC’s multidisciplinary neuro-oncology clinic is part of the Stereotactic Radiosurgy (SRS) program. Radiation oncologist Andrew Figura, MD directs the neuro-oncology clinic. Along with Dr. Figura, neurosurgeons from RCC’s partner hospitals in Erie (UPMC Hamot and Saint Vincent Hospital) see patients on alternating Fridays at the center. Following a joint review of cases, patient consults are done in the morning and the team collaborates on treatments in the afternoon. The clinic enhances the scope of services provided through a collaborative approach to treatment.
Patients referred to RCC with brain tumors and brain metastases are scheduled for multidisciplinary evaluation in the neuro-oncology clinic. Each case is evaluated by the team, considering opportunities available for each patient with all treatment modalities – surgery, radiation therapy (RT) and, when applicable, chemotherapy. Opportunities of strategic combinations of therapies are considered along with the tumor’s likely responsiveness to each.
The type of tumor, its size and location are primary factors in determining the best course of treatment. When tumors are in a critical or sensitive location surgery may not be optimal because of related risks. Radiation therapy is a less-invasive alternative.
If radiation therapy is selected as the preferred course of treatment for a patient the physicians collaborate to determine the best approach to RT. Together they review the patient’s status and symptoms, pathology and diagnostic images.
Various modalities of radiation therapy are available and combinations of each can be leveraged for the best possible outcome. Some situations call for a low dose of radiation with multiple treatments. In other cases single, or few, high dose treatments will ablate tumors over a short period of time.
For treating small targeted areas in particular the high dose RT delivered with stereotactic radiosurgery is preferred. Intensity Modulated Radiation Therapy (IMRT) is delivered with a broader yet still focused field over approximately 30 treatments. In some cases radiation of the whole brain is preferred. The majority of cases seen in the neuro-oncology clinic are brain metastases, most often from breast and lung cancers, and also from kidney cancer and melanoma, among others. For any diagnosis presented the team’s collective professional experience and expertise plays an important role in providing the best possible patient care.
Modern cancer care gives physicians tools for successfully treating many primary tumors. For patients who experience subsequent recurrence in the brain, specialized radiation therapy offers an opportunity for continued success through cancer therapy that includes good quality of life.