Category Archives: Brain Tumor

The Cyber Knife Breaths with You

Dr. Hughes explains how the Cyber Knife is used to treat cancers such as lung, prostate, kidney, brain, spine and many others. Not only can we control the radiation beam to mere millimeters, the real time imaging allows the Cyber Knife to track the tumor to ensure that we target only the cancer. It actaully breaths with our lung cancer patients.  It follows the motion of the prostate. It sees into the brain during treatment. There is NO other radiation treatment that can do this. Watch!

Cyber Knife is the Best for Brain Metastasis

Why Cyber Knife?   

Stereotactic radiosurgery (Cyber Knife)  alone – without whole brain radiation – is now considered the standard of care for patients whose cancer has spread to the brain in only 1-3 places.

But did you know that 3 Cyber Knife treatments are better than a single dose of Gamma Knife for patients whose metastatic brain tumors are greater than 2 cm? 

In a breakthrough study, Dr. G.  Minniti  and co-workers looked at 289 patients with brain metastasis greater than 2 cm who underwent radiosurgery as primary treatment.

Head frame is screwed into the skull for treatment with the Gamma Knife.

A head frame is screwed into the skull for treatment with the Gamma Knife.

The remarkable finding was that patients who underwent 3 doses with the Cyber Knife not only had better control of their brain metastasis but also had less risk of a bad side effect called brain necrosis.  Brain necrosis can result in weakness, numbness, speech problems and seizures.  So preventing brain necrosis and its side effects is very important for quality of life.  Dr. Minniti’s study was reported in the prestigious International Journal of Radiation Oncology Biology and Physics (95:1142-1148,2016). 

The Cyber Knife Difference  

A soft mess mask is designed for each patient receiving treatment with the Cyber Knife.

A soft mess mask is designed   for each patient receiving treatment with the             Cyber Knife.

So for patients whose brain metastasis are greater than 2 cm, Cyber Knife appears to be theanswer.  Cyber Knife’s accuracy is comparable to Gamma Knife, but Cyber Knife treatment is painless.  A custom mask holds your head in place with no pain and no incisions.  For Gamma Knife treatment, your neurosurgeon needs to give you conscious sedation and local anesthesia in order to screw the Gamma Knife frame into your skull.  It’s not a procedure that you want to go through 3 consecutive days in a row. Learn more about the Cyber Knife treatment here.

If you have any questions about your brain tumor treatment, please feel free to call me, Dr. Edward Hughes, at 855-DAYTON1.  I guarantee that I will see you in consultation within 1-3 days, an unparalleled guarantee for any cancer specialist in Southwest Ohio.

Targeted Therapy Improves Radiosurgery for Patients with Metastatic Melanoma To the Brain

Radiosurgery, like that delivered by Cyber Knife, plays a big role for patients with metastatic melanoma with spread to the brain.  It’s an all too common situation-as many as 25-50% of melanoma patients develop brain metastasis during the course of their disease.  And 20-50% of all deaths among melanoma patients are linked to spread to the brain. 

But there is now good news, especially for metastatic melanoma patients whose tumors carry that BRAF V600 E mutation – about 50% of all patients with melanoma.

Physician researchers from NYU’s Langone Medical Center in NYC showed that treating metastatic melanoma patients with drugs that inhibit the BRAF mutation after radiosurgery did better than those patients on BRAF inhibitors before radiosurgery for their brain metastasis. 

And the survival results were significant with 41% of metastatic melanoma patients surviving at 12 months after radiosurgery and treatment with the BRAF inhibitor drugs compared to 19% for those patients who did not have the mutation.  The inhibitor drugs included dabrafenib, vemurafenib, or the dabrafenib/trametinib combination. 

Dr. Amparo Wolf, the senior author of this study, told Medscape Medical News, “What we have shown is for the first time median survival of melanoma has passed 1 year.”  The paper was published in the May 2016 issue of the Journal of Neuro Oncology and presented at the recent meeting of the American Association of Neurological Surgeons. 

From my point of view, the implications of the study are huge.  Firstly, it’s great news for metastatic melanoma patients whose cancer has spread to the brain.  Secondly, using targeted therapies, like the BRAF inhibitor drugs, opens up the possibility of using other targeted therapies against many other cancers, like lung, breast, prostate, kidney, and colon cancer.  Finally, I believe that the use of targeted therapies, identified by genetically mapping an individual patient’s cancer, and combining a precision drug with radiosurgery is the wave of the future. 

If you have any questions about your brain tumor or brain metastasis, please feel free to call me, Dr. Edward Hughes, at 855-Dayton1