This means that a cancer somewhere else in the body has grown out of control and it has sent off cancer cells to other parts of the body. It has metastasized.
For patients with this diagnosis, maintaining mental sharpness is a priority because they want to enjoy their last years or months with their loved ones. Unfortunately, they are often faced with a difficult choice – maintain brain function or survive a little bit longer.
This is because whole brain radiotherapy, a longtime standard treatment when cancer has spread to the brain, is known to cause decreased learning and memory while prolonging survival.
Dr. Jeffrey N. Bruce, MD, Dr. Michael B. Sisti, MD and Dr. Guy McKhann II, MD from the Department of Neurosurgery recently collaborated with researchers from Columbia’s Departments of Radiation Oncology and Neurology as well as the Herbert Irving Comprehensive Cancer Center and the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain to study alternatives to whole brain radiotherapy. The research was published in the April 2015 Journal of Neuro-Oncology.
Researchers compared treatment combinations that included Gamma Knife Radiosurgery alone, with traditional neurosurgery, with whole brain radiotherapy or with both treatments. Because Gamma Knife Radiosurgery offers a radiation alternative that affects only the targeted tumor, it has been used as an alternative to whole brain radiotherapy.
The study shows that Gamma Knife Radiosurgery alone is not as effective as whole brain radiotherapy. However, survival was at least as good when Gamma Knife Radiosurgery was combined with neurosurgery, or with both neurosurgery and whole brain radiotherapy.
In fact, the combination of Gamma Knife Radiosurgery with neurosurgical removal of tumors offered an alternative to whole brain radiotherapy with similar survival times. This offers an option for patients who hope to avoid the unwanted effects associated with whole brain radiotherapy.
The optimal treatment of cancer that has spread to the brain remains elusive. But the team at Columbia continues to strive to solve this puzzle for their patients and for patients around the world.
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