New neuro-oncology services now available at Providence

John Zurasky
John Zurasky, M.D., medical director, neurology, Providence Brain and Spine Institute
Vivek Deshmukh
Vivek Deshmukh, M.D., medical director, neurosurgery, Providence Brain and Spine Institute

Providence Brain and Spine Institute provides comprehensive neurological services with sub- specialization in all major areas of neurological disorders at Providence St. Vincent and Providence Portland medical centers. With the addition of neuro-oncology, the institute has expanded its services to care for patients whose treatment plans may include neurosurgery, radiation oncology, medical oncology and other specialists.

Neuro-oncology care at Providence

Neuro-oncologists are dually trained to treat cancers and tumors of the brain as well as other neurological conditions. Dr. Ricky Chen treats patients using a variety of chemotherapies, either orally administered or delivered by vein at an infusion center. In many cases of brain malignancy, an oral chemotherapy is available that provides effective anti-neoplastic activity with minimal systemic side effects. Chemotherapy can be given alongside radiation therapy to maximize results.

In addition, neuro-oncology treatments may include:

  • Biologic therapies that target the mutations that are believed to promote cancer
  • Immunotherapies that improve and activate the body’s innate defenses against cancer
  • Tumor treating field therapy, a novel wearable device that stops the growth of tumors using alternating electric fields

Treatments using chemotherapy or other less traditional anti-cancer therapies require close monitoring for side effects, as well as a detailed assessment of brain imaging for treatment response or complications. As a board-certified neurologist, Dr. Chen also manages neurologic complications of cancer such as strokes; brain hemorrhage; cerebral edema; seizures; headaches; neuropathy; and impairments of cognition, vision and speech. He provides consultation to neurologists and primary care providers on appropriate triage and management of undiagnosed lesions of the brain and spine that are suspicious for malignancy.

Dr. Chen and the neuro-oncology team see patients at Providence Cancer Center Oncology and Hematology Care Clinic at Providence St. Vincent Medical Center. Patients can receive a full spectrum of services that include nurse practitioners, nursing, social work, palliative care, financial counseling and pharmacy support. The clinic can be reached at 503-216-6300.

Members of the team working together

Dr. Chen works closely with neurosurgeons Daniel Rohrer, M.D., director of cranial surgery, and Pankaj Gore, M.D., director of brain tumor and skull-based surgery at Providence St. Vincent. Together with other neurosurgeons, the brain tumor center uses:

  • Cutting-edge techniques that include intraoperative MRI to safely maximize extent of resection Functional MRI to map eloquent brain anatomy
  • Precision-guided localization for stereotactic biopsy (such as the brain path system for targeting of deep-seated lesions to avoid disruption of white matter tracts)
  • Laser interstitial thermotherapy for ablation of otherwise unresectable tumors

Dr. Chen also partners with radiation oncologists from Providence Cancer Institute – Eric Hansen, M.D., David Gannett, M.D., Stephen Bader, M.D., and Steve Seung M.D., Ph.D. (Gamma Knife Center) – to provide effective radiation therapies tailored for each patient with new or recurrent tumors of the brain and spine.

Based on patient and family needs, as well as the kind of tumor and its location, these radiation specialists tailor treatment plans to deliver an appropriate dose of radiation to destroy tumor cells while sparing adjacent vulnerable structures. Intensity modulated radiotherapy offers effective control of tumors of the brain and spine, while Gamma Knife radiation is used to ablate small tumors or metastases with precision.

Neuropathologists Allan Sacker, M.D., and Vasco Kaimaktchiev, M.D., are part of the neuro-oncology team, and they have a wealth of expertise in obtaining histological diagnosis for brain tumors and cancers. They also collaborate with Carl Bifulco, M.D., who leads molecular pathology at Providence to assess tumors for somatic and germline mutations with diagnostic and therapeutic significance. They provide an improved understanding of the biology of tumors and uncover markers for therapeutic response.

The neuro-oncology team also benefits from radiologists and neuro-radiologists with significant experience in evaluating brain imaging of tumors. This includes using special techniques such as perfusion and spectroscopic imaging to assess the vascular and metabolic characteristics of lesions.

This multidisciplinary approach includes managing complex diseases such as CNS tumors and cancers. A neurologically-based tumor board meets regularly to review cases, evaluate imaging, pathological findings, and discuss treatment options to provide consensus recommendations driven by clinical evidence. At times, when patients exhaust standard treatment options, the tumor board can also weigh in on experimental therapies based on the level of preclinical data.

Clinical research program in neuro-oncology

Brain malignancies comprise some of the most aggressive and disabling cancers known to medicine. As a field, there is intense activity to find more effective treatments that can delay progression and improve patients’ survival and quality of life. Providence’s neuro-oncology program is dedicated to translational clinical research through the collaboration between the brain and cancer institutes. This includes investigator-initiated clinical trials and increased patient access to industry-supported studies (including National Cancer Institute-approved studies) through research networks in regional and national consortiums.

Ricky Chen

About Dr. Chen

After earning his medical degree from OHSU, Dr. Chen completed an internal medicine internship and neurology residency at the University of Utah Hospital. He completed a fellowship in neuro-oncology at the University of California, San Francisco. 

Dr. Chen is board certified in neurology and neuro-oncology.

In addition to their work with Providence, these PBSI physicians have affiliations with the following clinics:

Comprehensive Neurosurgical Consultants

Daniel Rohrer, M.D.

The Oregon Clinic

Pankaj Gore, M.D.
Eric Hansen, M.D.
David Gannett, M.D.
Stephen Bader, M.D.
Steven Seung, M.D., Ph.D.