Q&A Topic: Treating Metastatic Brain Tumors

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Alain C.J. de Lotbinière, MD, CM, FACS, FRCSC

Q. Do brain tumors begin in the brain?

A. Actually, most brain tumors begin elsewhere in the body. Although there is a great deal of awareness around breast cancer and lung cancer, most people don’t realize 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.

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Q. If you’ve been diagnosed with cancer, how do you know if you run the risk of also developing brain cancer?

A. 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. An oncologist who suspects a patient is at risk may suggest a CT scan or an MRI to check for tumors in the brain.

Q. If brain cancer is confirmed, what happens next?

A. 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 used is called a Gamma Knife. 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.

Q. Why do you recommend the Gamma Knife procedure?

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A. 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. Because there’s no incision, patients are able to go back to their normal life within hours of the procedure. Gamma Knife Perfexion, used at Northern Westchester Hospital, is the gold standard for radiosurgery. The machine is easier to use, more precise, and safer for the patient.Northern Westchester Hospital is home to the only Gamma Knife in Westchester County, and has been treating patients using this technology since 2005.

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.

Northern Westchester Hospital
Medical Director of the Gamma Knife Center
Medical Director of the Cancer Treatment and Wellness Center
Learn More About Dr. de Lotbinière

Learn more about
Gamma Knife treatment

More from Dr. Lotbinière:
Trigeminal Neuralgia

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