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Article Category: Newsroom

New Clinic for Leptomeningeal Disease at Wellstar Georgia Cancer Center

Published on August 03, 2023

Last updated 08:19 AM August 03, 2023

A friendly image of nurse helping patient

When a family member receives a cancer diagnosis, you want the absolute best cancer care for them. Having multiple family members impacted by cancer and neurological conditions inspired Dr. Gerald Wallace to pursue neuro-oncology and to create the Leptomeningeal Disease Clinic at Wellstar Georgia Cancer Center. The goal of the clinic is to diagnose, treat and raise awareness of the life-threatening disease.

“Neurology and cancer have deeply impacted my life for as long as I can remember,” said Wallace, an assistant professor in the division of Hematology/Oncology at the Medical College of Georgia. “I love doing this job; everything about it is just fascinating to me.”

Leptomeningeal disease is a type of metastatic cancer. The leptomeninges are two layers of tissue within the meninges that cover the brain and spinal cord. They are the innermost layers, which line the surface of the brain, blood vessels and surround the cerebrospinal fluid. Researchers estimate that 5% to 8% of people with cancer will develop leptomeningeal disease. It is also estimated that of the nearly 54,000 Georgians diagnosed each year with invasive cancer, as many as 4,000 are at risk of developing leptomeningeal disease. While there is still much that is unknown about the disease, experts do know that it is life-threatening. Without treatment, most patients will only live another six to eight weeks. With treatment, people can live well for months and, in some cases, years.

“That six to 12 months is the next graduation, the next wedding, the next birth of a child… at the end of the day I think we are all just fighting for time to spend with our loved ones. So, we should do something. Treatment is not that bad; it is quite tolerable,” said Wallace.

Possible symptoms that are associated with leptomeningeal disease are visual changes, stiff neck, trouble walking, headache that worsens when lying down, urinary/bowel incontinence, and memory issues. Wallace is concerned when he sees a patient with neuropathies or new neurological symptoms that do not connect to a patient’s known disease. When he hears or sees these sorts of symptoms, he sends patients to get tested. He thinks leptomeningeal disease is easily missed because most patients will already have had cancer for months or years. For these patients, symptoms may be attributed to treatment rather than cancer in the leptomeningeal space.

“If you have problems with one nerve here and one nerve over there, and I cannot connect the two… that really makes me nervous. Something is going on in a more global space than would otherwise be indicated in, say, a tumor that was sitting in the visual cortex and you cannot see well,” he said.

There are treatment options for patients diagnosed with leptomeningeal disease. The first step is to confirm the diagnosis. Contrasted MRI of the brain and spinal cord is used to see if there is anything suspicious or out of the ordinary. MRI is followed by two lumbar punctures to see if there is cancer in the cerebrospinal fluid. Once the diagnosis is confirmed, the next step is radiation of the brain and possibly the spinal cord. Finally, patients meet with a neurosurgeon to discuss placement of an Ommaya reservoir. An Ommaya reservoir is a special port that allows access to the cerebrospinal fluid in the brain. It sits under the hairline on the scalp and is an easier way to give chemotherapy, evaluate spinal fluid and decrease intracranial pressure.

Wallace uses a variety of medications that are given through the Ommaya reservoir to treat leptomeningeal disease. The choice of medication depends on the type of cancer, specific mutations in the cancer and, most importantly, the ability of the patient to tolerate therapy. Patients start off going weekly for treatment for a few months. If they see good results, they can start going every other week, then monthly.

In recent years there have been major breakthroughs for drugs that may be able to treat leptomeningeal disease. Wallace is excited about their potential and is working to create clinical trials at the Wellstar Georgia Cancer Center to assess that potential. As people live longer with cancer, the likelihood of a cancer survivor being diagnosed with leptomeningeal disease also increases.

“I think there is great potential to make big strides in survival and quality of life for patients with leptomeningeal disease,” he said.

If you are concerned about leptomeningeal disease, you can schedule an appointment with Wallace and his team by calling (706) 721-2505.

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Wellstar Proposes New Acworth Area Hospital To Meet Community Need

To address the growing need for hospital beds in Acworth and the surrounding areas, Wellstar Health System is proposing to build a new 230-bed hospital, filing its Letter of Intent with the Georgia Department of Community Health. A Letter of Intent is the first step in the process to obtain a Certificate of Need for a new hospital.

The new hospital would be located on Cobb Parkway across from the Wellstar Acworth Health Park. Wellstar’s long history of service to this community makes it the ideal partner to continue to meet the area's growing healthcare needs. The project will be supported by Wellstar Health System resources, including Wellstar Kennestone Regional Medical Center and Wellstar Paulding Medical Center, and numerous primary, urgent and specialty care locations, which will further enable the project to provide high-quality care in an integrated, coordinated and efficient manner.

Wellstar will file a detailed Certificate of Need application on or before June 23, 2025, that will include architectural renderings and how the hospital would address the community’s health and wellness needs.

“Wellstar is improving access to care, and this new hospital is the latest in a series of projects that do just that,” said Candice L. Saunders, president and CEO of Wellstar Health System. “The area is growing so much that even when our new tower at Wellstar Kennestone opens next year, the region will need more hospital beds. A new hospital in Acworth would fill a crucial need for the region’s medical care.”

Wellstar is improving access to care for communities across Georgia through more than $1.4 billion in major projects, including:

  • Expanding Wellstar Kennestone with a new 200-plus bed tower for additional specialty care,
  • Expanding Wellstar Paulding with a new 56-bed tower and parking deck to meet growing community need,
  • Adding a new oncology center to Wellstar Spalding Medical Center to help keep cancer care local,
  • Committing to upgrading and expanding facilities in the Augusta area, including building a new 100-bed hospital and medical office building in Columbia County for the largest county in Georgia without its own hospital,
  • Adding primary care, pediatric, urgent care and specialty services in the communities Wellstar serves, and
  • Partnering with the Augusta University Medical College of Georgia Center for Digital Health to provide rural hospitals with access to specialty care.

The new hospital would be part of a Wellstar system that provides more than $1 billion each year in charity and uncompensated care—more than any health system in Georgia. Wellstar is also a leader in medical education through its partnerships with academic institutions, accelerates healthcare technology and innovation, and is recognized by Fortune magazine as one of the 100 Best Places to Work in America.

“Access to healthcare has been expanding throughout Cobb County, but we still have an unmet need for hospital beds in the northern portion of our county,” said Lisa Cupid, chairwoman of the Cobb County Board of Commissioners. “Wellstar is deeply committed to our region, and we’re grateful that they recognized this need and are stepping forward with a solution.”

“Acworth’s population grew fivefold in ten years, and we continue to attract people who want to live and work in our area,” said Tommy Allegood, mayor for the City of Acworth. “The City of Acworth has been expanding our critical infrastructure and creating a place where families will want to stay for generations. A hospital would be extremely beneficial to our community, and we appreciate Wellstar’s willingness to meet our need.”

Wellstar is headquartered in Cobb County and is deeply involved in the area, tracing its heritage to 1950 when Kennestone Hospital opened. In keeping with its community roots, Wellstar will establish a community advisory council to honor every voice throughout the Certificate of Need process.

“My patients are from all walks of life, but they share a desire for a hospital that’s closer to home, especially those who have chronic conditions or are elderly,” said Dr. Michaele Brown, a Wellstar primary care doctor in Acworth. “We live in a vibrant, growing area. Our patients’ access to all levels of healthcare should be just as vibrant and that includes a hospital where they can quickly get the level of care they need when they need it.”

“We will involve the community in every step of this process, and make sure this hospital meets the community’s needs for generations to come,” said Saunders.

In addition to providing care for generations of families, Wellstar actively supports community health and well-being through partnerships with nonprofit, civic and business organizations, as well as academic institutions. Through these partnerships, Wellstar serves all of its neighbors’ needs, ranging from access to healthcare to food and housing insecurity to educational support and career development.

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Dr. Nasarachi Onyeuku, a radiation oncologist at Wellstar, standing with one of the two TrueBeam linear accelerators in use for cancer care at Wellstar Cobb Cancer Center

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Wellstar Cobb Cancer Center Expands Treatment Services

New radiation technology and refreshed waiting and treatment areas are expanding world-class cancer treatment at Wellstar Cobb Cancer Center.

Cancer care in forward motion

Wellstar Cobb Cancer Center recently installed its second TrueBeam linear accelerator, which treats various cancers, including brain, head and neck, prostate, breast, lung, skin and gastrointestinal tumors. With the linear accelerator, clinicians can adjust the size and shape of beams to a tumor’s shape and spare healthy tissue.

With the second linear accelerator, Wellstar Cobb can offer patients more flexible and convenient scheduling. “An additional linear accelerator can lead to timely treatment starts and shorter wait times,” said Dr. Nasarachi Onyeuku, a radiation oncologist at Wellstar. “It expands our ability to treat more patients with cutting-edge care, continuing our commitment to bringing world-class cancer treatment closer to home.”

In addition to state-of-the-art external beam radiotherapy, TrueBeam delivers precise, high-dose stereotactic body radiotherapy (SBRT) targeting tumors in the body. It also provides stereotactic radiosurgery (SRS) for brain or spine cancer treatment. Patients will typically receive one to five treatments.

Patient-centered care at Wellstar Cobb

Wellstar Cobb Cancer Center recently renovated its treatment areas, front desk and waiting room, making it more welcoming and comforting for patients and their families. Within the treatment areas, the suite where patients receive high-dose radiation brachytherapy, a targeted treatment that involves placing radioactive material directly into tumors or near them, also underwent renovations.

“The beautifully designed space enhances patient comfort, offering a calm, supportive environment,” Dr. Onyeuku said. “We’re currently treating breast, cervical, uterine and skin cancers, with plans to expand to other cancer types. It’s advanced, efficient care—delivered close to home and with compassion.”

Early detection and support services

Cancer care begins with prevention and early detection. Wellstar Cobb is home to a lung cancer STAT Clinic, where specialists collaborate to diagnose and begin treatment within as little as 14 days. According to research by the Cleveland Clinic, patients can spend up to eight weeks on average visiting different specialists before starting a treatment plan. Earlier treatment can lead to the best possible outcomes.

Patients at Wellstar Cobb receive support at every stage of their treatment. These services include:

  • Emotional support from a social worker
  • Lymphedema therapy for patients with excess fluid and swelling
  • Meal planning with a dietitian
  • Monthly support group
  • Pain management
  • Physical therapy
  • Transportation assistance

“We have a superb team and state-of-the-art treatment here at Wellstar Cobb Cancer Center. And we’re backed by the resources of a nationally recognized health system,” Dr. Onyeuku said. “We are thrilled that our technology enhancements allow us to serve more people with exceptional cancer treatment.”

Learn more about cancer care in Cobb.

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A healthcare provider checks the lungs of her patient using a stethoscope. Reads "PhyllisCare".

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PhyllisCare

For Phyllis Burgess, staying on top of her health made all the difference. When lung cancer showed up on a routine screening, she was ready—and so was her Wellstar care team.

Friendly photo of Phyllis Burgess


Proactive primary care

When Phyllis retired after nearly 50 years as a bookkeeper, she looked forward to a slower pace and more time for herself. A breast cancer survivor and former smoker, she also wanted to be proactive about her health.

Encouraged by her Wellstar primary care physician, Dr. David Gose, Phyllis committed to regular lung cancer screening at Wellstar Paulding Medical Center —staying one step ahead of a disease that usually goes unnoticed until it's too late. Wellstar’s lung cancer screening program is a national leader in early detection, offering low-dose CT scans that help detect early-stage lung cancer before clinical signs or symptoms become evident.

Her first three CT scans came back clear. But on her fourth screening, doctors spotted something suspicious.

Quick answers with the STAT Clinic

Phyllis was quickly referred to the Wellstar Specialty Teams and Treatments (STAT) Clinic for Lung Cancer at Wellstar Paulding. The program quickly moves patients through screening to diagnosis and treatment with a multidisciplinary team of experts. Patients with lung and other chest cancers meet with multiple specialists in one place, often on the same day, to reduce delays and improve outcomes.

"Most of the time you don’t get two or three or four or five people on your case from the get-go,” said Phyllis. "But knowing that I had this group of qualified professionals looking at my tests, discussing what we need to do, how best to do it, when to do it—it’s very comforting."

At the Wellstar STAT Clinic, Phyllis’ care team included a thoracic surgeon, medical and radiation oncologists, pulmonologist and nurse navigators, who bring a highly personalized level of guidance and support to each patient and their family members.

"The support staff was just fabulous,” Phyllis said. "They’re like best friends. They’re there for you."

Behind the scenes, her care team was already working in sync to coordinate fast care.

“We plan patients’ appointments ahead of time, ordering multiple tests that will be necessary for the treatment decision-making. These can include PET scans, CT scans, MRIs and/or a pulmonary function test,” said Dr. Daniel Fortes, Wellstar chief of thoracic surgery. "We’re always gaining time in the patient’s overall treatment because we are anticipating and creating a plan as a team."

Dr. Fortes emphasized that timing matters when treating lung cancer. "We have data to show that if we delay treatment, even in early-stage cancers, we do decrease the chance of a cure,” he said. “The goal of the STAT Clinic is to get them the quickest we can into their final treatment plan."

Expert diagnosis and advanced surgery

To diagnose her cancer, Phyllis underwent a robotic bronchoscopy at Wellstar Kennestone Regional Medical Center. The advanced procedure allowed the pulmonary team to examine her lungs and collect tissue samples.

The biopsy confirmed lung cancer. Having already caught one cancer early, Phyllis was grateful she had remained vigilant—keeping up with annual screenings and following through on care every step of the way.

"I am sort of a walking advertisement for early detection," she said. "My mammogram showed up with stage zero breast cancer. And I think they described the lung cancer as 1.1—very early, no metastasis. I’ve been very fortunate. These processes that are there for people to take advantage of saved my life.”

Phyllis returned to the STAT Clinic, where the same team who had evaluated her case before came together again to review her results and finalize her treatment plan.

"Every single patient who comes through our clinic is discussed collaboratively by a group of lung cancer specialists so we can make a fast, informed decision as a team," Dr. Fortes explained. "Because Phyllis had good overall health and an early-stage diagnosis, she was an excellent candidate for surgery.”

Soon after, Phyllis had a lobectomy at Wellstar Kennestone. Dr. Fortes performed the robotic-assisted surgery using the  da Vinci Surgical System to remove the affected part of her lung.

"They told me what they would do, what kind of incisions they’d be making and what I could expect in the way of healing," Phyllis said. “So, I went in feeling like this is not some strange, scary process.”

Dr. Fortes noted that complex cancer surgeries are best performed at major centers like Wellstar Kennestone. "Complex cancer care demands a comprehensive structure of care around the patient that includes more than just physicians and technology," he explained. "At the same time, we are continuing to expand our STAT Clinics to bring them closer to people's homes and with the aim of improving access for patients.”

Ongoing care, close to home

Phyllis’ lung cancer surgery took place the day before a snowstorm was forecasted to hit the metro Atlanta area. However, thanks to Dr. Fortes’ minimally invasive techniques—which resulted in less pain, less scarring and less blood loss—she was able to be discharged from the hospital that evening and avoid being stuck at the hospital for several days due to poor road conditions.

Phyllis described her recovery as “easy” and now feels great. She continues her follow-up care for both lung and breast cancer at the Wellstar Women’s Imaging Services at Wellstar Paulding, close to home.

“Wellstar Paulding feels like home, even when I’m dealing with someone who I haven’t met before,” she shared. “Whether it’s the receptionist or the admissions nurse—they’re always very, very friendly and helpful. There’s a family feel to it."

Hope, health and staying vigilant

As she settles into retirement, Phyllis is sharing her story to encourage others to set aside any fear or guilt and talk to their healthcare provider about lung cancer screening.

"Cancers are so insidious. You’re not going to just go, 'Gee, I don’t feel good; it must be cancer,'" she said. "There’s no big warning signs until it’s serious. Early detection is absolutely our best weapon. It’s our best defense.”

Dr. Fortes echoed the importance of early detection. "We can only cure lung cancers if we pick them up in an early stage. That’s why lung cancer is the No. 1 cancer killer in the world,” he said. “The only way we can change that is by diagnosing early. And then they are truly curable.”

Phyllis is thankful for Wellstar’s STAT Clinics that are designed to move quickly when it matters most.

Her advice to others considering treatment at a STAT Clinic? "Please do it. It’s the difference between life and death,” she urged. “At the same time, it’s in an environment where you don’t feel like you’re a sample in a petri dish. These are people, and they’re warm, and they care."

Learn more about who is eligible for lung cancer screening, find a location near you or schedule your lung cancer screening at Wellstar.

Learn more about STAT Clinics at Wellstar.

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