Neuro-oncology: Specialty care for neurologic cancers

Cancer that affects the brain or other parts of the central nervous system (CNS) can be especially challenging — for patients and doctors. The CNS controls movement, thoughts, speech and more. Anything that interferes with these vital functions can affect the quality and quantity of life. 

Atlantic Health neuro-oncologists provide people with CNS tumors highly specialized, compassionate medical attention that’s rare in much of the U.S. 

What is neuro-oncology?

“Neuro-oncologists are kind of a cross between a general neurologist and a medical oncologist,” says Nicholas Metrus, MD, a neuro-oncologist with Atlantic Health’s Gerald J. Glasser Brain Tumor Center.

Medical oncologists treat many cancers. Neuro-oncologists specialize in tumors that start in the brain or spread there from elsewhere.

“We also help treat people who get neurologic complications of cancer, whether from the disease itself or from its treatment,” Dr. Metrus adds.

Comprehensive care for CNS tumors and neurologic complications of cancer

Brain tumors are the most common tumors neuro-oncologists see. These include gliomas and pituitary tumors, as well, which are usually benign, can be cancerous. Neuro-oncologists also address peripheral nerve and spinal cord tumors. 

Common cancer complications neuro-oncologists evaluate and treat, regardless of cancer type, include:

• Cancer-related cognitive changes (sometimes called chemo brain): Chemotherapy may inflame or damage brain cells or cause hormone changes. This may affect memory, attention or other cognitive functions. 
• Cancer-related seizures: Brain tumors may lead to brain swelling or alter the brain’s electrical signals. Scar tissue can develop after surgery or radiation therapy. This may interfere with brain function. 
• Chemotherapy-induced peripheral neuropathy (CIPN): Chemotherapy attacks cancerous cells. But it can also damage healthy cells. This may cause pain, tingling, burning or other sensations. CIPN commonly affects hands, feet, arms and legs. 
• Headaches: Cancer treatments can cause brain inflammation or swelling, or side effects, such as dehydration, which lead to headaches.
• Paraneoplastic syndrome: Some people have problems related to their immune system’s reaction to cancer. “The tumor itself makes antibodies, and the antibodies attack other parts of the brain or body,” says Dr. Metrus. 

Personalized, team-based treatment

Neuro-oncologists direct the overall care of people with a CNS tumor. However, treatment is a team effort. 

“We’re not making decisions alone, especially in complicated situations,” says Dr. Metrus. “We talk with our neuro-oncology tumor board. This group of doctors includes neurosurgeons, radiation oncologists, neuro-oncologists, neuroradiologists and neuropathologists.” 

The neuro-oncologist is the team’s quarterback. But everyone reviews the patient’s imaging and pathology. They talk about next steps and debate treatment options. 

“Increasingly, we’re finding the molecular signature, or DNA mutations, a specific tumor has, is essential in understanding how it will respond,” says Dr. Metrus. “It tells us how aggressive the cancer is going to be, and which treatment would be best.” 

Most patients have surgery. But many also have chemotherapy, radiation therapy, targeted treatments or a combination of these. Immunotherapy and cancer vaccines that stimulate the body to attack cancer are newer frontiers in treatment. 

“Treatment can be curative, but a lot of brain tumors, though treatable, are not curable,” says Dr. Metrus. “The goal is to provide the patient with the greatest quality of life for the longest period of time.” 

Exceptional, people-first care

“Patients don’t have to travel to a university-affiliated medical center to access exceptional brain tumor care. At Atlantic Health, our brain tumor center offers the comprehensive team, technology and expertise patients need, close to home,” says Dr. Metrus.

This includes advanced diagnostic tools and experienced physicians. Allowing patients to see multiple providers on a single visit is a plus, too. And clinical trials are vital. The trials, which aren’t widely available, offer promising new therapies — and hope. 

“Clinical trials are what help move the needle in terms of quality of life and overall survival,” says Dr. Metrus. “We also operate at a very high level. But our patients feel they’re an individual and not just a number running through a system.”