The diagnosis of an inoperable brain tumor doesn’t have to mean certain death. A spinal tumor does not have to mean paralysis and a tumor that pushes on the auditory nerve doesn’t have to mean a life of silence. Instead, patients like 41-year-old Doug Reedy are finding options in technology, and hope at The Nebraska Medical Center.
When he first heard he had a large brain tumor, Reedy said he “just shut down.” He was told his only chance was an invasive and dangerous brain surgery that could lead to a stroke, blindness and possibly a coma.
A second opinion led Reedy to The Nebraska Medical Center where he found a second option in the Novalis radiation therapy system, which became available to patients in May.
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Novalis — Treats tumors in the head, brain, spine, neck, liver, lungs, pancreas and prostate. Novalis — Is flexible and can be used with a head ring for single-dose fractions or with an immobilization mask for multi-fraction doses. Novalis — Multi-fraction doses can decrease side effects in high-risk areas. (i.e. decrease risk of hearing loss, loss of vision and paralysis). |
“There’s always got to be an option,” Reedy said.
The Novalis system is a good one for Reedy who says he has not suffered any side effects from the therapy.
“Novalis uses multi-directional radiation beams that shape a three-dimensional volume of radiation dose around the tumor while avoiding critical structures that may surround it such as the optic nerve in Mr. Reedy’s case,” said Robert Thompson, M.D. medical director of radiation oncology at The Nebraska Medical Center, which is one of only 21 Novalis treatment sites in the country and the only place in the region to offer this state-of-the-art technology.
Dr. Thompson says Reedy has probably had the tumor for as long as 20 years and while it is not cancerous, it is dangerous.
“The tumor is about the size of a large egg. It is compressing the hypothalamus and threatening his vision as well as the brain’s blood supply,” said Arun-Angelo Patil, M.D., a neurosurgeon at The Nebraska Medical Center.
Reedy has lost sight in his left eye and the vision in his right eye is impaired. But since starting treatment about a month ago, he says he is seeing some signs of improvement.
Another patient, Chrisie Butler, was being tested for multiple sclerosis when doctors found the unexpected.
“There is a walnut-sized tumor at the base of Chrisie’s skull,” said Britt Thedinger, M.D., an otologist-neurotologist at The Nebraska Medical Center. “Surgery to remove the benign tumor carries serious risks like injury to the nerves controlling hearing, balance, voice, swallowing and shoulder movement.”
In Butler’s mind those risks were too high. Reluctantly, she scheduled the surgery still hoping for another option. Then she got a call from neurosurgeon George Green, M.D., telling her to cancel the surgery, he had found a better option while training on the Novalis at UCLA.
“Novalis offers several different options for shaping the radiation dose. The ability to deliver the treatment in several fractions (treatments) instead of a single one can very significantly reduce the risk of side effects in many cases,” said Charles Enke, M.D., chairman of radiation oncology at UNMC.
With Novalis Butler has experienced sporadic headaches and an occasional metallic taste in her mouth.
“This is a piece of cake compared to surgery,” Butler said. She has a better than 70 percent chance that the tumor will stop growing and even shrink without damaging her cranial nerves. Those are odds she’ll gladly take. “If it works, I don’t have to have that surgery,” she said.
The Novalis system by Brain Lab is the most innovative and advanced option available to treat tumors of the brain, head, neck, spine, liver, lung and prostate without harming surrounding healthy tissue. This sophisticated approach to stereotactic radiosurgery and radiotherapy is quickly becoming the standard of care for advanced cancer treatment.
“Gamma knife has been available for decades as a way of delivering focused radiation in a single treatment,” Dr. Enke said. “Novalis can treat any clinical problem that the gamma knife can treat, but the converse is not true. For example, Novalis can treat areas in the skull base that gamma knife cannot reach. It can deliver a single fraction dose when appropriate but also has the ability to deliver fractionated treatment which may be desirable in certain clinical applications. In addition, Novalis is FDA approved to treat locations anywhere in the body while gamma knife is strictly limited to the brain and skull,” he said.
What makes it so appealing to patients is the non-invasive delivery of a precise dose of high-energy radiation, which can shrink or control the growth of a tumor by killing tumor cells or interfering with their ability to grow. It is virtually painless; the patient remains awake throughout the procedure, which is usually performed on an outpatient basis.
Reedy said he was thrilled when he heard about this option. “I was walking on air when I left the hospital that day,” Reedy said.
His wife Stacy agreed. “It was like music – it was too good to be true,” she said. “I thought it can’t be this easy!”
Butler and Reedy have continued working full-time during their therapy and are thrilled to have an option that wasn’t available to them a couple of months ago.