Brain Tumor Options

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Brain tumors are pernicious. How do you know when a headache is just due to stress or a sign of something more serious? Right now, 1 in every 161 cancer diagnoses involves a brain tumor, but these tumors can be a natural follow-on to other cancers. Glioblastoma is the most deadly form of brain tumor, killing 83% of the youngest patients it infects within five years.

Medicine is changing rapidly, and that brings both benefits and problems. Obviously, new treatment methods can improve outcomes for patients. However, it is a challenge to keep up with developments and know what’s best. It’s a challenge for doctors, and worse for patients.

The traditional approach has involved surgery, chemotherapy and radiation therapy to remove and kill cancer cells.  These approaches have met with varied success. The five year survival rates for various brain tumors are shown in the chart below:

Five-year survival rates, selected brain tumors (2)

Five-year survival rates Age of patient
Tumor type 20-44 45-54 55-64
Low-grade (diffuse) astrocytoma 65% 43% 21%
Anaplastic astrocytoma 49% 29% 10%
Glioblastoma 17% 6% 4%
Oligodendroglioma 85% 79% 64%
Anaplastic oligodendroglioma 67% 55% 38%

New research is finding that radiation treatment can affect brain function, possibly producing the cognitive impairment seen in many patients after treatment. (3,4)

There are a number of options, but your local doctor may or may not know what they are, or have access to them.

The NIH National Cancer Institute highlights three categories of research under way:

  • Therapeutic vaccines
  • CAR T-cell therapy (taking patient cells, re-engineering them, and reinjecting them in the patient)
  • Checkpoint inhibitors that allow the patient’s immune system to attack tumor cells (5)

These approaches fall under the broad label of immunotherapy.

Where are clinical trials happening?

  • Duke is a leader in brain tumor research and has a number of clinical trials underway testing treatments for brain tumors involving immunotherapy and the manipulation of T and B cells. (6)
  • Other centers with clinical trials include:
    • The University of Florida
    • The University of Texas Southwestern Medical Center, also featuring clinical trials with imunotherapy
    • The Dana Farber Cancer Center, Boston, Massachusetts
    • Cedars-Sinai Medical Center, Los Angeles, California
    • University of California, Irvine, California
    • Mayo Clinic, Rochester, Minnesota
    • University of Alabama
    • MD Anderson Cancer Center, Univ. of Texas, Houston
    • Provident Cancer Center, Portland, Oregon
    • City of Hope Medical Center, Duarte, California
    • NIH Clinical Center, Bethesda, Maryland

The bulk of innovative work is happening on the east and west coast, leaving people in the North Central, Midwest, Plains and much of the South and Southwest without ready access to advanced medical treatment. Even with access, doctors in these areas will have little experience dealing with side effects, and that could be fatal for a patient.

This explains in part why, as discussed in prior blog posts, where you live in the US effects your life expectancy.

How prepared are you to relocate for three or six months for treatment?


Sources:

  1. American Brain Tumor Association. http://www.abta.org
  2. American Cancer Society, “Survival Rates for Selected Adult Brain and Spinal Cord Tumors.” https://www.cancer.org/cancer/brain-spinal-cord-tumors-adults/detection-diagnosis-staging/survival-rates.html
  3. University of California – San Diego. “Radiation therapy vital to treating brain tumors, but it exacts a toll: Researchers say treatment alters neural networks and may cause long-term cognitive impairment.” ScienceDaily. ScienceDaily, 9 June 2017. <www.sciencedaily.com/releases/2017/06/170609133810.htm>.
  4. Carrie R McDonald et al. Altered network topology in patients with primary brain tumors after fractionated radiotherapy. Brain Connectivity, June 2017 DOI: 10.1059/brain.2017.0494
  5. Duke Neurosurgery, “Research Initiatives.” https://neurosurgery.duke.edu/research/basic-research/duke-brain-tumor-immunotherapy-program/research-initiatives.
  6. UT Southwestern Medical Center. “New approach to destroying deadly brain tumors.” ScienceDaily. ScienceDaily, 13 June 2017. <www.sciencedaily.com/releases/2017/06/170613102056.htm>.
  7. Musella Foundation, “Clinical Trials and Noteworthy Treatments for Brain Tumors,” last updated 5 February 2017. https://www.virtualtrials.com/Immunotherapy_treatments.cfm
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