The Johns Hopkins Kimmel Cancer Center has one of the nation’s most robust neuro-oncology cancer programs, designed to treat brain cancers. This program is now available at the Center’s Washington, D.C., location at Sibley Memorial Hospital as well as in Baltimore, Md.
The Washington, D.C., program is led by internationally renowned experts including neurosurgeon Youssef Comair, radiation oncologist Carmen Kut, and medical oncologist Solmaz Sahebjam. These specialists work together to develop an individualized and innovative treatment approach for each patient.
Sahebjam is also director of the neuro-oncology program, and deputy director for clinical research, in the Greater Washington Area.
A Team Approach
A team approach to brain cancers is critical. Other experts, such as speech and language pathologists, oncology pharmacists, physical therapists, social workers and nutritionists, can be brought in to ensure coordinated care. Dedicated nurse navigators also provide patients with a central point person who can help with coordination.
The neuro-oncology program at Johns Hopkins Kimmel Cancer Center at Sibley Memorial Hospital is already providing patients from across the nation and world with advanced treatment options for their cancer. This includes the Johns Hopkins Proton Therapy Center, which uses radiation therapy to pinpoint tumors in the brain while sparing critical structures such as the eyes, optic nerves and brainstem. Options such as awake surgery and clinical trials are also available.
Surgery and Pathology
With decades of experience, Comair is internationally recognized for pioneering the technique of operating on patients while they are awake. This approach helps preserve speech and motor functions.
Cancerous tissue removed during surgery can now be analyzed with increasing precision. “We rely on whole-genome sequencing and several molecular markers to classify all tumors, even benign ones, to understand if and how they might recur,” Comair says. When those pathology results are available, they are discussed among the cancer center’s multidisciplinary team, including in radiology, pathology, oncology, neurosurgery and other specialties as needed.
Radiation and Chemotherapy
Radiation and/or chemotherapy are also used in brain cancer treatments. Sometimes, these modalities are offered as standalone treatment. If recommended after surgery, radiation and/or chemotherapy typically begin about four to six weeks after surgery, when the wound has healed.
As Kut explains, radiation treatment to the brain includes photon and proton radiotherapies. The precision available from both photon and proton radiotherapies enable the specialists to target cancer cells with less damage to surrounding healthy tissue.
Photon therapy, Kut says, works by aiming beams of X-rays at abnormal tissues through the skin from multiple directions. Photon therapy includes 3D conformal radiotherapy (3DCRT), intensity modulated radiation therapy (IMRT) and stereotactic radiosurgery (SRS), which utilize precisely focused radiation beams to treat tumors in the brain, spine and other parts of the body.
Proton therapy, available at the Johns Hopkins Kimmel Cancer Center at Sibley since 2019, is an advanced and highly precise radiation treatment. Here, Kut says, advanced proton pencil beam technology is used to dose paint tumors with cancer cell-killing proton energy, layer by layer.
With advanced technology, these proton beams can be manipulated to provide precise radiation therapy for patients so that there is no exit radiation dose.
In certain clinical scenarios, proton therapy can help to limit radiation dose and protect critical structures such as the eyes, optic nerves and brainstem. Kut says the decision about which type of radiation to use depends on many factors, including the size and location of the tumor and any prior exposure to radiation treatments.
Patients who get a combined radiation and chemotherapy protocol generally have a month to recover before continuing with chemotherapy, usually for an additional six months, says Sahebjam. Following treatment, patients are monitored with MRIs every few months.
For more on our brain tumor program at the Johns Hopkins Kimmel Cancer Center in the greater Washington area, visit https://www.hopkinsmedicine.org/kimmel-cancer-center/washington-dc/brain-cancer.
