Brain Tumor Treatment Approaches

The City of Hope Brain Tumor Clinic offers patients the latest, most advanced treatment modalities. Our physicians specialize in the management of a variety of brain tumors, and through close collaboration, provide individualized patient care.
Neurosurgery is commonly used to treat patients with brain tumors. Our neurosurgeons have particular interest and expertise in the treatment of nervous system tumors including gliomas, metastatic tumors, meningiomas, pituitary, vestibular schwannomas (acoustic neuromas), skull base, peripheral nerve, spine, and spinal cord tumors. Our modern operating rooms are equipped with latest computerized stereotactic guidance systems and intra-operative imaging and monitoring modalities. Our group has special interest in the use of minimally invasive techniques, functional brain mapping, and stereotactic radiation therapy.
We believe that optimum care for patients with malignant brain tumor is only possible through a multidisciplinary approach with active involvement of neurosurgeons, neuro-oncologists, radiation oncologists, support staff and social services.

When applicable, our specialists utilize minimally invasive surgery (MIS) with advanced technologies such as laparoscopy. This surgery features small incisions and potentially:
Less blood loss, pain and visible incisions;
Shorter hospital stay and recovery time;
Fewer complications and quicker return to normal activities.
One of the following surgical procedures may be used:
  • Intraoperative cortical mapping
This technology gives the surgeon a computerized map of key brain regions, including speech, motor and sensory centers. By avoiding these critical areas, the risk of neurological damage is minimized while allowing as much of the tumor to be removed as possible.
  • Image-guided surgical navigation
In certain cases, City of Hope surgeons use this technology to guide the removal of tumors that are difficult to visualize or are located in “high-risk” areas of the brain. Using preoperative magnetic resonance images (MRIs), this highly accurate system allows for more complete removal of the tumor.
  • Endoscopic surgery
Certain brain surgery procedures may be performed through an endoscope - a thin, lighted tube that requires a small opening and accommodates tiny surgical tools. Smaller openings minimize postoperative discomfort and risk of infection. City of Hope researchers are working to develop a miniaturized surgical system that will allow brain surgeries to be even less invasive, with an even lower risk of complications.
Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells. Our Radiation Oncology was the first in the western United States to offer the  Helical TomoTherapy Hi-Art System , one of the first radiation therapy systems of its kind to integrate radiation therapy and tumor imaging capabilities comparable to a diagnostic computed tomography (CT) scan.
The Helical TomoTherapy Hi-Art system integrates two types of technology – spiral CT scanning and intensity modulated radiation therapy, or IMRT , that produces hundreds of pencil beams of radiation (each varying in intensity) that rotate spirally around a tumor. The high dose region of radiation can be shaped or sculpted to fit the exact shape of each patient’s tumor, resulting in more effective and potentially curative doses to the cancer. This, in turn, reduces damage to normal tissues and offers fewer complications.
TomoTherapy is particularly useful in treating children with certain brain tumors. Because it operates with absolute precision, normal brain tissue is protected, reducing the risk of long-term cognitive problems.
Chemotherapy - the use of anticancer medicines - is another strategy used to combat cancers of the brain. Drugs may be given alone, or in combination with surgery and radiation therapy.
Generally, brain tumors are more difficult to treat with drugs than other cancers. This is because most drugs cannot cross the blood-brain barrier, a natural wall that prevents toxic chemicals from reaching brain cells. However, new drugs are being developed that can either cross the barrier or be delivered directly to the brain. An example of this is gene therapy.
At City of Hope our clinical and research teams are exploring new ways to treat brain tumors using gene therapy which is based upon understanding the disease at a molecular level. Gene therapy is an experimental treatment that involves introducing genetic material (DNA or RNA) into a person’s cells to fight disease. The purpose of cancer gene therapy is to eliminate tumor cells while sparing non-tumor cells from the cytotoxic (cell-killing) effects of the cancer treatment.
Learn more about City of Hope’s gene therapy research or active brain tumor clinical trials .