The Seattle Cancer Care Alliance (SCCA) Brain and Spine Metastases Clinicoffers the most advanced treatment options to patients who have cancer that has metastasized to the brain or spinal cord. Our treatments are based on the latest available scientific evidence and clinical research.
Our goals for managing brain and spinal cord metastases are to:
- Remove or destroy the cancer through surgery, radiation and/or chemotherapy
- Relieve symptoms that are caused by a tumor pressing on the brain or spinal cord
- Improve the patient’s overall functioning and quality of life
The type of treatment we recommend for you will depend on several factors, including the type of cancer you have, its location, your overall health and your individual wants and goals.
Treatment options may involve one or more of the following:
- Radiation therapy
- Intrathecal or intraventricular chemotherapy
- Systemic therapies, such as immunotherapy and chemotherapy
- Clinical trials
- Palliative care
Surgery may be a treatment option for your brain metastases, depending on the number of masses, size and location. Your symptoms may also help to define if surgery is the best treatment for you. Surgery is often used for single, large brain metastases.
Our neurosurgeons are specially trained on procedures related to brain metastases and offer some treatments using endoscopy. Endoscopy is a minimally invasive technique that uses small incisions and an endoscope (a thin, flexible, lighted tube) to see and remove the cancer. There is often less injury to other surrounding tissue with endoscopy, and recovery can be faster compared to traditional surgery.
Regardless of how much cancer is removed by surgery, radiation therapy and/or chemotherapy may also be used as part of your treatment. Your neuro-oncologist will work closely with your surgeon and radiation team.
There are different types of radiation therapy that can be used to treat brain metastases. Depending on how much the disease has spread, this treatment may be able to either stop or slow the growth of brain metastases. Radiation therapy may be used alone or along with other treatments, like surgery or systemic therapies.
The different types of radiation therapy are:
- Gamma knife radiosurgery, a noninvasive or minimally invasive outpatient treatment for some patients with conditions that would typically require brain surgery or whole-brain radiation
- Whole-brain radiation therapy, which is most often used for multiple brain tumors
- Focused radiation therapy, which targets the tumor and immediate surrounding areas
- Intensity-modulated radiotherapy (IMRT), which allows radiation to be more exactly shaped to fit the tumor
Before radiation treatment begins, your radiation oncologist will use an imaging technique such as an MRI, CT scan, PET scan, angiography or a SPECT scan to find out where you need radiation.
Your neuro-oncologist will discuss treatment options with you, which may include radiation therapy.
Systemic therapies, such as chemotherapy and immunotherapy, use medication to attack fast-growing cancer cells or to stop the cells from dividing.
- Chemotherapy can play an important role in treating brain metastases. They are often given by infusion, through lumbar puncture (spinal tap) or through a special port called an Ommaya reservoir that delivers medication directly to the brain.
- Immunotherapy uses parts of the body’s own immune system to fight cancer. It can be used on its own as a treatment or in coordination with other treatments like traditional chemotherapy, surgery and/or radiation.
- Targeted therapy blocks the growth of cancer cells by using drugs that interfere with growth signals in cancer cells.
Your neuro-oncologist will discuss treatment options with you, which may include systemic therapy.
SCCA’s neuro-oncology team brings together specialized clinicians and scientists focused on neuro-oncology research. This means there are more treatment options at SCCA than you might find elsewhere, including the chance to participate in one of many ongoing clinical trials at SCCA and its partner organizations, Fred Hutch and UW Medicine.
Supportive and palliative care is specialized medicine for people who have a life-limiting or life-threatening condition. It is an additional layer of support for those with a serious illness.
The palliative care team plays a central role within cancer care at SCCA and within the Neuro-Oncology Clinic at SCCA.