Brain Cancer Care | Neuro-Oncology

• Outstanding neurosurgical and neuro-oncologic expertise that is unparalleled in the state
• An individualized medicine approach to care that is tailored to each patient
• Experience with treatment of inoperable plexiform neurofibromas in NF1 patients
• Coordinated care and integrated patient navigation and social work services
• Access to new therapies through participation in many different clinical trial programs
• Advanced pre-surgical and intraoperative planning: Our neurosurgeons employ neuro-navigational technology that combines sophisticated imaging techniques and advanced computer software to visualize the brain in three dimensions and determine the precise location of a brain tumor - minimizing risk to surrounding areas of the brain and improving the extent of tumor removal.
• Stereotactic radio surgery: This procedure allows for precise targeting of brain tumors otherwise unable to be removed with standard operating techniques.
• Intensity modulated radiation therapy: This technique of radiation treatment allows for higher doses of radiation to the tumor while protecting the surrounding brain tissue.
• Awake craniotomy with language mapping: This technique can be used in certain cases when a tumor infiltrates brain tissue that affects an essential function such as speech. The patient is fully anesthetized during the opening and closing portions of surgery; after the brain is exposed, the patient is brought into a conscious state and relevant areas of the brain are stimulated to assess for function and pinpoint what tissue can be safely removed.
• Chemotherapy: A full range of traditional chemotherapeutic agents and targeted molecular therapies are available.
• Advanced imaging techniques, including MRI perfusion, functional MRI, diffusion weighted imaging, and spectroscopy
• Embolization: This approach is performed by an interventional neuroradiologist, reduces the blood supply to the cancer, often causing the tumor to shrink and making it easier to treat surgically or with radiation.
• Neurosurgical innovations including 5’ALA for high grade glioma and Laser Interstitial Thermal Therapy (LITT)
• Prescriber of Optune^® medical device
• Skull base and endoscopic pituitary surgery
• Genetic counseling, monitoring and risk-reduction services for patients and families with a hereditary tumor predisposition 
   

We use individualized medicine to treat benign and malignant tumors of the central nervous system (brain and spine) including, but not limited to:

• Gliomas: grade 2 and 3 astrocytoma, oligodendrogliomas, mixed oligoastrocytomas, and grade 4 glioblastoma/gliosarcoma
• Pleomorphic xanthoastrocytoma, grade 2 and 3
• Pilocytic astrocytoma
• Ependymomas
• Meningiomas/Hemangiopericytoma
• Primary CNS lymphoma
• Metastatic cancer to the brain
• Medulloblastoma
• Chondrosarcoma
• Ganglioglioma and other neuronal tumors
• Inoperable plexiform neurofibromas

MaineHealth Maine Medical Center has the largest center for brain tumor research in Maine. Our team works closely with the MaineHealth Institute for Research (MHIR) and we also collaborate with Jackson Laboratories. Our ongoing participation in nationwide cooperative clinical trials and individual pharmaceutical industry trials means that eligible patients can gain access new therapies when other treatment options have failed.

Glioblastoma:

• EF32/TRIDENT: Randomized trial of radiation therapy concomitant with temozolomide +/- Tumor Treating Fields in newly diagnosed glioblastoma (Enrolling)
• NRG BN007: Randomized phase II/III open label study of ipilimumab and nivolumab versus temozolomide in patients with newly diagnosed MGMT unmethylated glioblastoma (Enrolling)
• CHEMO ID: Standard chemotherapy versus chemotherapy guided by cancer stem cell test in recurrent glioblastoma (Closed)

Grade 2 and 3 IDH mutant gliomas

• NRG-BN005: Phase II randomized trial of proton versus photon therapy (IMRT) for cognitive preservation in patients with IDH mutant, low to intermediate grade glioma (Enrolling)
• AG-881/INDIGO: Randomized double blind phase III study of vorasidenib (AG-881) versus placebo in patients with residual or recurrent grade II glioma with IDH mutation (Enrolling)
• CHEMO ID trial: grade 3 glioma (Enrolling)

Meningioma

• NRG-BN003: Phase III trial of observation versus irradiation for a gross totally resected grade II meningioma (Enrolling)

CNS lymphoma

• Alliance A051901: Phase 1 trial of methotrexate, rituximab, lenalidomide and nivolumab (Niv-MR2) induction followed by lenalidomide and nivolumab maintenance in primary CNS Lymphoma (enrolling)

Brain Tumor Patient Navigator

Sara Cox
Email: SCox@mmc.org
Phone: 207-662-1539

What is a patient navigator?

A patient navigator is a nurse or social worker who makes sure that you and your family have all the information you need to make the most informed decisions about your treatment plan. The service is free and provided at many MaineHealth locations.

What services does the patient navigator provide?

As part of your health care team, the patient navigator will:

• Ease your concerns and answer any questions you may have
• Explain your different treatment options
• Discuss any clinical trials that may be available to you
• Schedule consultations for you and your family with specialists as needed
• Provide information and literature relative to your specific diagnosis, treatment, and follow-up care

What other support to you offer?

A monthly support group is also available for brain tumor patients. Please contact Sara Schrock at SCox@mmc.org for more information.