Cleveland Clinic's Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center has a distinguished legacy of research and patient care. Our sub-specialists, offer a full range of advanced treatment options for adults and pediatric patients including state-of-the-art surgical options, therapeutic treatments and innovative clinical trials. Our staff understands the importance of tailoring a treatment plan for each patient. By bringing together physicians from different training backgrounds and experiences, we offer a collaborative, multidisciplinary environment to meet the needs of patients suffering from tumors of the brain and spine as well as their effects on the nervous system.
Advancing the care of brain tumor patients lies in a better understanding of the causes and mechanisms of tumor development. Research efforts at the Burkhardt Brain Center are focused on identifying the genetic, cellular, and molecular biology of malignant and benign brain tumors, investigating the mechanisms of tumor formation, and exploring new therapeutic developments of brain tumor treatment.
Francesca Fernández de Cordova
Hometown: Ecuador, currently living in Solon, OH
Diagnosis: Medulloblastoma, a malignant brain tumor
Treatment: Tumor resection followed by radiation and chemotherapy
When others couldn’t offer it to them, the Fernández family turned to Cleveland Clinic for hope
Four year-old Francesca Fernandez de Cordova was just an average child growing up in Ecuador until the fall of 2011 turned her life upside down. She began experiencing severe headaches and worsening coordination, so her parents, Sandra and Pedro, took her to a local Ecuadorian physician. He was able to diagnose the cause of her symptoms as a medulloblastoma, a type of malignant brain tumor found in children. While this was a devastating diagnosis to receive for their daughter, Francesca’s parents were determined to do everything in their power to save their youngest daughter. Their local neurosurgeon initially felt that the tumor was all but inoperable due to the size and critical area, in which it was located in Francesca’s brain. But he was able to remove a small portion of the tumor from Francesca’s brain. This meant the only option available for treating the remaining tumor were radiation followed by chemotherapy. Her parents knew that while this may give them some more time with their daughter, it was not the outcome they were hoping for.
So, Sandra and Pedro began their search for other options for Francesca. Her neurosurgeon in Ecuador recommended that the family visit Cleveland Clinic Florida neurosurgeon, Jose Valerio, MD, with whom he had met through a Latin American medical association. Soon, the family packed their bags, got on a plane and headed to Weston, Florida. for an appointment with Dr. Valerio. Following additional brain scans, Dr. Valerio suggested the Fernández family seek treatment for the remaining 4cm tumor with one of his colleagues at Cleveland Clinic’s main campus. Because of Francesca’s age, the nature of the remaining tumor and where it was located, he recommended Violette Recinos, MD, a pediatric neurosurgeon at the Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, who specializes in these types of pediatric brain tumor cases.
Within a few days of seeing Dr. Valerio in Florida, Francesca and both of her parents were soon meeting with Dr. Recinos in Cleveland. Dr. Recinos subsequently removed the remaining tumor from Francesca’s brain. Dr. Recinos comments, “She had a good tumor resection, we were able to get it all.” Dr. Recinos added, “Although, Francesca’s tumor is not the most common type, our team has treated a number of these cases and knew exactly how to approach her treatment when she arrived.”
Once the surgery was completed, Tanya Tekautz, MD, took the lead on Francesca’s ongoing care. She recommended a course of radiation followed by chemotherapy to ensure the tumor cells were completely treated.
Francesca’s radiation therapy was aggressive but, just like most children, she tolerated this type of intensive treatment very well. Erin Murphy, MD, was the radiation oncologist who managed this six-week portion of her treatment. “We were able to perform a very complex treatment plan, with the specific goal of reducing the short and long term side effects for Francesca,” Dr. Murphy noted.
The Fernández family stayed at the Ronald McDonald House for a portion of this treatment before moving their two older children, Eric and Michelle, from Ecuador to the Solon area for the remaining treatment time.
Francesca is about half way through her chemotherapy treatment now and her prognosis is good. Dr. Tekautz has resumed the oversight of her care and helps her to manage any side effects she might experience, such as sleepiness or poor appetite. Francesca should complete her final chemotherapy cycles later this year. Dr. Tekautz comments, “While her tumor is aggressive, she has responded remarkably well during the treatment process; with ongoing monitoring and follow-up we are optimistic for her future.”
Francesca’s parents have a very strong faith and are certain that their journey from Ecuador to Florida and now in the Cleveland area has been a blessing. This treatment path they are on with Francesca was because God has brought them to the right hospital and clinical team to best help their daughter.
Today, Francesca is doing phenomenally well. She recently celebrated her fifth birthday and is looking forward to learning English and visiting the Cleveland Aquarium and Cleveland Metroparks Zoo. Francesca told her mom recently that she "feels like a new person” and that “Cleveland Clinic is my hospital, my home. This is where they take care of me.”
Hometown: Columbus, Ohio
Diagnosis: Renal cell cancer and spine metastasis
Treatment: Stereotactic Spine Radiosurgery
Susan Davis is a veteran of conventional open surgery such as the 2005 procedure in which one of her kidneys was removed. When her renal cell cancer subsequently spread to her upper spine, she underwent another open surgery in Columbus to remove that tumor and then had conventional radiation. All too soon, however, she started feeling numbness in her left leg and foot, and learned that the tumor in her upper spine was growing back.
Ms. Davis’ husband, did some research and learned about radiosurgery, a noninvasive outpatient procedure that delivers a high dose of radiation to precisely targeted tumors, without damage to nearby normal structures. This innovation provides rapid pain relief and requires virtually no recovery time
When a nurse called to see how she was doing, Ms. Davis inquired about radiosurgery. The nurse told her that Cleveland Clinic offers stereotactic spinal radiosurgery, when appropriate, for patients with spine metastases.
Ms. Davis subsequently met with Cleveland Clinic radiation oncologist Samuel Chao, MD, and neurosurgeon Lilyana Angelov, MD, FRCS(C), who specialize in spine radiosurgery. They told her she was a candidate for the procedure.
So on a very snowy winter day in 2008, the Davises drove from their home to Cleveland for an early surgical appointment. Mr. Davis was invited into the nurses’ station to check the televised weather forecast as the snowstorm worsened. When his wife came out of surgery, they drove safely home the same day.
“Ms Davis has done extremely well post-spine radiosurgery,” says Dr. Angelov. The tumor growth and numbness that Ms. Davis previously suffered from have been controlled since the surgery. She has been required only to return to Cleveland Clinic for checkups every three months; recently, doctors told her she could return every four months.
“Ms. Davis is now more than three years from her radiosurgery treatment,” Dr. Angelov says. “She is pain free and neurologically normal, with no evidence of tumor progression. She lives life to the fullest and always brings a smile when she comes to clinic to see me.”
Ms. Davis, too, is pleased with her outcome. “I would recommend all my Cleveland Clinic doctors to anyone,” she says. She is thrilled that Dr. Angelov has agreed to speak with her cancer support group to answer questions about spine radiosurgery. “My experience has been extremely smooth. Coming home the same day was a blessing. It’s a wonderful system.”
It's become a classic scenario: You have a headache and after Googling it, you find out a headache can be a sign of a brain tumor.
If you rush to the emergency room suspicious that you have a tumor or something else deadly serious, chances are you're being paranoid. But sometimes you're not being paranoid -- you're being right.
- Read John's story about how his sudden onset of painful headaches led to a diagnosis and treatment for a brain tumor, available on CNN.com.
- Read more about how John is doing today on Cleveland.com.
Hometown: Hubbard, Ohio
Diagnosis: Lung cancer with metastasized brain tumor
Treatment: Gamma Knife® radiosurgery
Vigilance Pays Off
After battling cancer twice, this patient knows the importance of following doctors’ orders.
A few years ago, Mary Dattilo experienced chest pains and thought she might have cracked a rib. She knew it was something more serious when she started coughing up blood. Although she had quit her heavy smoking habit years earlier, she was diagnosed with lung cancer. As part of her treatment, parts of a lung and her chest cavity were removed. She subsequently received both radiation and chemotherapy.
Once her treatment was complete, Mrs. Dattilo was put on a plan of periodic check-ups and imaging studies and warned by her oncologist of the possibility of metastatic tumors, which result from spread of the primary cancer to other parts of the body. Indeed, a routine scans months later found a brain tumor (brain metastasis). Because Mrs. Dattilo had been diligent about her follow-up appointments, the brain tumor was caught early, when it was still very small and treatable.
Shortly after the tumor was found, Mrs. Dattilo met with Cleveland Clinic radiation oncologist Samuel Chao, MD, and Cleveland Clinic neurosurgeon Michael Vogelbaum, MD, PhD, who recommended Gamma Knife® radiosurgery to treat the growth.
“A diagnosis of brain metastases can be terrifying,” says Dr. Chao, “but patients can take heart because we have a number of treatment options, including surgery, radiation, stereotactic radiosurgery and, in some cases, chemotherapy. Thus, it is beneficial to take a multidisciplinary approach to this diagnosis, as we do at Cleveland Clinic. It allows us to tailor the best therapy for each patient to control brain metastases and limit the side effects of treatment.”
Dr. Chao, Dr. Vogelbaum and their staff explained that Gamma Knife treatment is a computer-guided therapy that delivers targeted radiation to a specific location in the brain. This outpatient procedure is nearly painless and, unlike conventional brain surgery, requires no incision.
Mrs. Dattilo and her husband, Gary, took this information to heart, but wanted the opportunity to do their own research online to better understand not only the medical side of the procedure, but also the patient side. The information they found from current and former Gamma Knife patients was overwhelmingly positive, so they decided to move forward with the recommended treatment plan.
In 2007, Mrs. Dattilo underwent radiosurgery at Cleveland Clinic Gamma Knife Center®. As always throughout this journey, her husband was by her side.
“Everyone was very professional there,” she recalls. “My husband and I were extremely relaxed throughout the treatment day. The staff was so friendly.”
Mary Dattilo still returns to Cleveland Clinic every six months for follow-up visits and imaging studies, but she is doing well and enjoying life. Now retired, she keeps busy traveling, babysitting her grandchildren, knitting, and spending time with family and friends.
Looking back four years after her first cancer diagnosis, Mrs. Dattilo reflects on what she has learned: “When you have stage IV lung cancer, you think that’s it. To make it through, you have to have a positive attitude and trust the doctors and the hospital you’ve chosen. I followed their advice to a T and it saved my life.”
Learn how this couple overcame two brain tumor diagnoses and how neurosurgeon Michael Vogelbaum, MD, PhD, was able to locate and remove a hidden tumor with the help of advanced intra-operative imaging technology.