BRAIN TUMOR TREATMENT

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Team Approach

At Cedars-Sinai, specialists from many perspectives and disciplines work together to plan and provide every patient’s care. Treatment recommendations are made after careful review and discussion in weekly Tumor Board meetings. In these meetings, every option is considered, including medical, surgical and radiation therapies, or inclusion in a clinical trial. Care is provided by physicians, surgeons and numerous other health care professionals, many of whom work behind the scenes in laboratories, imaging facilities, operating rooms, and therapy centers.

The Brain Tumor Center at Cedars-Sinai Medical Center became a major referral center – attracting patients nationally and internationally – because hospital leaders and neurosurgeon Keith L. Black, MD, had a shared objective in 1997. They envisioned the creation of a specialized, comprehensive destination that would provide the most advanced existing treatments and a focused research effort designed to discover new ways to defeat even the most aggressive tumors of the brain.

With its history dating back more than 100 years, Cedars-Sinai has long been recognized as a patient-centered community hospital – the “preferred” area hospital, according to patient surveys. With significant investments in research facilities and personnel over the past few decades, Cedars-Sinai has now become one of the top private research centers, as well. For patients, this combination offers the individualized attention found in a community hospital, with expertise and personal care provided by world-renowned physicians and surgeons, and access to innovative treatments and technologies.

When he came to Cedars-Sinai, Dr. Black was known as a skilled, experienced neurosurgeon who often was able to remove tumors that had been considered inoperable. Also a prolific research scientist, Dr. Black was studying ways to increase drug delivery to brain tumors and was pursuing the theory that a “vaccine” could stimulate the immune system to fight recurring malignant tumors.

The brain tumor program’s patient care and research teams work together through the Department of Neurosurgery, the Maxine Dunitz Neurosurgical Institute, which provides scientific research, and the Johnnie L. Cochran, Jr. Brain Tumor Center, which translates research findings into human clinical trials.

Dr. Black and many other surgeons and physicians providing patient care also direct research programs. In addition to his involvement with the experimental vaccine, Dr. Black continues to lead scientists seeking new methods to temporarily open the blood-brain barrier, the natural mechanism that protects the brain but also prevents chemotherapy from reaching tumors. Drugs that are typically used to treat erectile dysfunction are now being studied for their ability to allow anticancer drugs to cross the blood-brain tumor barrier.

Cedars-Sinai Brain Tumor Center Team Members:

Cranial Base Surgeon (skull base surgeon) 

A specialist in the treatment of disorders originating at the base of the skull. This may be a neurotologist or an otolaryngologist (ear, nose and throat specialist). These specialists have extensive additional training in medical and surgical treatment of the ears, the balance system and the nerves and other structures at the base of the skull and in the head and neck.

Neuroanesthesiologist 

A physician who provides anesthetics during surgery, a neuroanesthesiologist has training in special techniques that are often needed in brain or spine surgery or related procedures. In some brain surgery cases, for example, the patient must be awake during part of the operation to respond to questions. This enables the surgical team to protect areas of the brain responsible for speech, thinking and other vital functions.

Neurologist 

A physician specializing in the diagnosis and treatment of disorders of the brain, spinal cord and nerves. A neurologist may help to coordinate and provide medical care for a patient who has a brain tumor.

Neuro-oncologist 

 A physician specializing in the diagnosis and treatment of tumors of the nervous system. Neuro-oncologists often direct the use of medications designed to fight tumors of the brain and spine (chemotherapy).

Neuro-ophthalmologist 

A physician specializing in the diagnosis and treatment of disorders involving the eyes and the brain. A neuro-ophthalmologist is likely to participate in the care of a patient with a tumor at the base of the cranium, affecting the optic nerve or other vision-related structures.

Neurotologist 

A physician with specialized surgical training to operate on the parts of the brain and nervous system that control hearing and balance. A neurotologist is likely to be involved in the care of a patient who has an acoustic neuroma or other tumor situated at the base of the cranium.

Neuroradiologist 

A physician specializing in X-ray and other technologies used to create images of the nervous system.

Neurosurgeon 

A physician specializing in surgery and other interventions of the brain and spine. Relatively few neurosurgeons specialize in the surgical removal of tumors of the brain and spinal cord. A large referral center like the Brain Tumor Center at Cedars-Sinai has neurosurgeons with expertise in a wide range of areas.

Orthopaedic Surgeon 

A specialist in the treatment of bones, joints, ligaments, muscles and tendons. Because a tumor of the spine may damage the bones and other structures, complex operations may include teams of orthopaedic surgeons and neurosurgeons specializing in surgery of the spine.

Pediatric Neurosurgeon 

A neurosurgeon specializing in the care of children suffering from disorders of the nervous system.

Pediatric Specialists 

Specialists in oncology, neurology, neuroradiology, endocrinology, intensive care, anesthesiology, cranial base surgery, and physical medicine and rehabilitation, who focus on the care of infants, children and adolescents. Children’s brains are different from adult brains in size and in development. Pediatric specialists offer treatment options that are child-specific and carefully chosen to protect fragile and developing brain cells and structures.

Physiatrist

A physician specializing in physical medicine and rehabilitation. A physiatrist coordinates and provides care for patients who need physical, speech or occupational therapy.

Psychiatrist 

A medical doctor specializing in the treatment of mental, emotional and behavioral issues.

Psychologist 

A licensed professional who holds an academic doctoral degree (usually a PhD or PsyD) and helps patients solve problems or relieve distress.

Radiation Oncology Dosimetrist 

A specialist in the operation of radiation therapy equipment and calculation of radiation dosages. The dosimetrist works with the radiation oncologist and the radiation oncology physicist to design a treatment plan that provides a prescribed dose of radiation for each patient.

Radiation Oncology Physicist, or Medical Radiation Physicist 

A specialist in the science of radiation technology. These specialists are involved in the planning and delivery of treatment and are responsible for the design, calibration and evaluation of equipment. Physicists, who have master’s or doctoral degree, ensure precise and accurate radiation dosing and focus on patient and staff safety.

Social Worker 

A professional who provides support to help patients cope with difficult situations, and assists in making arrangements for services a patient may need at home after discharge.

Spiritual Counselor 

Patients may wish to have a spiritual counselor to help them cope with the emotions and uncertainty that come with the diagnosis of a brain tumor. Patients may request visits with a Cedars-Sinai chaplain of their choice at any time during their hospital stay. Spiritual counseling appointments may also be arranged with concerned family members. Patients and visitors are welcome to ask for the help and guidance from chaplains of various faiths.

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