Individualized cancer care with radiosurgery

Illustration of human spine

Patients who have metastatic cancer, or cancer that has spread to a secondary site, often have more symptoms than those in early stages of the disease.

They are more likely to have pain and debilitating side effects from wherever the tumor has spread. Even though many of these patients will require chemotherapy to treat the entire burden of their disease, it’s possible they have one area that’s especially symptomatic.

That’s where a new clinic at Emory comes in. Emory neurosurgeon Costas Hadjipanayis and colleagues recently launched a neuro-oncology clinic at Emory University Hospital Midtown.

In this multidisciplinary effort between radiation oncology and neurosurgery, physicians evaluate patients to determine which approach will work best for spinal tumors and associated pain. Choices for treatment include traditional surgical resection of the tumor, radiation, or spinal radiosurgery.

Initially stereotactic radiosurgery was used to treat brain tumors, but now it has gained currency as a treatment for various other types of cancer. The surgeon uses x-ray beams instead of scalpels to eliminate tumors of the liver, lung, and spine.

Stereotactic radiosurgery is actually a combination of surgical principles. But because it uses radiation, there’s no incision, no anesthesia, and no trip to the operating room—therefore, no hospitalization.

The surgery makes it possible to noninvasively eliminate spinal tumors—an ideal way to deliver palliative care to patients whose cancer has metastasized to the spine, causing acute pain. Palliative care enhances quality of life for patients suffering from serious, chronic, or terminal conditions.

In fact, Emory’s Winship Cancer Institute is now participating in a national clinical trial involving image-guided radiosurgery for spine metastasis, a common complication of many types of cancer. Although similar to other bone metastases, spine metastases have unique and problematic features, including spinal bone pain.

“This is an important study that we hope will lead to more effective treatment for spinal metastases with fewer side effects,” says Winship’s Executive Director Walter Curran.

“The impact on patients’ quality of life is a serious issue, and while previous studies have looked at partial pain relief, we hope the more advanced radiosurgery techniques will provide more effective and lasting pain control.” —Robin Tricoles

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