New Rochester program to coordinate patient care, research for patients suffering with brain and spinal tumors

The University of Rochester Medical Center and its Department of Neurosurgery are establishing a new multidisciplinary program to coordinate patient care, research and community outreach efforts for patients suffering with brain and spinal tumors.

The Brain and Spinal Tumor Program will work with James P. Wilmot Cancer Center physicians and researchers to introduce new clinical treatments, provide access to more clinical trials, expand on the body of research devoted to brain tumor growth and treatment, and organize community education and outreach activities.

Leading the effort is a husband and wife surgeon-researcher team that recently joined the Department of Neurosurgery from the University of Pittsburgh Medical Center. Kevin Walter, M.D., associate professor of Neurological Surgery, directs the new program, while Eleanor Carson-Walter, Ph.D., is co-director.

An accomplished neuro-oncologist, Walter specializes in the surgical treatment of and research into brain and spinal tumors. Each year, about 20,000 new cases of brain tumors are diagnosed, with about half of patients undergoing surgery to either remove a new or recurring tumor. Survival rates greatly depend on the type of tumor and its location.

As part of the program, a new multi-disciplinary Brain and Spinal Tumor clinic is in operation, providing streamlined care to brain and tumor patients. Oncologists, radiation oncologists and neurosurgeons, along with other essential health care providers, are available to meet with patients on the same day, making the process as convenient and worry-free as possible for patients.

“Brain and spinal cancers are very complex diseases to treat. Some tumors may not be malignant, but because of their location, are inoperable,” Walter said. “Other tumors can be safely removed, but tend to grow back. This new clinic ensures that all physicians who need to be involved in diagnosing and developing treatment plans are working together on the same timeframe, giving patients the greatest chance at survival without greatly impacting their quality of life.”

The Brain and Spinal Tumor Program also will expand the variety of clinical treatments for brain and spinal cancers available in Rochester . Walter has extensive experience with radiosurgery, a technique where high dose radiation is focused on a tumor to protect surrounding normal tissue. Walter plans to expand the use of radiosurgery to target more complex brain and spinal tumors with minimal patient side effects.

Walter also is trained in intra-tumor chemotherapy, which interestingly, he helped to develop in the mid-1990s during a research fellowship at Johns Hopkins University . During surgery, the neurosurgeon implants dime-sized wafers containing a chemotherapeutic drug into the cavity where the tumor resided.

“Over time, the wafers slowly dissolve, releasing high concentrations of the drug into the tumor site targeting microscopic tumor cells that sometimes remain after surgery,” Walter explained. “The specificity of the wafers minimizes drug exposure to other areas of the body, while reducing the chances of reoccurrence of another brain tumor.”

Walter helped to develop the chemical compound used to manufacture the wafer that both stores the chemotherapeutic drug, and then slowly releases it when inserted into the brain.

Expanded access to clinical trials is also available through the new program, offering patients the ability to participate in new experimental drug therapies here in Rochester . By the end of the year, the Brain and Spinal Tumor program hopes to be coordinating up to one dozen such trials, and will communicate the information to all brain and spinal cancer patients, regardless of what type of treatment they are currently receiving (i.e., surgery, radiation, chemotherapy).

Health care professionals associated with the new clinic also will be active in educational outreach activities. From regular newsletters to ongoing support groups to special events, the clinic will support a host of activities aimed at helping these cancer patients deal with their illness.

As established researchers, Walter and Carson-Walter are directing a basic science lab focused on brain tumor angiogenesis – the growth of new blood vessels into tumors that fuel their deadly growth. Specifically, their work aims to pinpoint which genes may control angiogenesis in hopes that they could develop ways to turn off angiogenesis, and in effect, starve and kill the tumor. While this approach is not necessarily new to cancer research, Walter stresses that for patients with brain and spinal tumors, developments in this area can make a huge difference.

"While we may not be able to cure a patient with a brain tumor with this type of research, if we can find ways to wound or shrink a tumor so that a patient can regain some function lost due to a tumor impinging on certain nerve areas in the brain or spine, we will have made a tremendous step forward for people suffering from this terrible disease,” Walter said.

Walter comes to the Medical Center from the University of Pittsburgh School of Medicine, where he most recently was director of Adult Neurosurgical Oncology. He received his medical degree from Johns Hopkins University School of Medicine, where he also completed residencies and fellowships in both general surgery and neurological surgery. He also served as a neuro-oncology research fellow at Johns Hopkins. He is active in a variety of national neurosurgical associations, and has published a dozen articles in neurosurgical and oncology related journals.

Carson-Walter's career path has followed a similar trajectory as her husband's. She obtained her doctorate in the Program in Human Genetics and Molecular Biology from Johns Hopkins, and completed a post-doctoral fellowship in Molecular Genetics and Oncology at the Hopkins ' Howard Hughes Medical Institute. She most recently served as assistant professor in the Department of Neurological Surgery at the University of Pittsburgh , where she also was director of the Department's Molecular Core Lab.