Brain Tumor Center

Cushing Neuroscience Institute’s Brain Tumor Center offers a multidisciplinary program that focuses on the management of benign and malignant brain tumors. The Brain Tumor Center is directed by Dr. Michael Schulder, an internationally recognized authority on the treatment of brain and skull base neoplasms (tumors). Our services include comprehensive diagnosis and multi-modality treatments, leading-edge research and brain tumor outreach education programs for healthcare professionals and our community.

As one of the country's leading brain tumor centers, we treat the following conditions:

  • Astrocytomas – the most common type of gliomas (malignant brain tumors). Astrocytomas are most commonly found in the cerebrum, the main part of the brain
  • Meningiomas – predominantly benign slow-growing tumors that account for about 20 percent of primary brain tumors
  • Pituitary tumors – Most pituitary gland tumors are adenomas (benign brain tumors). Adenomas do not spread outside the skull and usually remain confined to the pituitary gland or in tissue near it
  • Metastatic brain tumors – brain tumors that originate from cancers in other parts of the body
  • Brainstem gliomas – tumors located in the brain stem where the spinal cord connects to the brain just above the back of the neck
  • Ependymomas – tumors in the epithelial layers of the brain
  • Glioblastoma multiforme – the most aggressive of malignant brain tumors
  • Malignant brain tumors
  • Medulloblastoma – the most common type of childhood brain cancer
  • Oligodendrogliomas – brain tumors that arise from brain tissue
  • Schwannomas – benign brain tumors on the eighth cranial nerve

Staffed by a team of neurosurgeons, oncologists, neurologists, neuro-radiologists and neuro-pathologists, the Brain Tumor Center fosters a unique collaboration among the departments of Neurosurgery, Neurology and Medical and Radiation Oncology. Our accomplished team works together with the common goal of providing the most up-to-date evaluations and personalized treatments for patients with brain tumors.

The Brain Tumor Center's areas of expertise include:

  • Stereotactic neurosurgery – a form of minimally invasive surgery using radiation
  • Skull base surgery – this intricate surgery requires high-level skills to operate safely in the most complex area of the body where nerves, arteries and sensing organs are densely concentrated
  • Minimally invasive endoscopic surgery – this surgical technique inserts a thin, lighted instrument (endoscope) into a very small incision. It is sometimes an option to the traditional open surgery method which involves larger incisions
  • Stereotactic radiosurgery – a form of radiation therapy that focuses high-powered x-rays on a small area of the brain without affecting adjacent healthy tissue

These surgical techniques are spurred on by the Brain Tumor Center's research, which addresses important fundamental and clinical questions about brain tumors and gives our patients access to the most current clinical trials and treatments.

Brain Tumor Bank
Through the Tissue Donation Program (TDP), headed by Peter Gregersen, MD at The Feinstein Institute for Medical Research, physicians at the Cushing Neuroscience Institutes are collaborating with Marc Symons, PhD to create a brain tumor bank. The bank currently contains a substantial collection of malignant and benign tumor samples that have been collected from the Department of Pathology after the samples have been classified as “discards” and available for research purposes.

Physicians, working closely with TDP nurses, play a critical role in introducing the tissue bank to surgical patients and facilitating tissue collection at the time of surgery.

By supporting research initiatives, the Brain Tumor Bank may ultimately improve diagnostics and therapy for people with brain tumors. Currently, Dr. Symons and other researchers at The Feinstein Institute are using the brain tumor tissues to identify proteins that are deregulated in brain tumors and may serve as novel markers and/or therapeutic targets. The laboratory also studies brain tumor stem cells obtained from the collected tissue.

Neuropathology
Expert care of patients with brain tumors relies on the expertise of neuropathologists who are specifically trained in the diagnosis of brain tumors. Prognosis and management can vary greatly between seemingly subtle differences in diagnosis. Newer techniques of immunohistochemistry and molecular studies such as FISH for 1p and 19q co-deletion play an increasingly important role in diagnosis and prognosis and require special, dedicated expertise for interpretation. Intraoperative pathological consultations, including frozen sections and cytologic preparations, often are used by the surgeon to guide the extent of a resection or to confirm the success of a stereotactic biopsy.

There are three dedicated neuropathologists — Drs. Peter FarmerMansoor Nasim  and Jian Yi "Jim" Li -- at the Department of Pathology and Lab Medicine.

Laboratory for Brain Tumor Biology
Directed by Marc Symons, PhD, current research in the laboratory focuses on two types of brain tumors, medulloblastoma and glioblastoma. Work in the laboratory has shown that two Rho family members, Rac and Cdc42, play critical roles in the invasive behavior of both medulloblastoma and glioblastoma. Tumor cell invasion into normal surrounding brain critically limits the efficacy of surgery and radiation therapy. Molecular dissection of the signaling pathways that are governed by Rac and Cdc42 in brain tumor cells should yield novel therapeutic targets for these tumors.

Recent studies have identified several signaling elements that work either upstream or downstream of Rac in glioblastoma cells, including five guanine nucleotide exchange factors that activate Rac and three Rac effectors that mediate the role of Rac in invasion. Efforts are underway to identify small molecule inhibitors that selectively target these guanine nucleotide exchange factors.

The laboratory also studies brain tumor stem cells obtained from brain tumor tissue collected by the Tissue Donation Program. Brain tumor stem cells appear to be critical in tumor development and tumor resistance to radio- and chemotherapy. An outstanding question currently under investigation in the laboratory is whether brain tumor stem cells also contribute to the invasive behavior of brain tumors.

The skilled team of physicians at the Brain Tumor Center coordinates and collaborates with the following Cushing Neuroscience Institute centers to provide a comprehensive multidisciplinary approach to the treatment and care of patients with brain tumors:


Make an appointment at our Brain Tumor Center
Cushing Neuroscience Institute’s Brain Tumor Center makes it easy for you to take the first steps in ensuring the best neurological care for yourself or your family. Simply email us at neuro@nshs.edu, call us at (516) 941-1260 or fill out our Request an Appointment form.