At Rocky Mountain Gamma Knife Center, our three physicians have a combined 70 years of experience with stereotactic radiosurgery for the treatment of brain tumors. We sat down with each one and asked about their backgrounds and clinical interests. Here is what Robert E. Breeze, M.D., who has been using Gamma Knife for the treatment of brain tumors for 25 years, had to say.
If you’ve ever felt the zap of nerve pain from when the dentist begins drilling before your mouth is adequately numb, you have some idea of what it feels like to have trigeminal neuralgia.
Trigeminal neuralgia is a chronic pain condition caused by a malfunction in the trigeminal nerve, which connects the brain and the face. The trigeminal nerve has three branches—one running to the eyes, forehead and scalp; one to the cheeks and upper teeth; and the third running to the lower teeth and jaw. Pain occurs when a nearby artery or blood vessel puts pressure on the nerve. Typically only one branch is affected, although it’s possible for two or even all three to be affected simultaneously.
We spoke with J. Adair Prall, a neurosurgeon nationally recognized for his expertise in treating trigeminal neuralgia, about this painful condition.
Patients whose cancer has spread to their brains now have new treatment options that can eliminate brain tumors. Targeted therapies, such as kinase inhibitors and immunotherapy, can reduce the size and/or number of brain tumors in many patients. This allows us to treat those tumors with surgery or gamma knife radiosurgery (radiation treatment) with a 95 percent success rate.
Up until the past decade, when a cancer metastasized (spread) to the brain, the outlook was grim. Brain metastases were considered so devastating that people often stopped treatment and went to hospice once they developed brain tumors. Then, we started getting more aggressive with brain tumor treatment.
At Rocky Mountain Gamma Knife Center, our three physicians have a combined 70 years of experience with stereotactic radiosurgery for the treatment of brain tumors and brain conditions. We sat down with each one and asked about their backgrounds and clinical interests. Here is what Stephen Cass, M.D., who has been treating acoustic neuromas with Gamma Knife therapy for 18 years, had to say.
Just as with tumors in other parts of the body, not all brain tumors are the same, which means treatments for brain tumors won’t all be the same. There are many ways to classify brain tumors but they all fit within three categories: malignant brain tumors, benign brain tumors, and metastatic brain tumors.
Malignant brain tumors, or primary brain tumors, are tumors that have developed from brain tissue and are most often cancerous. The most common type of malignant brain tumor is glioma. Gliomas arise from glia cells, which are the supportive cells in the brain. Gliomas account for 80 percent of all malignant brain tumors, yet only 30 percent of all types of brain tumors.
Patients tend to assume that when faced with a serious health problem, such as a brain tumor, they will be referred to a physician who will present them with all possible treatment options. But some treatments are so specialized that not all physicians know about or know enough about them to recommend. This is the case with Gamma Knife stereotactic radiosurgery. To perform Gamma Knife therapy, a physician must have exclusive training and be certified.
Many primary care providers in particular just aren’t familiar with Gamma Knife’s many benefits. So they may not think to refer their patients to a physician who offers it. And some doctors are compelled to refer to surgeons within a particular hospital or insurance network who may not offer alternatives to traditional surgery for brain tumors. All of this, unfortunately, leads to some patients missing out on this valuable option.
Non-invasive radiosurgery with Gamma Knife nearly always stops acoustic neuromas from growing, and halts symptoms of those benign tumors from worsening.
Unfortunately, radiosurgery can’t always reverse any hearing loss a patient has already suffered from an acoustic neuroma, also known as a vestibular schwannoma.
Hearing loss, typically occurring in one ear, is one of the most common symptoms of acoustic neuroma, reported in 95 percent of patients. “Often that is how we discover the tumor. A patient comes in with hearing loss in one ear,” says Rocky Mountain Gamma Knife Center otolaryngologist Stephen Cass, MD, who is also fellowship trained in neurotology (treatment of neurological disorders of the ear).