Neuro-Oncology is the branch of medicine and a subspecialty of oncology that focuses on the diagnosis and treatment of brain and spinal cord cancers.
Seattle Cancer Care Alliance’s team of doctors and nurses that diagnose and treat brain and spinal cord cancer are experts in their fields. The mission of this team is to provide the best possible patient-focused care and state-of-the art treatment for patients with brain and spinal cord cancers.
Each patient has the option for treatment within a clinical trial or treatments based on the latest scientific evidence. Our program includes experts in brain and spine cancer neurosurgery, who perform over 500 cancer operations a year. Over 3,000 patients come see our doctors in the Neuro-Oncology Program each year.
Members of the neuro-oncology team include experts in these categories:
• Medical neuro-oncologists
• Surgical neuro-oncologists
• Radiation oncologists
• Specialized clinic and research team members
All are members of the Tumor Board that brings together over 20 University of Washington expert physicians, nurses, and researchers weekly to discuss and suggest treatment plans for newly diagnosed patients and to monitor, and if necessary change, the treatment of previously treated brain and spinal cord cancers patients.
Expertise & Technology
Treatment is available for every type of tumor, including meningiomas, gliomas, vestibular schwannomas, central nervous system lymphomas, and metastatic cancers in the brain and spinal cord. State-of-the-art rehabilitation services are also available to patients at UW Medical Center and SCCA.
There are many tests that can be used to see and diagnose brain and spinal cord cancers. The most important are the magnetic resonance imaging (MRI) and computed tomography (CT) scans. These scans show location and size of the cancer. The scans may also show the type of cancer and if it has spread.
The Neuro-Oncology Team uses the latest technology to diagnose and treat brain and spinal cord tumors:
• Computed Tomography (CT)
• Magnetic Resonance Imaging (MRI)
• MRI Spectroscopy
• MRI Perfusion Scans
• Functional MRI
• Diffusion Tensor Imaging
• Leskell Gamma Knife
• LINAC (Linear Accelerator) Radiosurgery
• Clinical Research Studies
(Image courtesy of Petra Lamon and Dan Lane)
Computed tomography (CT) scan
A computed tomography scan is an X-ray, usually called a CT scan (or CAT scan). The CT scanner takes many X-ray images or “slices” as it rotates, creating detailed cross-sectional pictures. The result is several pictures or slices (up to 64) of the brain or spine. This helps the team identify the location and size of cancer.
Magnetic resonance imaging (MRI)
The MRI is a scan that uses radio waves and magnetic fields to make pictures. The MRI scan provides very high quality images of the brain and spine. The MRI also shows a cross-sectional slice of the body (like a CT scan) and lengthwise slices. MRI often gives better details of the cancer and the surrounding structures than CT. This increases the ability to find and diagnose cancers in the brain and spinal cord.
Image courtesy of Dr. Marc Chamberlain
CT or MRI Scans may be used during surgery to:
o Pin-point the exact location of the cancer for biopsy (stereotactic biopsy).
o See the brain in three dimensions to improve locating the cancer exactly. This can be done for some cancers. Having an exact location of the cancer may decrease damage to normal healthy brain tissue during the treatment phase (3-D frameless intra-operative navigation).
o Identify important areas of the brain for movement, sensation, and language (functional MRI).
There are also many kinds of advanced MRI scans.
• MRI Spectroscopy (MRI SPECT) – Gives information about the chemical make-up of a cancer and the brain tissue surrounding the cancer. This can sometimes help find and diagnose the cancer. MRI SPECT can help separate between cancer and treatment-related effects.
• Perfusion MRI – Measures blood flow in the brain. Cancers need a blood supply in order to grow. The amount of blood supply a cancer has may assist in diagnosing the cancer. It may also be used to distinguish between cancer and treatment-related effects.
• Diffusion MRI – Measures water motion in the brain. Cancers can differ from surrounding brain in how easily water moves through the tissue. Special diffusion MRI (diffusion tensor imaging) may help locate white matter tracts in the brain.
• Specialized Scans Other specialized scan used with brain and spinal cord cancers include:
• Positron Emission Tomography (PET) - Usually gives a picture of brain metabolism. Glucose (sugar) provides the brain with a source of energy. Attaching a radioactive tracer to glucose and injecting this into the patient’s arm, the PET scanner and a special camera can pinpoint metabolic activity within the brain. Cancer cells may sometimes absorb different amounts of the radioactive glucose than the surrounding brain, allowing the cancer to be located and diagnosed. Additionally this test may be used to distinguish cancer from treatment effects.
(Image courtesy of Dr. Alexander Spence)
• - Single Photon Emission Computed Tomography (SPECT) - Is less often used in the diagnosis of brain and spinal cord cancers. This scan gives a picture of blood flow, which is different in cancer tissue compared to healthy tissue. A special camera takes pictures and measures how fast a radioactive tracer travels.