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Brain and Spine Cancer Overview

As the only National Cancer Institute-Designated Comprehensive Cancer Center in Georgia, Winship is at the forefront in radiation treatment for brain cancer. Our staff conduct innovative research and clinical trials that transform how these cancers are identified, treated, and survived.

The radiation oncologists at Emory Proton Therapy Center work with the multidisciplinary Brain and Spine team at Winship, which includes experts in neurosurgery, medical neuro-oncology, neuro-radiology, neuro-ophthalmology, neuro-pathology, supportive oncology, dieticians, social workers, physical therapy, and cancer rehabilitation. Your radiation oncologist will work closely with these and other specialists to customize your brain and spine cancer treatment plan and coordinate your every step. We can also partner and coordinate with a patient’s existing care team, whether they are across town or around the world.

Proton Therapy for Brain and Spine

A brain or spine tumor diagnosis can be one of the biggest challenges you and your family will ever face. Our team is dedicated to helping you meet that challenge through supportive care using the most advanced treatments available. Proton therapy may be a more precise radiation option for treatment of your tumor to help protect important functions of the normal brain and spine like thinking and memory, movement and balance, hormone regulation, hearing, and vision. Our brain and spine specialists will work with you to develop a personalized spine or brain tumor radiation treatment plan that aims for fewer side effects and improved quality of life.

Cancers Treated

Benign (non-cancerous)

  • Meningioma
  • Pituitary adenoma
  • Optic nerve sheath tumor
  • Optic nerve glioma
  • Paraganglioma or Glomus tumor
  • Giant cell tumor
  • Craniopharyngioma
  • Vestibular schwannoma (acoustic neuroma)
  • Hemangioblastoma
  • Pilocytic astrocytoma
  • Myxopapillary ependymoma
  • Ganglioglioma, Gangliocytoma
  • Pineocytoma

Other brain tumors

  • Astrocytoma
  • Oligodendroglioma
  • Ependymoma
  • Neurocytoma
  • Pineoblastoma
  • Medulloblastoma
  • Atypical teratoid / rhabdoid tumor (ATRT)
  • Retinoblastoma
  • Glioblastoma
  • Choroid plexus carcinoma

Skull base and spine cancers

  • Astrocytoma
  • Oligodendroglioma
  • Ependymoma

Comparison of Proton and X-Ray Therapy

Proton Therapy

Proton therapy is an extremely precise form of radiation treatment that can often better focus the radiation to match the shape and depth of the target. After treating the target, protons stop, avoiding exit dose radiation through the body. By reducing or avoiding radiation to sensitive normal healthy tissues and organs, proton therapy may reduce some of the side effects that can occur as a result of radiation treatments.

X-Ray Therapy

X-ray based radiation typically requires more beams or angles to deliver the radiation to the target. Unlike proton therapy where the radiation stops at the target, x-rays continue to deliver radiation as they exit through the body. As a result, x-ray based treatments typically result in increased radiation to normal healthy tissues and organs.

Proton Therapy Spares Radiation to the Brain

Proton Therapy for Brain Spine Cancer Illustration
Proton Therapy
X-Ray Therapy for Brain Spine Cancer Illustration
X-Ray Therapy

Benefits of Proton Therapy

In treatment of brain  tumors and cancer, proton therapy can reduce or avoid radiation to surrounding healthy tissue and organs.

Depending on the tumor location and type, proton therapy may achieve the following benefits:

  • Reduction in fatigue, radiation swelling (edema) or injury (necrosis) in normal brain.
  • Reduced risk of problems with thinking and memory (neurocognitive deficits).
  • Reduced risk of hearing loss after radiation. This is relevant for tumors near the cochlea, such as those in the posterior fossa or temporal lobe.
  • Reduced risk of hormone imbalances (endocrine dysfunction) which can particularly affect growth and development in children and young adults. This is relevant for tumors near the pituitary and hypothalamus, such as those in the frontal or temporal lobe.
  • Reduced risk of dry mouth after radiation, which can be relevant for tumors nears the parotid glands such as temporal lobe or skull base tumors.
  •  Reduced or no radiation to the bone marrow and circulating lymphocytes, which may help support the function of the immune system in fighting cancer.
  • Reduced risk of developing a future second tumor or cancer, which is most relevant in younger patients, those with a good prognosis and a long life expectancy, and those patients who may have genetic conditions putting them at higher risk for developing other cancers.

In treatment of the spine, the reduction of unnecessary radiation on spine can lead to:

  • An improved ability to treat certain tumors that are located near the spinal cord and require a high dose of radiation.
  • Reduced risk of inflammation of the heart (pericarditis) and future heart problems like hardening of the arteries (atherosclerosis), stiffening of the heart muscle (fibrosis, cardiomyopathy), and heart attacks. This is relevant for tumors near the heart, for example in the thoracic spine.
  • Reduced risk of inflammation of the lungs (radiation pneumonitis) and lung function (lung fibrosis). This is relevant for tumors near the lungs, for example in the thoracic spine.
  • Reduced risk of nausea and diarrhea. This is relevant for tumors near the bowels, for example in the lumbar or sacral spine.
  • Reduced radiation to the bone marrow and circulating lymphocytes, which may help support the function of the immune system in fighting cancer.
  • Reduced risk of low blood counts (anemia, neutropenia) which may support the body’s tolerance of chemotherapy.
  • Reduced risk of developing a future second tumor or cancer, which is most relevant in younger patients, those with a good prognosis and a long life expectancy, and those patients who may have genetic conditions putting them at higher risk for developing other cancers.

Schedule a Consultation

What to Expect With Proton Therapy

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The first step in your care is a consultation. During consultation, we review your medical history, perform a physical exam, decide if any additional tests are needed, discuss all radiation options that may be appropriate for your treatment plan, make recommendations, and answer questions.

To plan your treatment, you will undergo a “simulation” or planning session. During this visit our radiation therapists will help position you the way you will be treated each day. For patients receiving radiation treatment to the brain, a custom plastic mesh mask is made. This mask helps to get you in the correct position for treatment and fits snugly to remind you to hold still during treatment. You can see and breathe through the mask. A CT scan will be done to create a picture of you in the treatment position to design your radiation plan. Some patients also undergo an MRI during this visit to help identify the target for treatment. It normally takes 10 days for the team to design the proton treatment plan and perform the quality assurance checks before treatment begins.

Proton therapy is typically delivered once daily during weekdays, Monday through Friday. Most patients with brain tumors receive five to six weeks of daily radiation, but some conditions are treated through a shorter course, such as three weeks. While some conditions are treated with radiation alone, proton therapy may be integrated with surgery, chemotherapy, immunotherapy, or other treatments as part of an extensive plan of care.

Like other types of radiation, proton therapy treatments are invisible and painless. Most brain tumor treatments average 30 minutes each day in the treatment room.

Patients are seen by the radiation oncology physician team weekly during treatment to monitor progress, answer questions, address concerns, and manage any side effects from treatment. Your radiation oncologist will discuss a plan to assess response to treatment and for long-term follow-up after therapy.

Studies on Proton Therapy in Brain & Spine Cancer

Our team has identified these studies as examples of the clinical benefits of proton therapy in brain & spine cancer.

Patient Stories