Our Treatment Approach
The specialists at MD Anderson take a team approach to skull base tumors, bringing together extraordinary expertise from many areas. We personalize your treatment to deliver the most-advanced care with the least impact on your body.
Skull base tumor patients benefit from the most advanced technology and treatments, many available at only a few locations in the country. Your recommended therapy may include:
- Minimally invasive surgery
- Proton therapy
- Innovative radiotherapy delivery techniques
- Advanced reconstruction surgeries
And we’re constantly researching newer, safer, more-advanced treatments for skull base tumors. This means we are able to offer a range of clinical trials for new treatments.
Our Skull Base Tumor Treatments
If you are diagnosed with a skull base tumor, your doctor will discuss the best options to treat it. This depends on:
- The type of tumor
- The location of the tumor
- Possible side effects of treatment
- Your health
Most skull base tumors may require surgery. Some can be treated without surgery (for example with radiation or chemotherapy). Others do not need to be treated right away and can be watched closely over time.
Your treatment for a skull base tumor will be customized to your particular needs. It may include one or more of the following.
Like all surgeries, skull base tumor surgery is most successful when it is done by a specialist with a great deal of experience in the procedure.
MD Anderson’s renowned skull base tumor surgeons work in multi-specialty teams. They perform a high number of skull base tumor surgeries each year, using the least-invasive, most-advanced techniques.
The main types of skull base tumor surgery are:
Open surgery: Incisions (cuts) are made in the skin or the membranes of the nose or throat to expose the bone of the skull base. The incision often can be hidden in the hair, skin creases, nose or mouth.
The affected bone is removed to expose the tumor and to identify the important nerves and blood vessels. After the tumor is removed, the membrane that protects the brain and the surrounding soft tissues is closed to seal off the skull base. Occasionally, when large skull base tumors are treated, plastic surgeons rebuild the soft tissues and bone to optimize function and appearance.
Minimally invasive endoscopic surgery: Using no incisions or a few small ones in the skull or back of sinuses, the surgeon uses an endoscope (link to definition) to biopsy or remove the skull base tumor. This approach may:
- Lessen damage to healthy tissue
- Lessen time in hospital and recovery time
- Reduce complications
Image-guided surgery: CT (computed tomography) or MRI (magnetic resonance imaging) scans are taken before surgery. They then are used in the operating room to help guide the surgeon to the precise location of the tumor. This enhances the accuracy and precision of minimally invasive surgery of the skull base.
Real-time MRI: Provides surgeons with precise, "live" images of the tumor and surrounding areas during surgery. This increases the surgeon’s accuracy and the chance for complete removal of the skull base tumor.
New radiation therapy techniques and remarkable skill allow MD Anderson doctors to target skull base tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells. MD Anderson provides the most advanced radiation treatments, including:
Intensity-modulated radiotherapy (IMRT) including:
- 3-D conformal radiation therapy, which uses sophisticated computerized controls to deliver radiation beams from different angles to fit the exact shape of the skull base tumor
- Dynamic multi-leaf collimator (DMLC) uses metal ‘leaves’ to shape the radiation beam that is delivered to the tumor. As the radiotherapy arm moves, the computer-controlled ‘leaves’ are repositioned so that radiation beams can target even irregularly shaped skull base tumors.
Radiosurgery, such as Gamma Knife, focuses one large dose of radiation to small tumors (less than 3 centimeters)
Proton therapy: The Proton Therapy Center at MD Anderson is one of the largest and most advanced centers in the world. It’s the only proton therapy facility in the country located within a comprehensive cancer center. This means that this cutting-edge therapy is backed by all the expertise and compassionate care for which MD Anderson is famous.
Proton therapy delivers high radiation doses directly to the skull base tumor site, while decreasing the risk of damage to nearby healthy tissue. It is especially valuable for some cancers deep in the body (such as skull base tumors) because it is targeted to deposit energy only in the area of the tumor. For some patients, this therapy results in better cancer control with less impact on the body.
The choice of chemotherapy is based on the type of tumor cell that is found in the skull base tumor. MD Anderson offers the most up-to-date and advanced chemotherapy options.
Our Skull Base Tumor Clinical Trials
Because of its status as one of the world’s premier cancer centers, MD Anderson participates in several clinical trials (research studies) for skull base tumors.
Studies of treatments based on tumor cell type may include laboratory or imaging tests to see if the treatment is working. Other studies track the quality of life of patients and their families. This may help lessen the effect of the tumor and its treatment on patients’ physical, mental and social well-being.
MD Anderson patients have access to clinical trials offering
promising new treatments that cannot be found anywhere else.
Find the latest news and information about skull base tumors in our
Knowledge Center, including blog posts, articles, videos, news
releases and more.
My meningioma story began on a sunny and hot afternoon with a bright blue, cloudless sky.
As I crossed a parking lot, I looked up, closed one eye and noticed
that the sky seemed dark and grey. Then, I closed my left eye. The sky
looked bright blue. I closed my right eye again and saw grey. I made
an appointment with my optometrist the following Monday.
My meningioma diagnosis
It turned out that the problem wasn't in my eye. It was behind my eye. My optometrist sent me to a neuro-ophthalmologist.
After an MRI and other tests, I got my diagnosis -- meningioma, a noncancerous tumor, on my optic nerve. The doctor said the tumor was inoperable and recommended targeted radiation.
Because meningioma is slow-growing, the doctor also recommended waiting a month for another MRI.
None of this seemed like a good idea to me. I didn't want to put off
another MRI, and I was nervous about radiation.
My daughter and two friends suggested I go to MD Anderson. I immediately nixed their idea. MD Anderson was only for cancer patients, I told them. But when I looked online, I learned that MD Anderson treats both cancerous and non-cancerous skull base tumors like meningioma.
Choosing MD Anderson for meningioma treatment
The next week, I had an MRI at MD Anderson. Five days later, my care team presented my treatment plan.
One surgeon talked about trying a surgical procedure that had never been done before.
Shaan Raza, M.D., and Shirley Su, M.D., would perform the surgery.
First, Dr. Su would correct a deviated septum and make a path to the
tumor through my nose and sinuses. Dr. Raza would expose the optic
nerve, and then he and Dr. Su would remove the tumor.
I looked at my husband and said, "They are talking about removing this surgically!" We were ecstatic. I had complete confidence in my team and couldn't wait to be tumor-free.
My meningioma surgery
I had the surgery just a week later. I couldn't believe how quickly MD Anderson coordinated everything.
The night before the surgery, Dr. Raza said he would do everything he could to save my sight. He would try not to harm the nerve near the tumor, but he reminded me that the nerve was very sick. I shouldn't expect it to recover. I told Dr. Raza that a lot of people were praying for me and that my faith in a 100% recovery was not changing. He said he liked my optimism.
Recovering from my meningioma surgery
The procedure went exactly as planned. After I woke up, Dr. Raza asked what I saw. I looked at the white board on the wall and told him it looked a little lighter, but the room was dim so I couldn't be sure.
Before surgery, one of my symptoms was color variation, which meant red looked orange with my left eye. So, Dr. Raza rushed to get an American flag. "Now, what do you see?" he asked. I covered my left eye. The stripes looked red. I covered my right eye and looked with my left. "Red!" I told him.
Everyone in the room was elated. My nurses wouldn't let me speak anymore; they were having a hard time keeping my blood pressure down.
I was released three days after surgery. The next two weeks were extremely trying. I had splints in my nose to protect the areas from which they had harvested skin, and I couldn't breathe through my nostrils. I was prescribed steroids, which kept me awake.
Once the splints were removed, I slept better. For a while, I lost my sense of smell and taste, but they slowly returned.
My eyes also continued to improve. The nerve returned to a healthy shade of pink. Since the tumor was non-cancerous and the MRI after surgery shows no tumor left behind, I don't need any more treatment. I just get MRI scans to make sure my vision keeps improving and that my tumor doesn't come back.
A reason to celebrate
My husband and I now saw what was really important in our lives. We celebrated with a trip to Hawaii. We'd been putting off that trip for years, and, without my meningioma diagnosis, we probably would've kept putting it off.
I thank my own family and friends who prayed me through to good health.
I also thank God for directing us to MD Anderson. It is the most caring, professional, and overall best place to be for medical treatment. Every time I see beauty through my eyes, I am reminded of my miracle and how fortunate I was to be treated at MD Anderson, where I received hope for great eyesight and a healthy, long life.