Central Nervous System (CNS) Cancer

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Matthew Ballo, MD, FACR

If you have a patient dealing with a diagnosis of central nervous system (CNS) cancer, our multidisciplinary team of CNS specialists at West Cancer Center is here to surround you with the latest treatments and technology to design a personalized treatment plan specific for this disease. Our goal is to also provide resources and information to better help your patient understand and manage CNS cancer.

What is Brain Cancer?

Brain tumors are abnormal growth cells in the brain. Although such growths are popularly called brain tumors, not all brain tumors are cancerous. Cancer is a term specifically reserved for malignant tumors. Malignant tumors can grow and spread aggressively, overpowering healthy cells. They can spread throughout the body. Tumors that do not spread to invade nearby tissue are called benign.

Some brain cancers occur when one type of cell transforms from its normal characteristics. Once transformed, the cells grow and multiply in abnormal ways. As these abnormal cells grow, they become a mass, or tumor.

Primary brain tumors are tumors that start, or originate, in the brain. The most common primary brain tumors are gliomas, meningiomas, pituitary adenomas, vestibular schwannomas, and primitive neuroelectrical tumors (medulloblastomas). The term “glioma” includes glioblastomas, astrocytomas, oligodendrogliomas, and ependymomas. Most of these are named after the part of the brain or the type of brain cell from which these abnormal cells originate.

Stages of Brain Cancer

“Staging” is a method to assess and describe the spread of cancer beyond the site of origin. It is very rare for brain cancer to spread outside of the brain; therefore, we use a different system to describe these cancers, called “Grading”.

The grading depends on characteristics of the cancer studied by the pathologists through microscopy and other conventional testing.

Grade I means the cancer cells look almost normal and they grow very slow. Most people with Grade I can live a long time.

Grade II means the cancer cells look somewhat abnormal and grow slowly, but can invade normal tissue. Sometimes, they return after treatment as a higher grade.

Grade III means the cancer cells don’t look like normal cells and quickly increase in number.

Grade IV means the cancer cells don’t look like normal cells and grow very quickly.

Source: NCCN Patient Guidelines-Brain Cancer Version 1, 2016

Symptoms of Brain Cancer

If you are experiencing any of these symptoms, we urge you to speak to your provider as soon as possible for further examination.

Difficulty with balance
Confusion
New pattern of headaches
Increased intensity of headaches
Unexplained vomiting or nausea

Seizures
Hearing problems
Vision problems
Speech difficulties
Gradual loss of sensation in leg or arm

How to Diagnose Brain Cancer

If your provider would like to further investigate the possibility of a brain tumor, one or more of the following diagnostic procedures may be performed:

BIOPSY

A sample of tissue is removed for examination to determine the diagnosis of a suspected mass.

CT SCAN

A “computed tomography scan” makes use of computer-processed combinations of many x-ray measurements taken from different angles to produce cross-sectional images of specific areas of a scanned object, allowing the provider to see inside the body without surgery.

PET

“Positron-emission tomography” is a nuclear medicine functional imaging technique that is used to observe metabolic processes in the body as an aid to the diagnosis of a disease.

MRI

“Magnetic resonance imaging” is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves to generate images of the organs in the body.

NEUROLOGICAL EXAM

The assessment of sensory neuron and motor responses, especially reflexes,is used to determine whether the nervous system is impaired. This typically includes a physical examination and a review of your medical history.

Types of Brain Cancer Treatments

Your brain cancer treatment plan will vary depending on multiple factors including, but not limited to, your stage of diagnosis, as well as the location of your cancer. Your dedicated team of cancer experts will discuss your treatment options and plan with you, allowing you and your loved ones to consider all possible treatment options for your diagnosis.

CHEMOTHERAPY

Chemotherapy is medication that destroys cells that are growing and dividing. Cancer cells grow by dividing, and they grow faster than normal cells. However, normal cells also grow and divide, so chemotherapy affects both normal and cancerous cells.It may be given alone or in combination with surgery, radiation therapy, or both. If you do not receive chemotherapy before surgery, chemotherapy may be given to destroy any microscopic tumor cells that remain after you have recovered from surgery. The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea, vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away after treatment is complete.

CLINICAL TRIALS

A clinical trial is a research study designed to evaluate potential new treatment options. West Cancer Center is a proud partner in the field of research regarding cancer treatments. We host a variety of clinical trials and welcome any conversation about your eligibility to participate in a trial for your specific cancer. Talk to your provider or visit our website here to learn more about brain cancer clinical trials available right now.

OPTUNE® TTFIELD THERAPY

Optune creates Tumor Treating Fields (TTFields) to slow or stop GBM( Glioblastoma)cells from dividing and may also destroy some of them. Optune works differently from surgery, radiation, or chemotherapy. The TTFields created by Optune can slow or even stop GBM tumor cells from growing and dividing.

To learn more: https://www.optune.com/

RADIATION THERAPY

Radiation therapy is the use of high x-rays or other particles to destroy cancer cells. Radiation therapy may be done before surgery to shrink the tumor so that it may be more easily removed. Radiation therapy may also be done after surgery to remove any cancer cells left behind. Radiation treatment may make it possible to do less surgery, often preserving critical structures in the arm or leg if the sarcoma is located in a limb.

STEREOTACTIC RADIOSURGERY (SRS)

Stereotactic radiosurgery uses multiple high-dose radiation beams to precisely treat tumors in the brain using 3D imaging with less radiation to minimize damage to the surrounding healthy tissue.

SURGERY

Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. Your surgeon’s goal is to remove the tumor and enough normal tissue surrounding it to obtain a clean margin around the tumor. A “clean margin” means there are no tumor cells visible at the borders of the surgical specimen. This is currently the best method available to ensure that there are no tumor cells left in the area from which the tumor was removed.

TARGETED DRUG THERAPY

Targeted therapy is a cancer treatment that works by targeting specific genes or proteins to help stop cancer from growing and spreading. These genes and proteins are found in cancer cells or in cells related to cancer growth, like blood vessels. It may seem simple to use a drug that works specifically to your type of cancer, but targeted therapy is very complex. It is important to remember that a tumor may not always respond to a drug – each person and each tumor is different. Most people may also need surgery, chemotherapy, radiation or hormone therapy. Researchers are always in the process of developing more targeted drugs and West Cancer Center is at the forefront of research, targeted therapies, and clinical trials.

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Gillian Reed, DNP, FNP-BC, OCN

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Shandell Kidd, MSN, FNP

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Lachre Brown, NP

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Margaret Mitchell, DNP, FNP-C

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Lauren Cunningham, NP

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Holly Fuller, NP

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Catherine Phelps, NP

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Mary Orian, NP

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Riley Upchurch, FNP-C

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Felix Caldwell, MD

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Leonard “Jeff” Harris Jr., MD, MS

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Ben Abdu, MD, FACOG

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Evan Swift, PA

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Jennifer Rich, FNP-C

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Stacy Reschke, MSN, FNP-C

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Porshia Mahoro, DNP, APRN, FNP-C

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Christy Izzett, PA-C

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Marcus Norris, ANP-FNP

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Haley Holbrook, ANP-FNP

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Kathryn Steele, WHNP, FNP

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Heather Hicks, ANP-FNP

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Cindy Cox-Berryhill, ANP-FNP

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Jamie Watkins, ANP-FNP

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Sridhar Shankar, MD

Radiology

Lauren Taylor, MSN, FNP-C

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Valarie Mitchell, FNP

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Stephanie Ham, MSN, APRN, FNP-C, OCN

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Emily Dunaway, MSN, FNP

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Brian Lam, ANP-FNP

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Ashley Pounders, ANP-FNP

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Kathryn King, ANP-FNP

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Yuefeng Wang, MD, PhD

Radiation Oncology

Paul Koerner, MD

Radiation Oncology

Mihaela Onciu, MD

Pathology

Parrish Throckmorton, PT

Rehab and Lymphedema

Michael Ulm, MD, MS, FACOG

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Amber Wade, PA-C

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Deanne Wade, PT

Rehab and Lymphedema

Donna Thomas, PT

Rehab and Lymphedema

Anita Vincent, RDN, CSO, LDN

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Tricia Harris, SLP

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Lauren Albertine, ANP-FNP

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Allen Ardestani, MD, PhD

Radiology

Michael Levinson, MD

Gastroenterologist

Anita Arnold, MD, FACP

Internal Medicine

Leslie Norman, MSN, NP

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Matthew Ballo, MD, FACR

Radiation Oncology

Adrian Banks, APRN, AGACNP-BC

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Ramakrishna Battini, MD

Medical Oncology / Hematology

Saradasri Wellikoff, MD

Medical Oncology / Hematology

Scott Baum, MD

Radiology

Jeffrey Green, MD

Radiology

Sonia Benn, MD

Medical Oncology / Hematology

Liangping Weng, MD

Regional Specialist, Medical Oncology / Hematology

Linda Han, MD

Breast Surgeon

Michael Berry, MD

Breast Surgeon

Richard Gilmore, MD

Breast Surgeon

Angela Brady, ANP-FNP

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Brandi Crowe Harmon, PA-C

Advanced Practice Provider/MedOnc

Jason Chandler, MD

Medical Oncology / Hematology

Ashley Dowdy, PA-C

Advanced Practice Provider/Breast

Michael Farmer, MD

Radiation Oncology

Richard E. Fine, MD, FACS

Breast Surgeon

Phyllis Fiveash, ANP-FNP

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Heather Greene, MSN, FNP, AOCNP

Advanced Practice Provider/MedOnc

Axel Grothey, MD

Medical Oncology / Hematology

Kristen Hayes, DNP, FNP-C

Advanced Practice Provider, High Risk Breast Cancer Provider

Holger Gieschen, MD

Radiation Oncology

W. Clay Jackson, MD, DipTh

Palliative Care

Robert A. Johnson, MD, FACP

Medical Oncology / Hematology

Bethany Kelley, ANP-FNP

Advanced Practice Provider/MedOnc

Michael Levinson, MD

Gastroenterologist

Aimee Martin, MS, CGC

Genetic Counseling

Carrie McKiernon, ANP-FNP

Advanced Practice Provider/MedOnc

Michael G. Martin, MD

Medical Oncology / Hematology

Micah Monaghan, MD

Radiation Oncology

Arnel M. Pallera, MD

Medical Oncology / Hematology

Janice Pazar, PhD

Psychologist

Lisa Rader, ANP-FNP

Advanced Practice Provider/MedOnc

Daniel K. Powell, MD

Radiology

David C. Portnoy, MD, FACP

Medical Oncology / Hematology

Thomas Ratliff, MD

Medical Oncology / Hematology

Jason Porter, MD

Medical Oncology / Hematology

Jarvis D. Reed, MD

Medical Oncology / Hematology

Mark Reed, MD, FACOG

Gynecologic Oncology

Sylvia S. Richey, MD

Chief Medical Officer, Medical Oncology / Hematology

David B. Robins, MD

Pathology

Kurt Patton, MD

Pathology

R. Grant Muller, MD

ENT Oncology Surgeon

Courtney Shires, MD

ENT Oncology Surgeon

L. Mackenzie Harbin, MD

Gynecologic Oncology

Linda Smiley, MD, FACOG

Gynecologic Oncology

Bradley G. Somer, MD

Medical Oncology / Hematology

Kurt W. Tauer, MD, FACP

Medical Oncology / Hematology

G. Gary Tian, MD, PhD, FACP

Medical Oncology / Hematology

Sommer Brannan MSN, FNP-C

Advanced Practice Provider, Palliative Care

Lan Tran, PA-C

Advanced Practice Provider/MedOnc

Todd Tillmanns, MD, FACOG

Gynecologic Oncology

Patricia Turner, MD

Breast Center, Radiology

Daniel Vaena, MD

Medical Oncology / Hematology

Steven Nokes, MD

Breast Center, Radiology

Noam VanderWalde, MD, MS

Clinical Research, Radiation Oncology

Katie Vaughn Wells, ANP-FNP

Advanced Practice Provider/MedOnc

Carmel Verrier, MD, PhD

Medical Oncology / Hematology

Leah C. Tonkin, MD, MBA, DipABLM

Lifestyle Medicine

Gregory Vidal, MD, PhD

Medical Oncology / Hematology

Eric Wiedower, DO

Medical Oncology / Hematology

Elizabeth Wheeler Ott, PA

Advanced Practice Provider/MedOnc

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