Cancer that has spread from elsewhere in your body to your brain or spine is called metastatic cancer of the central nervous system. Most brain tumors are metastatic. At the University of Chicago Medicine, we offer leading-edge treatments for all forms of metastatic brain and spine tumors.

Why choose UChicago Medicine for metastatic tumors of the brain and spinal cord?

  • From your first visit, diagnosis, treatment and follow-up care, our multidisciplinary approach engages experts in neuro-oncology, neurosurgery, radiation oncology and medical oncology to deliver the most effective, convenient care.
  • MRI-guided laser ablation is one of our state-of-the-art technologies that ensures patients receive the least-invasive treatment so that they heal faster and return to regular activities sooner.
    Our physicians are actively conducting ground-breaking clinical trials. 
  • UChicago Medicine brain and spinal tumor experts regularly provide second opinions on diagnosis and treatment plans, including for complex and rare cases

Physicians at the UChicago Medicine metastatic brain and spine cancer program have developed a comprehensive approach focused on the management of brain and spine metastases, including:

  • Brain metastases of any type (including lung, breast, skin, colon and kidney cancer as well as lymphoma)
  • Cancer that has spread to spinal fluid (leptomeningeal metastases, also known as carcinomatosis meningitis)
  • Spinal metastases
  • Dural metastases (tumors that arise in the membrane surrounding the brain and spinal cord)

Treatment 

At UChicago Medicine, we harness the power of precision medicine and a team approach to provide personalized care for patients with metastatic brain and spine cancer.

Surgery

Neurosurgeons at UChicago Medicine now operate on many tumors that were previously considered inoperable thanks to high-precision surgical techniques and tools:

  • Minimally invasive neurosurgery offers shorter recovery times and fewer complications than traditional surgery. For instance, surgeons may use endoscopic techniques that involve operating through a small incision using thin tubes to preserve critical, delicate tissues while providing more direct access to tumors.
  • Image-guided minimally invasive laser ablation can destroy tumors while preserving surrounding brain tissue.
  • Neuro-navigation tools are used like a GPS for the brain, allowing greater accuracy when removing abnormal tissue while preserving healthy tissue.  
  • Skull base surgical techniques enable our neurosurgeons and neuro-otologists to operate on tumors located near the base of the skull without destroying vital brain and brain-stem functions.
  • The full range of conventional and complex open skull and spine surgeries involving microsurgical techniques to treat tumors. 

Radiation Therapy

Even when a brain or spinal metastasis is removed through surgery, radiation therapy is often recommended to destroy any remaining cancer cells. Radiation can be used alone or with other types of treatment like surgery or chemotherapy. UChicago Medicine patients with brain and spine metastases have access to sophisticated radiation treatments, including:

Stereotactic radiosurgery (SRS) uses highly accurate positioning systems and 3D imaging to precisely map the location of the tumor and surrounding anatomy. Without any incision, doctors can accurately target a high-dose radiation beam on the tumor, causing it to shrink or even disappear. Even very small lesions can be treated with SRS. Since it is very focused, the normal tissue around the tumor gets little or no radiation. SRS can be used for inoperable skull-base tumors, arterial venous malformations (AVMs), pituitary tumors, trigeminal neuralgia and other benign conditions.
Intensity-modulated radiotherapy (IMRT) is a precise form of three-dimensional radiotherapy that uses computers and multiple beams to shape radiation to the treatment area. IMRT allows doctors to "turn up" the radiation dose on tumor areas while excluding sensitive regions, such as the brain stem and spinal cord.
UChicago Medicine was one of the first hospitals to provide this advanced imaging and treatment technology, which can more precisely identify a tumor’s position. This ensures the accurate delivery of radiation to the tumor.
Whole brain radiation is used when there is more than one tumor in the brain or if cancer has spread throughout the brain. 
Hippocampal-sparing whole brain radiation may be used to reduce memory problems related to whole brain radiation treatment. Because the hippocampus plays an important role in memory function, minimizing radiation to this area can help reduce the side effects that radiation can have on memory and cognition.

Chemotherapy

Chemotherapy is a type of treatment in which medication is usually delivered through your bloodstream to destroy the growth, spread or recurrence of cancer. You may receive a single medicine or a combination, and this may be used alone or with surgery or radiation therapy. Although clinical trial research is expanding the use of chemotherapy in treating brain tumors, it’s still only effective on a limited number of them. 

Chemotherapy is given in cycles; you may receive your therapy by injection or pill. If your cancer has crossed into the fluid that surrounds your spinal cord and brain, your doctor may treat you with intrathecal chemotherapy, which involves injecting medication directly into the cerebrospinal fluid. 

If the type of brain tumor you have can be treated with chemotherapy, your UChicago Medicine doctor will analyze your tumor’s cells to determine whether a particular drug may be more effective, based on the tumor’s molecular signature. New chemotherapies are also in development.

Targeted Drug Therapy 

Targeted therapy uses medicine to either target the parts of cancer cells that make them unlike normal cells or target other cells that help tumors grow. Targeted therapy can help when other treatments aren’t working; it may also have less-severe side effects than standard chemotherapy. There are numerous targeted therapies to treat metastatic brain tumors: EGFR, ALK/RET, HER2 and BRAF inhibitors are examples of some of the medications that slow or stop proteins involved in cancer cell growth.

Immunotherapy 

Your immune system protects you from infection, illness and substances that can harm your body. Immunotherapy is a developing field that harnesses the power of your own immune system against disease. Cancer immunotherapy acts on the cells of the immune system to seek out, recognize and attack cancer cells. For clinical trials involving immunotherapy, please visit the UChicago Medicine cancer clinical trials page.

Research and Innovation

Clinical trials and research are critically important when it comes to metastatic brain and spine tumors. Cancer that has spread from other parts of the body to the brain or spine is cancer that treatment has failed to contain. If you have a brain or spine metastasis, you may wish to participate in a clinical trial with the goal of further controlling your cancer.

UChicago Medicine is a leader in cancer clinical trials in Illinois, offering numerous phase I, II and III studies. Through our research, physicians are  establishing the standard of care when it comes to multiple metastatic brain tumors: for instance, hippocampus-sparing radiation means patients may have improved cognitive function after targeted radiation. 

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