Minimally Invasive Treatments

A New Frontier for Brain and Spine Metastases from Lung Cancer

By Gregory Cannarsa, MD, Fellowship-Trained Neurosurgeon

November is Lung Cancer Awareness Month, and while a lung cancer diagnosis is distressing enough, discovering subsequent metastases to the brain or spine adds another layer of complexity and stress. However, medical and surgical science has made remarkable strides, particularly in minimally invasive treatments that offer patients improved longevity and better quality of life. This article will focus on these state-of-the-art interventions that are making life significantly better for patients.

Stereotactic Radiosurgery (SRS): Precision in Brain Treatment
Stereotactic radiosurgery (SRS) has been a groundbreaking development for treating brain metastases. Not a surgery in the traditional sense, SRS is a highly accurate form of radiation therapy. The treatment is extremely precise, often completed in a single session, and spares surrounding healthy tissues. Suitable for treating multiple metastases, SRS allows for rapid recovery, often having patients back to regular activities in a day or two.

Radiofrequency Ablation (RFA) and Vertebral
Augmentation: Twin Solutions for Spinal Metastases
Radiofrequency Ablation (RFA) is a pioneering technique for treating spinal metastases. By using electrical currents to heat targeted nerve tissue, pain signals are decreased. This technique pairs well with vertebral augmentation procedures like kyphoplasty, which restore the shape of a damaged vertebra and stabilize the spine. These minimally invasive approaches are often ideal for patients who are not candidates for more invasive surgeries.

Keyhole Craniotomy: Minimally Invasive yet Maximally Effective
A keyhole craniotomy represents a quantum leap in neurosurgical techniques. Instead of making a large incision and removing a significant portion of the skull, surgeons make a small hole just large enough to insert surgical instruments. The metastatic tumor can then be completely excised with minimal disturbance to surrounding brain tissue. This technique drastically reduces both the risks associated with surgery and the postoperative recovery time, making it an increasingly popular option for treating brain metastases.

Enhanced Recovery Protocols: The New Standard of Care
Postoperative recovery plays a crucial role in a patient’s overall treatment experience and outcome. Enhanced recovery protocols have been designed to optimize every aspect of patient care before, during, and after surgery. These can include optimized pain management regimens, early mobilization, and individualized care plans designed to minimize hospital stays and speed up recovery. These protocols not only improve patient comfort but also reduce the risks of complications, representing a significant advancement in the overall approach to metastatic disease treatment.

Robot-Assisted Spine Surgery: A Minimally Invasive Approach to Spinal Metastases
Robot-assisted techniques have been making inroads into neurosurgery, especially for spinal metastases. Through tiny incisions, specialized instruments allow for stabilization of the spine while a small incision over the area of the tumor allows for the removal of tumor and decompression of the spinal cord. The technique minimizes damage to surrounding tissues, leading to reduced postoperative pain and quicker recovery.

Spinal Radiosurgery: Non-Invasive and Effective
Spinal radiosurgery offers another non-invasive option, especially beneficial for tumors near critical structures like the spinal cord. Highly targeted radiation destroys the tumor while sparing surrounding tissues. Much like SRS for brain metastases, spinal radiosurgery allows for quick recovery and is a particularly appealing option for those who have reached their lifetime limits for radiation exposure.

The Future is Bright: Optimism in the Face of Challenge
The landscape of treating metastases from lung cancer to the brain and spine has never been more promising. These minimally invasive treatments not only promise quicker recovery times but also offer multiple approaches for what is often a complex, multifaceted disease. As research progresses, these techniques will likely become even more refined, offering patients not just life-extending options but also better quality of life.

Why Minimally Invasive and Minimally Disruptive Is the Way Forward
The benefits of these cutting-edge treatments are manifold and transformative. From the precision of stereotactic radiosurgery in treating multiple brain metastases to the pain alleviation and spinal stabilization offered by radiofrequency ablation and vertebral augmentation, these interventions are game-changers for patients. The minimized surgical trauma and reduced hospital stays associated with keyhole craniotomy and enhanced recovery protocols ensure that patients can return to their lives more quickly and with fewer complications. These treatments represent a paradigm shift in the way we approach metastatic disease, placing patient comfort and quality of life at the forefront, while still effectively tackling the complex challenges of metastases from lung cancer.

About Gregory Cannarsa, MD
Dr. Cannarsa completed neurosurgical residency at the University of Maryland Medical Center/Shock Trauma Center, training in all types of neurosurgery both cranial and spinal. He focuses on cranial neurosurgery including brain tumors, hydrocephalus, stroke, brain bleeds, trauma, aneurysms, and other cerebrovascular malformations. He did a further specialized Cranial and Cerebrovascular Neurosurgery Fellowship at Swedish Neuroscience Institute in Seattle, WA. His goal is to ensure patients’ quickest recovery and the longest lasting treatment whenever possible through minimally-invasive and minimally-disruptive techniques. He’s a strong advocate of no-hair-shave neurosurgery such that the patient keeps all of their hair, as well as invisible closures which involves closing all incisions without the use of staples or sutures that need to be removed. He is accepting new patients which are seen within one week of referral at his practice, Apex Brain & Spine, located in Naples, Florida.
APEX BRAIN & SPINE
239-422-APEX (2739)
3530 Kraft Road, Suite 203 • Naples, FL 34105
www.apexbrainandspine.com