Brain and Spine Tumor Program

Top experts from Overlake Medical Center and EvergreenHealth come together at the Eastside Neuroscience Institute to provide world-class care for the surgical management of tumors involving the brain and spine.

The symptoms and diagnosis of a tumor can be frightening and stressful. At the Eastside Neuroscience Institute, we’re by your side through every step of your patient journey. We’ve brought together a team of experts to provide you with the most advanced diagnostics and treatment options.

You need individualized care for your diagnosis, and the team at Eastside Neuroscience Institute can provide this level of dedication. It is our goal to make sure that patients with brain and spine tumors and their family members are completely integrated into the care plan and decision-making process.

Our personalized approach at our Bellevue and Kirkland locations provides the antidote to the assembly-line medicine that can frustrate brain and spine tumor patients at other institutions.

Our goal is to help you achieve the highest quality of life.

Diagnosing brain and spine tumors

Brain and spinal cord tumors are defined as abnormal masses or uncontrolled growths of cells in the brain or spinal cord.

These tumors can arise from the brain, spinal cord, nerve roots, or surrounding structures, such as the bones or dura, and can be a result of spreading from other locations in the body.

It is important that symptomatic brain and spinal cord tumors be treated as early as possible. We use sophisticated diagnostic technology to provide you with an accurate diagnosis.

Brain and spinal cord tumors are diagnosed in various ways, including:

  • Physical and neurological exam: A physician checks general health, mental status, power, sensation, reflexes and coordination.
  • Blood tests: Check for hormone changes caused by pituitary or pineal gland tumors.
  • Imaging: CT scans, MRI studies, myelogram (to evaluate structures with abnormal anatomy, spread along nerve roots or because of difficulty assessing anatomy by MRI due to previous spinal hardware), and/or angiogram (used to assess tumor-related blood vessels and to possibly reduce the blood flow to tumors through catheter interventions)
  • Investigational imaging: Including magnetic resonance spectroscopy and positron emission tomography (PET). These newer imaging tests can detect tumors, sometimes earlier than other types of imaging. They can also help measure how the tumor is responding to treatment.
  • Biopsy: A sample of tissue is removed for evaluation by our neuropathologists. A biopsy helps to confirm the diagnosis of a brain or spinal tumor.
  • Spinal tap (lumbar puncture): To look for cancer cells in cerebrospinal fluid that surrounds your brain and spinal cord.

Spine and brain tumor treatments

Information about each patient is presented to our neuro-oncology tumor board, which is a team of cancer specialists from Overlake, EvergreenHealth and Seattle Cancer Care Alliance (SCCA). Specialists from multiple medical fields come together to thoroughly discuss your diagnosis and the best treatment strategy, which may include surgery, radiation therapy, chemotherapy and/or targeted therapy.

The main goal in brain tumor surgery is to maximize tumor removal while minimizing pain and neurologic deficits.


If surgery is recommended, our neurosurgery, neuroradiology and neuropathology experts work together in real-time to provide the best care. A variety of sophisticated tools also enhance the precision and safety of brain cancer surgery and allow for the removal of tumors that may otherwise have been inoperable, while preserving neurologic function. We are the only institute on the Eastside offering laser interstitial thermal therapy (LITT) intervention.

These tools include:

  • Intraoperative neuro-navigation: Uses an advanced MRI system to map areas of the brain responsible for important functions. The map then allows us to precisely plan surgery to help avoid damage to those important areas.
  • Intraoperative electrophysiology “brain mapping” (also called motor mapping and language mapping): This is like GPS for the brain. We use small electrodes placed on the outer layer of the brain to stimulate the brain and areas around the tumor. This helps us locate regions of the brain to avoid, such as those responsible for speech or movement.

Surgical techniques include:

  • Laser interstitial thermal therapy: This technique can destroy tumors while preserving surrounding brain tissue.
  • Endoscopic (Neuroendoscopy): A minimally invasive surgical technique in which the neurosurgeon removes the tumor through small holes (about the size of a dime) in the skull or through the mouth or nose.
  • Minimally invasive neurosurgery: This method offers faster recovery times and a lower risk of complications compared to traditional open surgery. In these procedures, the surgeon operates through a very small incision, which gives them direct access to the tumors while ensuring minimal scarring.
  • Craniotomy: Remove a portion of the skull to access and remove the tumor. After the tumor is removed, the surgeon may replace the pieces of the skull and will close the wound.
  • Skull base surgical techniques: This procedure allows our neurosurgeons to operate on tumors located near the base of the skull while preserving vital brain and brain stem functions.

Radiation therapy

We offer the most advanced types of radiation therapy, including:

  • External beam radiation therapy, which uses a machine to direct high-energy beams at the tumor with pinpoint accuracy. This is the most common type of radiation therapy.
  • Internal radiation therapy (brachytherapy), which delivers radiation into or near the tumor through the placement of radioactive pellets, wires or catheters.
  • Stereotactic radiosurgery, which uses focused beams of radiation (either gamma rays, protons or X-rays) to target and destroy cancer cells.


Doctors may deliver chemotherapy locally to the brain during surgery. Because chemotherapy is administered as close as possible to the brain tumor edges at the resection area rather than systemically, this technique may help to reduce typical chemotherapy-related side effects.

Chemotherapy utilizes medications to target and destroy rapidly dividing cancer cells. The medications may be given orally, intravenously or via injection. Chemotherapy is often used in conjunction with other therapies to treat cancer.

Targeted therapy

Targeted therapy is a cancer treatment that uses medications to target specific genes and proteins that are involved in tumor cell growth. This type of therapy helps slow uncontrolled growth and reduce the production of tumor cells. Targeted therapies include oncogenes, growth factors and molecules aimed at blocking gene activity.

Clinical trials to expand your treatment options

Our doctors are at the forefront of the most advanced treatments and technology. We’re actively involved in research studies and clinical trials to improve brain and spine tumor treatments and find new therapies. Our involvement means you may be able to try promising new therapies while they’re still in development.

The Eastside’s leading brain and spine tumor specialists

Your team includes experts from multiple specialties who work together to provide you with compassionate care. They’re with you through each step of your patient journey. These doctors are consistently rated as among the best in their fields by Seattle Met and Seattle Magazine. Other physicians routinely refer patients who have the most complex brain and spinal cord conditions to our team.

At the Eastside Neuroscience Institute, you receive the highest level of care from our:

  • Neurologists and neurosurgeons
  • Medical oncologists
  • Radiologists and radiation oncologists
  • Endocrinologists
  • Neuropsychologists
  • Pain specialists
  • Physiatrists
  • Rehabilitation specialists
  • Social workers

Llisten to our experts speak about Brain Tumor Treatment

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Meet your care team

Dustin M. Hayward, MD
Dustin M. Hayward, MD
Amitoz Manhas, MD, MPH, FAANS
Amitoz Manhas, MD, MPH, FAANS
Ryder P. Gwinn, MD
Ryder P. Gwinn, MD
Brian L. Dial, MD
Brian L. Dial, MD
Orthopedic Surgery
Mark A. Freeborn, MD
Mark A. Freeborn, MD
Orthopedic Surgery
Published Research