Neuro Oncology Program
Maine Medical Center's Neuro Oncology Program is a unique collaboration between the medical center's Neuroscience and Cancer Institutes. The program provides comprehensive care for patients with primary brain tumors, metastatic lesions (cancer that has spread from original site) to the central nervous system, and complex spinal tumors. Each year, we treat hundreds of patients with brain and spinal tumors, including some of the most difficult cases in the state.
Our Neuro Oncology team treats brain and spinal tumors in both adults and children, including:
- Anaplastic and low-grade astrocytomas
- Mixed malignant gliomas
- Primary CNS lymphomas
- Primitive neuroectodermal tumors (medulloblastoma, neuroblastoma, esthesioneuroblastoma)
- Ewing's sarcoma
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The Neuro Oncology Team
A multidisciplinary team of specialists in medical oncology, neurosurgery, radiation oncology, neurology, neuroradiology, pathology, and palliative care works together to tailor treatment plans to the individual patient. These plans take into account the needs of each patient and family while providing state-of-the-art care.
The team holds interdisciplinary case conferences and has developed a research and quality outcomes database on more than 1,000 brain tumor patients who have been treated in recent years. For example, a recent study comparing MMC's median and two-year survival rates for Glioblastoma Multiforme (GBM) indicates that our results compare favorably with national trends. Also, as part of our commitment to ongoing medical education, the MMC Cancer Institute sponsors an annual cancer symposium to keep clinicians abreast of advances in oncology diagnosis and treatment.
The Maine Center for Cancer Medicine, a private oncology group affiliated with the Cancer and Neuroscience Institutes, also maintains a robust database that can be used for improving the quality of neuro oncology care for patients. One of the outstanding oncologists from this group, Dr. Devon Evans, is Medical Director of Neuro Oncology.
Leading-edge Methods of Diagnosis &Treatment
Our patients benefit from the newest advances in surgical techniques, radiotherapy, chemotherapy and neurodiagnostic imaging. The medical center remains on the leading edge of therapy by participating in basic, translational and clinical research in the neuro oncology arena. As a result, patients have access to the latest treatment protocols as well as appropriate clinical trials, resources that may not be available at other hospitals.
Diagnostic and treatment resources for brain and spinal tumors available at MMC include:
- Advanced pre-surgical and intraoperative planning - Our neurosurgeons use neuro-navigational technology that combines sophisticated imaging techniques and advanced computer software to visualize the brain in three dimensions. This enables them to determine the precise location of a brain tumor, minimizing risk to surrounding areas of the brain and improving the extent of tumor removal.
- MR spectroscopy assesses the metabolic status of a tumor, helping to differentiate between tumor recurrence and tissue necrosis (tissue that has been destroyed by treatment).
- Intensity-Modulated Radiation Therapy (IMRT) is a new type of conformal external beam radiation therapy that enables the radiation oncologist to not only more precisely shape the beam to the tumor, but also vary the intensity of the beam as it passes near or through non-cancerous tissues. As a result, a uniform dose of radiation can be delivered to the tumor while sparing toxic doses to nearby critical neurologic structures.
- Stereotactic radiosurgery is a minimally invasive treatment option that has revolutionized the treatment of lesions deep within the brain. Using beams of radiation that deliver a lethal dose to the tumor while minimizing radiation exposure to the surrounding brain, stereotactic radiosurgery avoids the risks of open surgery and long hospital admissions. Patients are able to return home right after the procedure.
- Awake craniotomy with language mapping can be used in certain cases when a tumor infiltrates brain tissue that affects an essential function such as speech. The patient is fully anesthetized during the opening and closing portions of surgery. After the brain is exposed, the patient is brought into a conscious state and relevant areas of the brain are stimulated to assess for function and pinpoint what tissue can be safely removed.
- Chemotherapy is an option for some patients with brain tumors. In addition to a full range of traditional chemotherapeutic agents administered intravenously, a new method of delivering anti-cancer drugs directly into the area of the tumor also is available. Chemotherapy-impregnated wafers can be applied by the neurosurgeon at the time of surgery; the wafers slowly secrete the drug into the tumor, enabling patients to receive chemotherapy without systemic side effects.
- Embolization, performed by an interventional neuroradiologist, reduces the blood supply to the cancer, often causing the tumor to shrink and making it easier to treat surgically or with radiation.
- Investigational therapies. As an academic medical center, MMC believes that quality patient care depends on ongoing research and education. Because of MMC's own research initiatives and connections to other research centers, patients diagnosed with cancer in Maine have access to the very latest clinical trials and new protocols.
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Support for Patients & Families
We recognize the emotional impact that a diagnosis of brain or spinal cancer can have on the patient and family. Neuroscience patients admitted to MMC have access to resources in the areas of social work, care coordination, discharge planning, behavioral medicine, and more to help support them through their care process. In addition to these resources, the services of a specialized Neurosciences Patient and Family Liaison are available to provide expert, personalized, and compassionate support to patients and their families throughout the continuum of care, in both inpatient and outpatient settings. Mary Otis, RN, MS, CCRN, is a seasoned and highly regarded MMC Special Care Unit nurse serving as the Neurosciences Liaison.
Referrals for these services for patients in the hospital may originate from the nursing staff, medical staff, social workers or care coordinators. Patients and family members or their physicians may also choose to contact the Neurosciences Patient and Family Liaison directly in the outpatient setting. Reasons for a consult vary, but may include the need and/or the desire for more education about their diagnosis or procedure. Patients and their loved ones may also want to establish connections with outpatient or community resources and need assistance doing so. The Liaison can help guide people through their inpatient and outpatient course of therapy and be a point of contact after discharge to help resolve any issues affecting their recovery.
Neuro Oncology at Maine Medical Center
Mary Otis, Patient and Family Liaison
22 Bramhall Street
Portland, ME 04102