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Our doctors are happy to discuss your individual case with you. Serious inquiries only, please. To request an initial
team consultation, call Dr. Arenson, For more information
about CNI's Brain & Spinal Tumor Team, |
Two very different philosophies exist when it comes to treating malignant brain tumors. Our strategy is to use in a coordinated fashion several available treatments with known value aimed at achieving a state of complete remission where no tumor can be identified by MRI scan (also known as "radiographic remission"). Patients who achieve this goal, we believe, have the possibility of substantial improvement in survival and, most importantly, are legitimate candidates for cure.
The CNI Center for Brain & Spinal Tumors employs a neurosurgery, combined chemotherapy and radiation therapy, sometimes followed by another surgery or radiosurgery, and biological therapy. Using this approach we have had very encouraging results over the last 3 years. These results will be posted on this website in the near future and will be updated on a quarterly basis.
Doctors who treat cancer patients diagnosed with malignant brain tumors can be divided into two camps espousing very different philosophies. One camp believes that these tumors are uniformly fatal and that the best approach for such patients is to avoid doing harm. This philosophy has merit since statistically most patients die of their disease, and it is important to preserve dignity and quality of life. The problem with this approach is that it is a self- fulfilling prophecy which, while sparing some patients the burden of ineffective treatment and its side effects, also may deprive many patients of a chance for a better outcome. Furthermore, the "do no harm" approach can never lead to progress.
The other camp, which we support for most patients, believes that the worst enemy of the brain tumor patient is the tumor itself, and that aggressive treatment can provide some patients with substantial improvement in duration of outcome as well as quality of life. Such aggressive therapy if it becomes too burdensome or is not successful can be discontinued; but most patients, in our experience, want to take an aggressive approach to their tumors if it is appropriate to do so.
Our strategy is to use several available treatments with known value in a coordinated fashion aimed at achieving a state of complete remission where no tumor can be identified by MRI scan. Patients who achieve this goal, we believe, have the possibility of substantial improvement in survival and, most importantly, are legitimate candidates for cure. Not all patients are good candidates for this aggressive approach because of a number of factors that include neurologic status as well as the location of their tumors and whether or not there are multiple tumors. Each patient is treated as an individual with unique needs, and treatment is determined accordingly after extensive discussion between family members and the Brain Tumor Team.
Essentially, along with initial surgery where the surgeon attempts to remove as much tumor as possible. Our highly experienced neurosurgeons employ the latest tools and techniques, including awake craniotomy, functional MRI with pre- or intraoperative functional mapping, frameless stereotaxy, and laser. Read more about surgical treatments.
Consistent with our philosophy to treat with the intent to cure, we have developed an innovative approach, which provides chemotherapy during radiation and then intensifies chemotherapy after radiation. This approach is now formalized into an institutional research protocol CNI/SMC BT2001. The use of combined chemotherapy and radiation therapy is an innovative technique that takes advantage of the potential of chemotherapy to increase the sensitivity of the tumor to radiation therapy. In addition, two effective treatments given simultaneously are apt to be more efficacious than when given sequentially. Read more about our chemotherapy treatments.
Following completion of the combined chemo radiotherapy program, which can take 3-5 months. patients are reevaluated by MRI scan and presented to the entire team. Surgery is our preferred recommendation for removal of any residual disease. Many times, the initial chemo radiotherapy will significantly reduce the amount of residual disease to the point where complete surgical removal is feasible. When possible, this is the best approach. If not, residual disease may be treated with radiosurgery, is a non-surgical technique in which radiation therapy is used as if it were a surgical procedure using a method which precisely focuses the radiation on the area of residual disease in a single treatment which is calculated to destroy the residual tumor.
Following completion of this aggressive phase of therapy, patients then go on to a final biological therapy phase in which they will take the drug tamoxifen in high doses plus or minus the drug thalidomide. These drugs are not chemotherapeutic agents, and as such, are not nearly as toxic. They are, however, agents which have been shown to have a beneficial effect on malignant brain tumors in such a way that the tumor will either stop growing or become more differentiated and therefore less likely to progress. We have had very encouraging results with this phase of therapy which has been well tolerated by our patients.
In summary, in order, to achieve complete radiographic control of a malignant brain tumor, which we consider to be an essential requirement for long term survival, we employ a combination of surgery, combined chemotherapy radiation therapy and biological therapy. Using this approach we have had very encouraging results over the last 3 years. These results will be posted on the website in the near future and will be updated on a quarterly basis.
Please visit our Treatments page for more information.
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Colorado Neurological
Institute Center for Brain & Spinal Tumors
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