Neurosurgeon Sheds Light on McCain Brain Cancer

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Senator John McCain’s diagnosis of brain cancer has put the spotlight on glioblastoma, an aggressive and deadly type of brain tumor.

Health Now talked to neurosurgeon Ania Pollack, MD, Premier Health Clinical Neuroscience Institute, about the treatment and outlook for Sen. McCain and others with the disease.

Dr. Pollack describes glioblastoma as a Grade 4 tumor, “one of the most aggressive cancers we know of. Surgical cure really doesn’t exist. We [try to] control it. The mean [average] survival of glioblastoma, with surgery, radiation and chemotherapy, is approximately 15 to 16 months.”

She’s says no more than 5 percent of people with glioblastoma survive beyond three years. She adds, “This is mean survival. There are people who live longer and people who don’t live as long,” depending on the treatment, how the person responds to treatment, the location of the tumor, and the genetic make-up of the tumor.

“The problem with this tumor,” Dr. Pollack continues, “is that it mixes with normal brain. This tumor is known for having finger-like, infiltrating pathways. It can involve much more brain than what you see on the MRI.”

Because of the challenges of removing the entire tumor surgically, doctors prescribe additional treatment with chemotherapy (usually a pill called temozolomide, which is able to pass the blood-brain barrier that normally protects the brain from toxins). Targeted radiation therapy is also used in conjunction with low doses of chemotherapy to enhance the effectiveness of radiation.

She notes a newer treatment device, called Optune®, which delivers low-intensity, alternating electrical fields to the tumor site to slow or stop rapidly dividing cancer cells. The individual wears a “skull cap” with electrodes that attach to the skull for up to 18 hours a day. Patients use Optune following standard treatments of surgery and radiation therapy and coinciding with chemotherapy.

Dr. Pollack says presenters at a recent conference reported the average survival for patients using both Optune and temozolomide was 20.9 months. “In comparison to 16 months…it’s almost five months’ improvement in survival. In my opinion, it’s a lifetime.”

She says researchers also continue to work on vaccines to prevent glioblastoma.

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