Neurosurgery is a complex and intricate process, and it is important to continuously refine and seek innovative techniques to make it safer, gentler and more precise and effective. The team of experts at Sarah Cannon Cancer Institute at Swedish Medical Center have begun using the recently approved drug compound 5-aminolevulinic acid (5-ALA) to aid in tumor visualization during surgeries. This compound reacts with tumor cells, making them more visible and distinctive during surgery, which helps the surgeon remove the tumor and preserve structures of the brain.
"The challenge with brain tumors, particularly invasive tumors, is that the margins include a mixture of functional brain tissue and tumor cells," explains Vadim "Eddie" Tsvankin, MD, a neurosurgeon at Sarah Cannon Cancer Institute at Swedish Medical Center. "Innovate techniques such as 5-ALA that can provide enhanced visualization to discriminate between the two helps resect more of the tumor and accomplish a safer surgery."
The 5-ALA compound is provided as a drink to the patient prior to surgery. Once ingested, it reacts with the cells of the tumor, causing them to fluoresce under a specialized microscope during surgery. "The tumor cells fluoresce while the neighboring brain tissue remains dark," details Dr. Tsvankin. "This helps define the tumor, allowing us to achieve a more complete resection, which ultimately leads to better outcomes for our patients."
As part of Sarah Cannon, the Cancer Institute of HCA Healthcare, Swedish Medical Center offers patients compassionate, comprehensive cancer care close to home. From diagnosis to treatment and survivorship care, our oncology expertise ensures that patients have access to locally trusted care with the support of a globally recognized network.
The use of 5-ALA is just the latest of many innovative techniques the neurosurgery team at Swedish Medical Center employs to treat patients with neurological conditions, including robotic and laser-assisted surgery, minimally invasive brain tumor surgery, and brain mapping. "Removing the tumor is not enough," says Dr. Tsvankin. "Some of the structures infiltrated by the tumor may be those that make the patient who they are or that allow them to derive joy from life, and the ability to remove a brain tumor while preserving all the essential brain structures is critical. The metric for success is not only a clean MRI after surgery, but also the quality of life our patients enjoy after our job is done."
Swedish Medical Center ranks among the nation's top neuroscience programs and was designated as a Neuroscience Center of Excellence (COE). A leader in the field of neurology and neurosciences and the treatment of stroke, the program at Swedish combines state-of-the-art technology with an outstanding team of staff and physicians who have extensive experience and expertise in treating nearly all forms of neurological disease. Learn more about the Neuroscience Center of Excellence at Swedish Medical Center.