Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center

What We Treat

Diseases and Conditions 

• Gliomas Tumors.
• Glioblastoma Tumors.
• Metastatic Tumors.
• Meningiomas.
• Pediatric Tumors.
• Pituitary Tumors.
• Lymphomas Tumors.
• Schwannomas.
• Skull Base Tumors.
• Spinal Tumors.

Diagnostics and Testings

• CT imaging of the brain and spine.
• MR imaging of the brain and spine including MR perfusion and CSF flow and CSF leak studies.
• Functional MR imaging.
• Diffusion Tensor imaging.
• MR spectroscopy.
• Myelography.
• Lumbar puncture.
• Image-guided percutaneous biopsy.
• Diagnostic Angiography.
• Carotid Ultrasound.
• Transcranial Doppler.
• PET, CT and PET MR imaging.
• Bone Scan and other Nuclear Medicine examinations.
• Radiographs.

Treatments and Services

• Blood patch.
• Brain Surgery.
• Chemotherapy.
• Gamma Knife.
• Interventional Angiography (stenting,embolization, thrombolysis, petrosal sinus sampling).
• Personalized Medicine.
• Radiation Necrosis Clinic.
• Reconstructive Craniofacial Surgery.
• Rehabilitation Services.
• Stereotactic Spinal Radiosurgery.
• Vertebroplasty.

Surgery Program

If you have a brain or spine tumor, you want a combination of all available resources and an experienced, empathetic team of providers. We look at many factors when crafting a personalized treatment plan for you — including type, size and location of the brain or spine tumor.

Cleveland Clinic Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center has a patient-focused, comprehensive, and team-based approach that offers a wide variety of surgery treatment options for adults and children with primary and metastatic tumors of the brain, spine and nerves.

Treatment options we offer include:

Traditional (Open) Brain Surgery

Traditional brain surgery is used to diagnose and treat brain tumors.

Brain tumors can be surgically removed several ways, and the approach depends on the type, location, and size of your tumor.

In addition to surgery, some people may be given chemotherapy or radiation therapy to destroy any remaining irregular cells.

Gamma Knife^® Radiosurgery

Gamma Knife radiosurgery is one of the most advanced and minimally invasive options for treating brain tumors, vascular malformations and other abnormalities of the brain. This computer-guided therapy can deliver targeted radiation to stabilize, shrink or destroy tumors or lesions deep in the brain with pinpoint accuracy and without incisions.

Cleveland Clinic has completed the highest number of Gamma Knife cases in the U.S. and was the first in North America to use the state-of-the-art, Elekta Esprit Gamma Knife machine. This is the latest and most advanced Gamma Knife machine, offering improvements in both the patient and clinical team’s experience. This machine provides the highest precision, sparing healthy tissue and optimizing safety and quality of life for our patients. With two Gamma Knife machines on our main campus, we offer immediate access and highly personalized, same-day planning and treatment, minimizing disruptions to daily life and returning our patients home within a single day. 

Laser Interstitial Thermal Therapy (LITT or Neuroblate®)

Laser interstitial thermal therapy (LITT) transmits heat to coagulate, or “cook,” brain tumors from the inside out. The robotic NeuroBlate® System allows the surgeon to steer and monitor the effects of the laser beam, sparing surrounding healthy tissue.

Stereotactic Spine Radiosurgery

Stereotactic spine radiosurgery is a non-invasive treatment option for metastatic tumors located on your spine.

The Burkhardt Brain Tumor and Neuro-Oncology Center’s Spine Tumor Excellence Program (STEP) uses unique Novalis and Edge technologies to deliver a high dose of radiation to spinal tumors. The procedure is able to target tumors very precisely, minimizing the radiation dose to nearby normal structures.

Stereotactic spine radiosurgery often results in rapid pain control that can significantly and meaningfully improve function. The success rates for this procedure depend on the type of tumor being treated. In general, Cleveland Clinic achieves 80 to 85 percent local pain relief in people within one month (or less) of treatment.

Skull Base Surgery

Surgery on skull base tumors combines the highly specialized techniques of interventional neuroradiology, otolaryngology, neurosurgery, ophthalmology, plastic surgery and neuro-anesthesiology. The goal is to access difficult-to-reach tumors or lesions by navigating the complex anatomy within the skull as delicately as possible, minimizing injury to the brain, cranial nerves and blood vessels during surgery. To improve safety and outcomes, Cleveland Clinic specialists may also use sophisticated interventional neuroradiological procedures that decrease the amount of blood flow to the tumor during operation, reducing surgical risks, like stroke.

The Skull Base Tumor Program at Cleveland Clinic is one of only a few specialized centers across the country to offer comprehensive services for treating skull base tumors, treating more than 200 new patients with meningioma and schwannomas annually.

Brachytherapy (GammaTile®)

Brachytherapy is a form of radiation therapy used to treat various cancers. GammaTile® is a brachytherapy that is specifically designed to be used inside the brain.

Radiation from brachytherapy targets tumor tissue, sparing healthy, surrounding tissue. You’re most likely to benefit from this treatment option if you have recurrent meningiomas and have already undergone multiple rounds of radiosurgery, or if you have gliomas and have exhausted all other treatment options.

Tumor-treating fields (Optune™)

Tumor treatment fields (TTFields) is a non-invasive option for people with glioblastomas. You wear a device that sends low-intensity electric fields (TTFields) to the tumor through electrodes on the scalp. TTFields are delivered right into the area where the tumor is located and disrupt cancer cells, preventing them from multiplying and growing. Providers may consider this treatment after chemoradiation is complete.

Interventional Angiography

Interventional Angiography is a way to take a close look at what’s happening inside your body. We inject a dye into your blood vessels that allows us to examine the blood supply to the tumor. Once identified, we can use embolization techniques before or during surgery to help control the bleeding of a tumor in the brain by blocking the blood vessel supplying blood to the tumor.

Traditional (Open) Spine Surgery

Spine surgery, including minimally invasive spine surgery, can be used to treat malignant or benign spine tumors.  Spine tumors can have very serious consequences and need to be treated as early as possible. Cleveland Clinic Neurological Institute and Taussig Cancer Center experts work together to use the most innovative approaches and advanced technology to treat these types of tumors. Spine surgery can be used to fully remove or reduce the size of the tumor, while stabilizing the spine, reducing pain for the patient and improve function and quality of life.

Neuro-Oncology Program

At Cleveland Clinic, we pride ourselves on using a personalized approach to each and every patient. Our neuro-oncologists team up with our neurosurgeons and cancer specialists to give you individualized care. We are also part of innovative research, investigating the best ways to treat brain and spine tumors.  

Non-surgical treatment options for brain and spine tumors include:

Chemotherapy

Chemotherapy is a type of treatment that uses drugs to fight against various types of cancer. It’s the most common type of cancer treatment and can work on its own or paired with other treatments or surgery. Chemotherapy can be used in numerous ways:

• Adjuvant therapy: Chemotherapy destroys cancer cells after surgery or radiation therapy.
• Curative therapy: Chemotherapy is the only treatment. It cures the cancer.
• Neoadjuvant therapy: Chemotherapy shrinks a tumor before surgery or radiation therapy.
• Palliative therapy: Chemotherapy shrinks tumors and lessens symptoms but does not cure the cancer.

Radiation Therapy

Radiation therapy is another common type of treatment for cancer, and like chemotherapy and surgery it’s very powerful. It uses radiation — usually high-powered X-rays to kill cancer cells. There are two main types of radiation therapy:

• External beam radiation therapy (EBRT).
• Internal radiation therapy.

Radiation can be used independently or alongside other treatments, for example surgery or chemotherapy.

When you receive radiation, you’ll work with a radiation oncologist. They will determine what type of radiation is best for you depending on the type of cancer you have. Your radiation oncologist will design a treatment plan that works best for you.

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Appointments & Locations

Make an Appointment

For our patients' convenience, the Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center offers same day or next day appointments at Cleveland Clinic main campus. To make an appointment please call 216.636.5860 or toll free at 866.588.2264.

For clinical trials information please call 866.223.8100.

Virtual Visits

New and existing patients can receive an initial evaluation or follow-up care from a Brain Tumor Center specialist from the comfort and convenience of home using our MyClevelandClinic tool. Benefits of choosing this appointment option include no travel or parking, less waiting, significant time savings and the convenience of seeing a specialist from wherever you choose. If you would like to use MyClevelandClinic for your or a loved one’s Brain Tumor Center appointment, please call 216.636.5860 or your Brain Tumor Center provider’s office. Our team will schedule your virtual visit and provide details on the visit cost and setup instructions.

• Learn more about virtual visit options for scheduled appointments.

Patient Assistance Programs

Programs called PAPs (Patient Assistance Programs) provide free or low-cost prescription medicine to low-income people who are uninsured or under-insured and meet the guidelines. Most medicines are provided by the pharmaceutical companies who manufacture the medicine.

NeedyMeds – NeedyMeds is a 501(3)(c) non-profit with the mission of helping people who cannot afford medicine or healthcare costs. The information at NeedyMeds is available anonymously and free of charge.

AutoLITT/NeuroBlate Line

If you are interested in AutoLITT/NeuroBlate as a treatment option for you or someone you love, please contact us at our dedicated AutoLITT/NeuroBlate phone line to arrange a consultation with a Burkhardt Brain Tumor Center physician.

Please call us locally at 216.636.5392 or toll-free at 888.273.1409.

MyChart

MyChart connects you to your health care team from the comfort and safety of home. With this secure, online tool you can manage your appointments and complete pre-visit tasks, communicate with your providers, and keep track of your test results and medications.

• Visit clevelandclinic.org/mychart to get started.

Locations

Research & Clinical Trials

Brain Tumor Research

Advancing the care of brain tumor patients begins with a better understanding of the causes and mechanisms of tumor development. Basic science research efforts at the Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center are focused on identifying the genetic, cellular, and molecular biology of malignant and benign brain tumors, and investigating the mechanisms of tumor formation. This enhanced understanding of tumor biology can lead to new therapeutic developments of brain tumor treatment.

The novel treatment strategies being investigated at Burkhardt Brain Tumor Center involve immunotherapy, targeting angiogenesis or using targeted therapies to attack the dysregulated or altered genetic changes that occur in tumor cells. Immunotherapy is a form of treatment that harnesses a person's immune system to fight diseases like cancer.

One example of the promising research being conducted by the Burkhardt Brain Tumor Center researchers and physicians involves further investigation of the process of apoptosis, or programmed cell death, as it presents in brain tumor cells.

Normally, when a cell acquires DNA damage that it cannot repair properly, the cell should eliminate itself through the process of apoptosis. Tumors result, in part, when genetic mutations occur and the apoptosis mechanism fails to eliminate the cell. Institute researchers are studying the mechanisms by which brain tumor cells have eliminated their ability to undergo apoptosis.

Cleveland Clinic researchers are also working to identify genes that could serve as molecular diagnostic and/or prognostic indicators, or potential therapeutic targets for glioblastoma and other gliomas. By enhancing the detailed understanding of the structure of tumor cells and the mechanisms that control their growth, researchers are striving to identify therapeutic agents that show the greatest promise to address individual tumor types, such as glioblastoma.

This research is coordinated through the Burkhardt Brain Tumor Center and the Lerner Research Institute and includes efforts in the Departments of Molecular Biology, Cancer Biology, Neuroscience and the Center for Surgical Research.

Clinical Trials

Brain tumor clinical trials are designed to identify treatments that are potentially more effective and/or have fewer side effects than standard brain tumor treatments. Clinical trials are recommended for patients with tumors where results of treatment are generally poor, or that are considered incurable with conventional treatment. Clinical trials also are recommended for most pediatric patients with brain tumors.

Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center patients have access to numerous brain tumor clinical trials, many designed by Cleveland Clinic physicians, others as a part of multi-center trials in partnership with pharmaceutical companies or research consortia to further the care of brain tumor patients. The Burkhardt Brain Tumor Center actively participates in several of these clinical trial groups, including:

• Adult Brain Tumor Consortium (ABTC).
• Southwest Oncology Group (SWOG).
• Brain Tumor Trials Collaborative (BTTC).
• NRG Oncology.
• Ohio Clinical Trials Collaborative (OCTC).
• American College of Surgeons Oncology Group (AcoSOG).
• Children's Oncology Group (COG).

These associations contribute to the exciting environment of clinical trial research and development, discussion and the sharing of data that is so important to the dynamic evolution of the therapeutic protocols of tomorrow's brain tumor treatments.

The medical therapy based clinical trials focus on immunotherapy, other approaches that target the DNA replication of the tumor as well as the blood supply of the tumor. Novel drugs that target the dysfunctional or altered genetic pathways are often an area of active investigation in these clinical trials.

Ongoing surgical clinical trials are investigating the effectiveness of new approaches of specially designed laser probe to heat and destroy brain.

• Search Cancer Clinical Trials.

Contact Us

The Cancer Answer Line: 866.CCF.8100 (866.223.8100)

For Medical Professionals

Refer a Patient

The Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center offers direct referral lines to ease the process of making a patient referral.

To refer a patient to the Neurological Institute via phone, please call our dedicated physician referral hotline at 216.445.8455. An intake coordinator will handle your call directly. If you are unable to reach an intake coordinator, please leave a message and they will return your call within the work day (if left before 1 p.m. ET) or the next work day (if left after 1 p.m. ET).

To refer a patient to the Neurological Institute via fax, please download and complete our physician referral form and fax to 216.636.2596.

• Physician Referral Form.

DrConnect

Stay connected to patients you refer to Cleveland Clinic through online updates and electronic medical records.

• Learn More.
• Sign-up or Log in.

Residency and Fellowship Programs

• The Burkhardt Brain Tumor & Neuro-Oncology Center has a long-standing tradition of training future leaders in the field of neuro-oncology and neurosurgery.  Learn more about residency and fellowship opportunities available through Cleveland Clinic’s Burkhardt Brain Tumor & Neuro-Oncology Center: Neurosurgery Residency Program.
• Neurosurgery Fellowships.
• Neuro-Oncology Fellowship.

Advanced Training Programs

Advanced training programs are available:

• SBRT Symposium - Annual International Symposium on Stereotactic Body Radiation Therapy (SBRT) and Stereotactic Radiosurgery (SRS).
• Gamma Knife Training Courses – Introductory and Upgrade Courses.

Alumni Information

The Cleveland Clinic Foundation alumni represent a vital constituency of physicians and scientists throughout the world who reflect the institution's commitment to excellence. The Cleveland Clinic Foundation is committed to continue serving as a resource to its alumni in their post-residency years by providing access to information and programmatic support necessary to assure their professional growth and success. The goal of these efforts is to bolster the bond between the institution and its alumni and create an atmosphere that encourages a commitment among alumni to offer support for, and to participate in the life of the institution.

Please keep in contact!

We want to stay on top of significant changes in your life. Have you moved? Taken on a teaching position? Received an academic promotion or professional recognition? Decided to retire? Have an interesting hobby or avocation you'd like to share? Your former CCF colleagues really want to know what you are up to. Please keep us informed and send photos! alumni@ccf.org

National Medical Meeting Receptions

The Cleveland Clinic Foundation Alumni Association together with the Departments of Neurology and Neurosurgery are pleased to sponsor alumni gatherings at the following major national medical meetings and other special events. All local alumni, as well as those attending the meetings, are cordially invited to these Alumni gatherings along with their spouse/companion.

• Alumni Relations.

Resources

Cancer Center Resources

We are dedicated to helping you face the challenges associated with your diagnosis and treatment. Patients treated in Burkhardt Brain Tumor & Neuro-Oncology Center have access to numerous patient support services and programs through Cleveland Clinic Cancer Center.

Brain Tumor Support Group

The Burkhardt Brain Tumor & Neuro-Oncology Center team realizes you may have concerns about how a brain tumor may affect your family, your job or your ability to carry out other daily activities. You are not alone, and we have found our Brain Tumor Support Group to be helpful in dealing with these concerns. This group provides the opportunity to share experiences and to socialize with others in similar situations. An advanced practice provider and social worker assist the group, provide information and answer questions regarding treatments, medications, resources and other important issues.

Join us in a virtual meeting on the Zoom platform from 4 p.m. - 5 p.m. every 3^rd Tuesday, beginning January 18.

Mark your calendar for:

• January 17: Coping & Support.
• March 21: Guest Speaker – Headache Specialist.
• May 16: Guest Speaker – Dr. Weinstein discussing palliative medicine.
• July 18: Coping & Support.
• September 19: Guest Speaker – Brain Tumor research nurses discussing clinical trials.
• November 14: Community Resources.

For more information, please call 216.636.0007, option 2.

B-AWARE® Program

Have you been diagnosed with cancer?

You should and know the facts about brain metastases. Brain metastases are treatable, but early detection is critical. Know the signs.

Know the facts - B is for Brain

More than one million Americans are diagnosed with cancer every year. Approximately one-quarter of these individuals will develop metastatic brain tumors during the course of their illness. If you or a loved one have cancer, be aware of the symptoms of brain metastasis and the available treatment options.

What is primary cancer?

Cancer can form in any organ or tissue in the body. The original tumor that forms is considered the primary cancer or primary tumor.

What is metastasis and how does it happen?

Metastasis means secondary cancerous growth formed by the movement of cancerous cells from a primary growth located elsewhere in the body. Cancer cells can break away from a primary tumor and enter the body’s bloodstream. This is the way in which cancer cells spread to other parts of the body.

When cancer cells spread and form a new tumor in a different organ, the new tumor is called a metastatic tumor. The cells in the metastatic tumor come from the original tumor. This means, for example, that if breast cancer spreads to the brain the metastatic tumor in the brain consists of cancerous breast cells (not brain cells). In this example, the tumor in the brain is metastatic breast cancer and not brain cancer.

Are certain primary cancers more likely than others to result in a brain metastasis?

Recent studies indicate that the most common origins of brain metastasis are cancers of the lung, breast, skin, kidney and colon.

What symptoms to look for

Like with most cancer diagnosis, early detection is key. Know the symptoms and talk to your oncologist about any abnormal changes that you experience.

Metastatic brain tumors present with the same symptoms as a primary brain tumor. This can include:

• Vision changes such as double vision or partial blindness.
• Headaches possibly with nausea.
• Numbness or tingling in part of the body.
• Paralysis or difficulty moving any part of the body.
• Inability to walk.
• Difficulties with balance and an increased incidence of falls.
• Difficulty speaking, including slurring words or incoherent speech.
• Problems with mental acuity such as not being able to read or tell time.
• Seizure or convulsions.

Though most of these symptoms are of gradual onset, severe episodes can also occur.

Treatment options - What to do

Just like with most cancers, early detection and diagnosis can improve treatment options and results. These options vary from patient to patient and primarily depend on location, type and extent of the disease.

What treatment options are available if I am diagnosed with a brain metastasis?

The good news is, just like many other cancers, a brain metastasis can be treated. Although radiation to the whole brain was the traditional treatment, today surgery and radiosurgery are often the treatment of choice – either alone or in combination with conventional radiation. Chemotherapy may also be used in selected cases.

Can I treat my primary tumor brain metastasis simultaneously or separately?

If there are tumors elsewhere in the body, the brain metastasis will normally be the top priority, both because brain metastasis is life threatening and because the treatment is different from and often incompatible with treatment of tumors elsewhere.

Do you still have questions?

If you have questions about your specific care you should speak directly to your oncologist.

If you have general questions about cancer, Cleveland Clinic is here to help you get the cancer information you need. Please contact us via Cleveland Clinic's Cancer Answer Line toll-free 866.223.8100, Monday – Friday, 8 a.m. – 4:30 p.m.

Two oncology clinical nurse specialists and their staff can provide information and answer questions about cancer. If desired, appointments can be scheduled with one of the expert physicians at Cleveland Clinic.