Treatments and Technologies at the Brain Tumor Center at The Jewish Hospital – Mercy Health

Each patient’s treatment depends on the type, size and location of the tumor, so the Brain Tumor Center's specialists meet at a bi-weekly Tumor Board Conference to discuss complex cases, review treatment options and create a treatment plan for each individual patient.

For more information, please call (855) 823-1537.

Airo® Mobile Intraoperative CT Scanner

Airo Mobile Intraoperative CT ScannerThis small but powerful mobile CT scanner provides high-resolution images in real time, giving surgeons a clear view of the patient’s anatomy during brain tumor surgery. The technology helps surgeons perform minimally invasive approaches and procedures and enables them to confirm that the tumor has been completely removed before the surgery is completed and no fragment is left behind.  

Awake Craniotomy

A craniotomy is a procedure in which neurosurgeons remove part of the skull. In some delicate procedures, this is done while the patient is awake so that the surgeon can use brain-mapping techniques to avoid critical functional areas, such as speech or arm movement. The patient performs tasks, such as reading, while the exposed brain is stimulated. The patient feels no pain. 

Chemotherapy: Intrathecal

Intrathecal chemotherapy involves the delivery of chemotherapy drugs into the brain or spinal fluid through a catheter or port. This treatment is appropriate for patients whose cancer cells have metastasized into the brain or spinal fluid.

Chemotherapy: Systemic

The Brain Tumor Center offers the complete spectrum of systemic chemotherapy for patients with primary brain tumors or cancers that have metastasized to the brain from other parts of the body. Treatments include targeted therapies such as Avastin. Chemotherapy is often prescribed as a treatment in addition to surgery and/or radiosurgery.   

Continuous EEG Monitoring

State-of-the-art electroencephalogram (EEG) monitoring is available for continuous, 24-hour use for patients who are undergoing or have undergone the removal of a brain tumor.  Continuous EEG is used to monitor for electrical seizures that occur during surgery or after surgery when the patient is recovering in the intensive care unit. 

Endoscopic Surgery

Endoscopic surgery is minimally invasive surgery in which surgeons make small, keyhole incisions in the skull, eyelid or nose, and use long slender instrumentation (endoscopes) to remove tumors located deep within the brain. Endoscopic surgery is often performed during skull base surgery, with tumors being removed through the nose.

Gamma Knife® ICON Radiosurgery

Gamma Knife ICON RadiosurgeryGamma Knife uses precise, high-intensity gamma rays to treat lesions in virtually any location in the brain with ultra-high precision and minimal effect on healthy tissue. When a small tumor is being treated, a single dose of radiation is given in a single session using a rigid frame. When a large tumor is being treated, radiation is given in 5 treatments using a mask system. The ICON promises accuracy to .5 millimeters while delivering a radiation dose to healthy tissue that is two to five times lower than competing technologies. The ICON’s frameless “mask” option enables treatment of previously challenging tumors, including large lesions. 

Intraoperative Electrophysiology

Surgeons use various types of intraoperative electrophysiology during surgery to make sure they do not cause harm during tumor removal. This important technology is critical when surgeons operate near “functional” tracts – areas involved with movement, balance and coordination. Evoked potential monitoring is used during surgery for acoustic neuromas to ensure that the facial nerve is not harmed.

Intraoperative Fluorescence-Guided Surgery

Intraoperative fluorescence imaging helps neurosurgeons remove malignant brain tumors that have poorly defined borders. High-grade gliomas may have a central mass, but they often extend tentacles of tumor cells into adjacent brain tissue. Surgeons can identify these cells more easily when they are illuminated and made to fluoresce with special medications.

Intraoperative Ultrasound

When surgeons remove a tumor, the brain adjusts to the vacancy by shifting. Intraoperative ultrasound is a type of real-time image guidance that helps surgeons understand how the brain is adjusting during tumor removal. Intraoperative ultrasound also enables surgeons to ensure that blood flow to the brain continues unimpaired during the procedure. 

Skull Base Surgery

The skull base is the area from the ears and nose to the base of the skull. It is a complex anatomical filled with arteries, cranial nerves and bones. Extracting tumors from this region – including pituitary and meningioma tumors – requires surgical dexterity, experience and care. Neurosurgeons often work in tandem with ear, nose and throat surgeons when operating in the skull base, using image-guidance systems and endoscopes to skillfully remove tumors. 

Stereotactic Neuronavigation

Neurosurgeons use neuronavigation, or “GPS for the brain,” to plan and guide surgeries. Different types of brain scans are fused together to create a 3D map of the patient’s brain and are installed into a surgical guidance computer. The surgeon is able to view the brain tumor and its relationship to blood vessels, electrical pathways, and “eloquent” areas involved in speech and mobility. This enables the surgeon to operate without harming areas that are vital to the patient’s quality of life.

Tumor Treating Fields or TTFields (Optune™)

TTFields is an FDA-approved treatment that slows and reverses tumor growth by keeping cells from dividing. TTFields is used for the treatment of glioblastoma multiforme (GBM) in combination with temozolomide in adults who have been newly diagnosed. It is also approved for treatment of recurrent GBM after surgical and radiation options have been exhausted. Treatment involves wearing a device resembling a bathing cap that delivers electromagnetic energy to the scalp. Patients wear the device for 18 hours a day over a period of 4 weeks.