Patients are guaranteed appointments within 72 hours and can typically see all necessary providers (oncologists, radiation oncologists, neurosurgeons, and/or palliative care specialists) on the same day in one facility. All patients are assigned a navigator who knows their treatment goals, coordinates their tests and appointments, and helps them through their care at Duke.
Call the referring provider team Monday through Friday between 8:00 a.m. and 4:30 p.m. at 866-385-3123 (1-866-DUKE-123). You can also email OncologyReferral@Duke.edu or fax 919-613-2316.
The Duke Center for Brain and Spine Metastasis (DCBSM) provides comprehensive, multidisciplinary evaluation and treatment for patients with metastatic disease involving the brain and spine. Experts from neurosurgery, medical oncology, radiation oncology, palliative care, neuroradiology, neuropathology, interventional radiology, and more collaborate to provide innovative treatment options for advanced cancers affecting the central nervous system (CNS).
“Our goal is to quickly get new patients an appointment and see multiple specialists with our DCBSM team in one day,” says Catherine Sellers, MSN, RN, AGNP, DCBSM assistant clinical program manager. The team’s collaborative model allows for efficient patient intake and scheduling. “Our new patient coordinator works with patients’ medical teams to get all previous records, imaging, and notes, so our physician team is prepared to have an informative initial appointment,” she adds.
Patients referred to the center benefit from multidisciplinary case review, including weekly tumor board meetings focused on brain and spine metastases. During these discussions, up to 40 clinical specialists collectively evaluate surgical candidacy, radiation strategies, systemic therapy considerations, symptom management, clinical trial candidacy, and each patient’s goals.
“The care of patients with brain and spine metastasis is in some ways more complex than other cancer care because of the diversity of cancer types that fall under this umbrella. This requires a multidisciplinary approach to ensure that the nuances of each patient and their cancer type are being considered when developing a treatment plan that involves so many different treatment modalities,” adds Anoop P. Patel, MD, neurosurgeon and DCBSM co-director.
Patients have support from a nurse navigator to guide every step of their care at Duke. “We have three dedicated nurse navigators, one for spine metastasis at DUH, one for brain metastasis at DUH, and one for all DCBSM patients in Wake County,” Sellers explains.
Comprehensive care plans
DCBSM offers advanced surgical and radiation capabilities, including minimally invasive neurosurgical approaches and precision radiation therapies. “As an academic medical center, we can offer unique, cutting-edge therapies, such as laser interstitial thermal therapy [LITT] for brain radionecrosis and stereotactic radiosurgery (SRS),” says Sellers.
Patel notes that this complex patient population requires some of the most advanced surgical and precision radiation techniques available today. “An approach that works for one patient may not be best for another, so each patient is considered individually to derive a nuanced and optimized treatment plan that deploys a combination of innovative surgical technique, radiation therapy, and medical therapy to maximize outcomes and minimize side effects.”
Supportive and rehabilitative services are also incorporated early in patients’ care pathways. Sellers adds that symptom management, activities of daily living, quality of life, and functional preservation are important considerations for patients. Because care has so many components, DCBSM teams prioritize frequent communication and continuity of care with referring physicians throughout the treatment process.
“Many patients travel to see us for specialized care or trials, so we coordinate with their local providers to ensure consistent and cohesive communication throughout the trajectory of a patient’s disease and treatment. Partnering with our patients’ local oncology teams is an important part of helping our complex patient population maintain normalcy in their day-to-day lives and supporting them to get the highest quality care close to home.”
Expanded treatment options through clinical trials
The DCBSM also maintains an active clinical research program. Patients may be eligible for clinical trials evaluating emerging therapeutic approaches for CNS metastases. “CNS involvement has historically been an exclusion criterion for many clinical trials, but not at Duke,” says Sellers. “We have a broad range of clinical trials that can extend lives and improve quality of life for our patients.”
A key goal of the DCBSM is to provide cutting-edge therapies to patients, which may currently be accessed only through clinical trials. “We are committed to providing therapies via clinical trials to our patients with brain and spine metastases. In this manner, we hope to help individual patients receive the most up-to-date, novel treatments and technologies, while accelerating the development of these strategies for all patients with brain and spine metastases,” says Carey K. Anders, MD, DCBSM director.