The University of Mississippi Brain Tumor Program has developed an extensive
referral system for the diagnosis, management, rehabilitation and long-term
care of patients with tumors of the brain, spinal cord, skull
base, spine, peripheral nerves and nerve plexuses. The functions
of the Adult Brain Tumor Program program are facilitated by the University’s
state-of-the-art facilities and collaboration between the Departments of
Neurology, Radiation Oncology, Neurosurgery, Medicine, Radiology, and Pathology.
The comprehensive management of tumors of the nervous system requires four
stages: Diagnosis, Primary Treatment, Adjuvant Treatment, and Long Term
Follow-up and Rehabilitation. Treatment usually consists of a combination
of surgery, chemotherapy, and radiation.
Diagnostic Services
Newly diagnosed patients will be evaluated at the multidisciplinary
Neuro-oncology Clinic at the UMC Thad Cochran Comprehensive Cancer
Center.
Neuroradiological technology available at the UMC includes
computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance
spectroscopy (MRS), radionuclide SPECT scanning, PET scanning, and cerebral
angiography.
Once a possible tumor has been identified, it is generally necessary
to obtain tissue to confirm the diagnosis and identify the specific tumor
type. The Department of Neurosurgery offers a complete array of diagnostic
capabilities including open biopsy, frame-based and frameless
(image-guided) stereotactic biopsy, and Interventional MRI-guided biopsy.
Following tumor biopsy, complete pathologic analysis
including general histopathology, electron microscopy, immunopathology,
hormone receptor analysis, cytogenetic studies, and flow cytometric DNA
analysis are routinely available and performed by a dedicated neuropathologist.
These studies allow a "tailored" approach to the management
of some tumors.
Surgery and Radiosurgery
The Faculty members of the Department of Neurosurgery have extensive
experience in the surgical treatment of tumors of the skull, skull base,
spine, brain, spinal cord, peripheral nerves and brachial plexus. The
Department of Neurosurgery employs state-of-the-art surgical instrumentation
and technology in the management of brain and spinal tumors including
frameless stereotaxy, intraoperative ultrasound, intraoperative cortical
motor and language mapping and electrophysiological monitoring, the ultrasonic
surgical aspirator, surgical laser, neuroendoscopy, and intraoperative
angiography.
Intraoperative
MRI:
UMC was one of the first centers in the country to install the General
Electric Signa SP Intraoperative MRI. This technology allows the surgeon
to “see” the tumor during surgery, to ensure that the maximum
amount of tumor is removed while preserving the normal brain tissue. This
machine is available at only a handful of centers around the country.
Stereotactic
radiosurgery
is alternative to standard surgery in which the patient is given a
one-time dose of focal radiation to the tumor. It is performed as an outpatient
procedure in which the patient has a head-frame placed, an MRI scan is
obtained, and then the radiation treatment is performed, which usually
lasts less than one hour. We utilize linear-accelerator (LINAC)-based
radiosurgery at the University of Mississippi Medical Center, as well
as the Gamma Knife at the Robert R. Smith Gamma
Knife Center.
In some cases, endovascular embolization of tumor
vessels will be performed (through the Interventional Neuroradiology Program)
to decrease the blood supply to the tumor, thus increasing the safety
of surgical excision and decreasing the need for blood transfusion at
the time of surgery.
The perioperative care of patients undergoing tumor surgery is facilitated
by involvement of dedicated Neuro-anesthesiologists and Neuro-intensivists
in the new UMC Neuroscience Intensive Care Unit.
Chemotherapy
Because we concentrate on treating brain tumors,
only the most up-to-date chemotherapy protocols are used and the specific
needs of brain tumor patients receiving chemotherapy are addressed. Dr.
Fredericks is currently the only dedicated neuro-oncologist practicing
in the state of Mississippi.
Radiation Therapy
The Department of Radiation Oncology, relocating to the UMC Comprehensive
Cancer Center in the fall of 2004, will have state-of-the-art treatment
planning and therapy equipment allowing for more precise delivery of radiation.
In addition to traditional techniques, Intensity-Modulated Radiation
Therapy (IMRT) combines multiple imaging sources (CT, MRI, PET,
SPECT) to better define the target lesion. UMC will be one of the first
10 academic centers in the country to have this capacity. UMC will also
be working with NASA to develop a 3-dimensional holographic system to
further improve treatment planning.
New equipment will allow for stereotactic radiation to be delivered
anywhere in the brain or spine. Like the Gamma Knife, which is limited
to lesions in the head, this precise form of radiation is given as a one-time
dose.
Long Term Follow-up and Rehabilitation
Following treatment, an experienced team of physical, occupational, and
speech therapists works in conjunction with the Brain Tumor team to develop
a tailored plan of recovery for each patient. Nationally recognized adult
and pediatric Rehabilitation Hospitals adjacent to the University Medical
Center are available to persons requiring more intensive rehabilitative
services. The UMC Brain Tumor Program works closely with the referring physician
to coordinate the long-term follow-up and care of patients with tumors of
the central and peripheral nervous systems.
Research
Clinical Trials:
UMC participates in several National Cancer Group Programs and Protocols
investigating new treatments. UMC also participates in several multicenter
trials of new chemotherapeutic agents.
In addition to the clinical research UMC participates in, tumor specimens
are kept in the UMC Brain
Tumor Laboratory’s tumor bank for use in molecular
and genetic studies investigating the cause, diagnosis, and treatment
of brain tumors.
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