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How Technology Helps Treat Your Tumor

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When you have a brain tumor, you need the advanced level of care that an academic-based medical center provides. You are assured of a better outcome when you have access to superior expertise and technology. Sylvester’s Brain Tumor Initiative offers South Florida’s most sophisticated diagnostic and treatment treatments.

Our techniques and technologies allow us to treat tumors other facilities often consider inoperable.

After a thoughtful and thorough review of your condition, our Molecular Tumor Board recommends a treatment option. We then develop your personalized treatment plan to address your needs before, during and after surgery.

To ensure the safest, most effective surgery, we invest in a variety of advanced technologies. The following provides a general overview of our capabilities. Your surgeon will review your specific procedure with you and answer any further questions you may have.

Brain Mapping (fMRI/DTI): Considered the gold standard of neuro-oncologic care, functional MRI and diffusion tensor imaging give our surgeons valuable information about a tumor’s characteristics. These neuronavigation tools help our surgeons perform pre-surgical planning known as “brain mapping”. Armed with this knowledge, they remove as much of the tumor as possible while preserving vital areas of the brain. Used for gliomas and metastatic tumors, this less invasive method promises a faster recovery and better long-term tumor control.

Intraoperative Computated Tomography (IOCT) Imaging:  The IOCT technique uses an imaging system that visualizes the tumor in real-time. This allows our surgeons to access difficult-to-reach brain tumors, especially those at the base of the skull. By enhancing surgical sensitivity, intraoperative imaging permits cleaner surgical margins. For patients, this means a lower recurrence rate and better long-term survival.

Clinical Research: Hearing our researchers discuss their work, you sense the passion and urgency behind their quest to cure complex brain cancers. To prevent or control tumor growth, we study a variety of factors, including how inflammation, immunity and conditions like obesity affect tumors. Some of our neuro-oncologic trials focus on immune-modulated tumor therapy using vaccines, radiation therapy and surgical procedures. With a dedicated lab and access to 10 other Health System labs, we can offer more cancer clinical trials than any other South Florida hospital. As our patient, you have access to emerging treatments and experimental drugs when or sometimes before they become widely available.

Vaccine-based Clinical Trials: We made medical history by using a patient’s tumor to create a vaccine to prevent recurrence. To make the vaccine, the surgeon harvests and purifies proteins from the tumor. The proteins are concentrated, then injected back into the patient as a vaccine. This stimulates the immune system to fight the tumor and prevent its return. Our program is one of only 10 in the U.S. offering these clinical trials. While still experimental, the vaccine is the best chance for survival for patients with aggressive glioblastoma multiforme or recurrent tumors.

Endoscopic Surgery: Using an endoscope, a thin, flexible tube with an attached light and camera, a neurosurgeon can reach gliomas or metastatic tumors within the brain (parenchyma) and within its fluid-filled cavities (ventricles). When inserted through one or two small incisions, the endoscope projects detailed images of the brain onto a screen. Guided by these images, our surgeons safely remove tumors while protecting the brain and surrounding nerve tissue.

Robotic Assisted Biopsies (ROSA): Our surgeons use robotic assistance to access, biopsy and treat tumors deep within the brain with submillimeter accuracy. ROSA enhances minimally invasive techniques such as laser ablation, by ensuring a highly precise placement of the laser catheter that is used to destroy tumors. Patients experience less pain, a faster recovery and typically spend just one night in the hospital.

Laser Interstitial Thermal Therapy (LITT): Patients often seek a second opinion when told their primary or metastatic brain tumor is inoperable. LITT is a viable response to many of these requests. To perform LITT, we insert a small laser catheter into the tumor through a tiny incision. The catheter tip is heated to a temperature that “cooks” or destroys the tumor from the inside out. Using real-time MRI feedback, the surgeon carefully regulates the laser temperature while focusing directly on difficult-to-reach tumors. This allows direct visualization of the surgical site while protecting important adjacent brain tissue. LITT also improves blood brain barrier penetration, which affects supplemental treatments such as chemotherapy. LITT generally takes just minutes to perform. Most patients go home the next day and resume normal activities quickly.

Tubular Minimally Invasive Neurosurgery: Using a tubular system, our neurosurgeons remove large, deep brain tumors without significantly displacing or manipulating brain tissue. By minimizing surgical trauma, we reduce complications, hasten healing and improve long-term outcomes.

Gamma Knife Radiosurgery: One of the most precise and effective treatments for benign or malignant brain tumors, gamma knife radiosurgery aims multiple weak radiation beams at the tumor. This focuses a stronger level of radiation directly on the tumor, while protecting surrounding healthy tissue. Because it requires no incisions, this method is used when traditional open surgery is too risky. Some patients only require one radiosurgery to treat multiple glioma tumors. Radiosurgery also treats vascular malformations, pain and functional conditions.

Awake Craniotomy Surgery: Using a sophisticated intraoperative monitoring and neuro- stimulation system, we safely remove gliomas and metastatic tumors while the patient is sedated but awake. In this way, our surgeons remove complex tumors while protecting crucial speech and motor functions. Throughout the procedure, the surgical team instructs the patient to speak or move parts of their body. This alerts the surgeon to avoid affecting areas of the brain responsible for these functions. By providing real-time feedback, patients experience better quality of life after surgery. This method also minimizes bone and brain tissue injury. We are one of the few South Florida hospitals performing this procedure.

Fluorescence-guided Surgery: The new FDA-approved medication 5-ALA actually “lights up” tumors to aid in identification and removal. During surgery, it can be difficult to tell a tumor apart from healthy brain tissue. When patients take the 5-ALA compound before surgery, the drug turns the tumor neon pink but does not affect healthy tissue. This helps the surgeon accurately identify and remove unhealthy masses. Clinical trials show that surgeries performed with 5-ALA maximize the ability to completely and cleanly remove malignant tumors. We were one of the first facilities in Florida using this technique.

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