Function-sparing Surgery & Therapies

Tumors near critical areas that control movement, speech, and vision long were considered inoperable or extremely risky to treat without causing impairment. However, our world-class experts at the Peak Center have pioneered use of revolutionary approaches for removing and treating brain and pituitary tumors while preserving function.

The concept is based on multi-modality therapy, capitalizing on the idea that more than one technique can be used to successfully treat and eliminate a brain tumor.  Some tumors are located in critical areas or densely adherent to critical brain structures.  An attempt at total surgical removal will lead to complications.  Because other technologies are available, surgery can now be performed to remove the portion of the tumor that is safe to remove, and the remainder can now be treated with precisely focused radiation called stereotactic radiosurgery or radiotherapy.

Our skilled specialists perform minimally invasive surgery and function-sparing treatments so precisely that our complication rates are lower than 1 percent. We craft personalized and aggressive treatment plans involving surgery, oncology and chemotherapy and focused radiation therapy.

Within the last few years, important advancements in software technology and imaging have enhanced our experts’ abilities to better visualize tumors and more accurately map paths to reach them without damaging tissues and vital areas.

Innovations in surgical and therapeutic equipment have made treatment of brain and pituitary tumors safer than ever, allowing our experts to remove or shrink as much of the tumor as possible while sparing critical brain structures.

Brain Mapping Software that Maps Both Structure and Function
Our neurosurgeons are experts in using a revolutionary brain mapping technology which is transforming brain surgery.  The technique combines state-of-the-art brain imaging, GPS-like navigation and high definition optics to achieve unprecedented surgical precision. This latest technology allows our surgeons to be accurate within one millimeter – the width of a pencil tip – when finding and removing tumors.

Before surgery, our neurosurgeons study a patient’s brain images to decide on the safest route to the tumor and actually plan the surgery in virtual reality before the surgery starts.  The technique includes a virtual surgical image guidance system that employs functional magnetic resonance imaging (fMRI) to make tumors accessible for surgical removal. The imaging captures real-time activity as the brain responds to stimuli. Functional brain mapping identifies the brain's critical functions such as speech and language, sensation, vision, and motor functions so neurosurgeons can avoid damaging those areas. 

Using this technology, our neurosurgeons can precisely determine how much tumor can be safely removed real time in the operating room.   Many times a total removal is possible.  If not, the small residual can be treated with radiosurgery.

Technological advancements in Radiation Therapy-Radiosurgery
Houston Methodist specialists administer stereotactic radiosurgery, which uses precisely focused radiation beams to treat tumors and avoid normal brain tissue. Contrary to what radiosurgery would imply, it is a treatment that does not involve an operation. The procedure can be done in one day, and no incisions are made. Instead, 3-D imaging precisely targets and focuses high radiation doses to the tumor, minimally affecting surrounding healthy tissue. The treatment can reach tumors once considered inoperable.

Our experts use the Novalis system, which combines radiosurgery technology and computer software for radiation therapy planning. The system rotates around the patient from different angles, delivering narrow, well-defined cancer-fighting shaped treatment beams that conform precisely to the complex three dimensional shape of the tumor. Image guidance and motion management tools give doctors real time detailed information about the shape, size and position of the tumor as treatment is ongoing.

Gamma Knife radiosurgery also is used to treat tumors and other brain abnormalities in the brain. Specialized equipment focuses an estimated 200 tiny radiation beams on a tumor or other target. Each beam has little effect on the brain tissue it passes through, but a strong radiation dose is delivered where all the beams meet. Gamma Knife radiosurgery usually is a one-time therapy done in one day.

Stereotactic Radiosurgery or Radiotherapy 
Stereotactic radiosurgery (single dose treatment) or Stereotactic Radiotherapy (focused treatment with multiple sessions), uses precisely focused high-energy beams (X-rays, gamma rays or protons) to kill tumor cells and prevent their growth. These beams are configured to the complex, three-dimensional shape of each person’s tumor, which allows physicians to administer higher radiation doses more precisely and safely than ever before in a way that spares normal tissue. This non-invasive, non-surgical treatment is less toxic than traditional brain tumor radiation treatments.

It may be used before, after or instead of surgery and delivered in a single treatment or up to five treatments, instead of the typical 20 to 26 treatments traditional radiation therapy requires.

Beyond Tumors
The use of function-sparing surgeries and therapies extends beyond treatments for brain tumors. They also are promising for patients who suffer from other neurological conditions such as arteriovenous malformations, some types of facial pain, Parkinson's disease and epilepsy.
As it does for brain tumor patients, radiosurgery can help patients with brain abnormalities that cannot be reached through surgery or whose age or other medical conditions make brain surgery too risky. It allows for more effective treatment of smaller brain abnormalities and those near vital structures in the head.