Neuro-oncology specializes in the diagnosis and treatment of cancers of the central nervous system. This medical specialization encompasses parts of neurology and oncology.
Neuro-oncology deals with malignant tumor diseases (malignancies) that originate either from tissues of the nervous system. But it also deals with tumors that originate from other organs, as well as metastases in the brain or spinal cord.
Neuro-oncology specialists mainly treat patients with brain tumors and spinal cord tumors. Neuro-oncologists also treat patients with brain and spinal cord metastases.
The diseases that neuro-oncology treats include the following brain tumors:
The neuro-oncology experts are also the right people to contact for patients with paraneoplastic syndrome.
Paraneoplastic neurological syndromes (PNS) are complications that are not caused by the tumor itself, but by other causes.
These do not necessarily have to be neurological tumors. Rather, lung carcinomas (lung cancer), breast cancer or ovarian cancer are common causes of this syndrome.
PNS can be seen, for example, in diseases of the central or peripheral nervous system or muscles.
Glioblastoma is the most common malignant brain tumor in adults @ Richman Photo /AdobeStock
The doctors who work in the field of neuro-oncology are usually:
Together with other experts(radiologists), they develop a treatment strategy tailored to the individual patient as part of a tumor conference.
Other professional groups are also involved in the care and support of cancer patients, such as
A neuro-oncology center is a clinic that treats patients with tumors of the central nervous system.
The care includes
The doctors come from different specialties such as:
These centers have modern equipment. They can also perform difficult operations.
Clinical studies also take place at neuro-oncological tumor centers. In these studies, doctors test the effectiveness of new drugs or procedures.
Ideally, the neuro-oncology center is certified by the German Cancer Society as a neuro-oncological tumor center.
Certification is subject to strict quality requirements for patient treatment (staffing, facilities and equipment). These clinics must also be able to demonstrate a minimum number of annual therapies.
The following steps are important for the diagnosis in order to determine the extent of the neurological deficits:
Several diagnostic procedures are often required to diagnose a tumor of the nervous system.
Imaging procedures such as
Another imaging procedure is positron emission tomography (PET). In contrast to CT and MRI, PET also provides information about the metabolic activity of the tumor.
Cerebrospinal fluid diagnostics can be important for the differentiation of an inflammatory disease. Here, doctors take cerebrospinal fluid (CSF) by means of a spinal cord puncture.
In the case of certain symptoms, such as cramps, an electroencephalogram (EEG) can provide further information on the disease and treatment planning.
Doctors do not refrain from performing a stereotactic biopsy (tissue removal), especially when making an initial diagnosis, even if the tumor is clearly visible.
Doctors plan this procedure down to the last detail with the help of a computer. It is considered one of the safest procedures in neurosurgery.
The pathologist examines the removed tissue and assesses whether there are any pathological cell changes. He examines the type of tumor and its degree of differentiation. He also checks whether it is a primary tumor or a metastasis.
The result of this histological examination is crucial for treatment planning. Not every type of tumor responds in the same way to different therapeutic options.
For this reason, molecular genetic examinations of the tumor cells for certain genetic changes are also frequently used.
.jpg "Positronenemissionstomographie (PET)")
The PET/CT scan of the brain shows the metabolic activity in the brain with bright highlights @ Maxim /AdobeStock
The type of therapy depends on the following factors
Depending on the type, location, size, age, general and neurological condition of the patient, surgical removal is the primary procedure.
Neurosurgical interventions on the brain can be performed using stereotactic (minimally invasive) or open surgery. This depends on the location and size of the tumor as well as the age and condition of the patient.
With the help of computer-assisted intraoperative neuronavigation, surgical interventions in critical regions of the brain and spinal cord can now also be performed safely.
Depending on the results of the histological examination and the operation, chemotherapy and/or radiotherapy is given after the operation.
In some cases, chemotherapy or radiotherapy is given before surgery. The aim is to shrink the tumor so that doctors can operate on it at all.
Chemotherapy is one of the central pillars of cancer therapy. Patients are given drugs that stop the cancer cells from multiplying. These drugs are also known as cytostatics.
A modern method of tumor treatment is targeted therapy with monoclonal antibodies that specifically inhibit the growth of the tumor.
These do not have a non-specific effect on the entire body like classic cytostatics. For example, doctors can stop the growth of a glioblastoma tumor (the most common type of malignant brain tumor in adults) with a combination therapy.
Another important treatment method is radiotherapy. In contrast to chemotherapy, it does not act systemically (on the whole body), but locally.
The high-energy radiation damages the cancer cells to such an extent that the tumor shrinks or, ideally, disappears completely.
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