Glioblastoma Multiforme (GMB) is the most common form of primary malignant brain tumor in adults. With the current standard therapy, median survival time hovers just over 12 months. This incurable disease is devastating with a median survival time of 6-8 months from time of recurrence (J10). The current standard of therapy at first diagnosis consists of surgery followed by radiotherapy with concommittant and adjuvant chemotherapy using the agent temozolamide (TMZ) (Multiple sources). In 2003, the United States Food and Drug administration approved the Gliadel Wafer (GW) for treatment of newly diagnosed GBM (C3). The monoclonal antibody Bevacizumab (BEV) was first used to treat recurrent GBM in 2005 and has a significant survival benefit for patients with grade IV glioma (E5). Many more promising avenues for new treatment have been and are currently being studied. Such areas include the use of antiepileptic drugs, using Convection-Enhanced Delivery of chemotherapeutic agents, and targeting specific molecular markers and pathways such as the epidermal growth factor receptor (EGFR), O6-methylguanine-DNA-methyltransferase (MGMT), and the PI3K/Akt/mTOR pathway.
CURRENT STANDARD OF THERAPY
The current standard of therapy is resection of the tumor plus radiotherapy and TMZ (E5). Multiple studies performed between 1976 and 1991 have led postoperative radiotherapy to be accepted as standard treatment (L12). The universal dosing schedule for radiotherapy in GBM is fractionated irradiation over 6-7 weeks for a total of 60 gray (Gy) (G7,M13). TMZ is an oral alkylating agent that can be used concomitant with radiotherapy and as an adjuvant. The European Organization for Research and Treatment of Cancer (EORTC) and the National Cancer Institute of Canada (NCIC) organized a study showing that adding TMZ to standard radiotherapy is beneficial to overall survival. This study enrolled 573 patients from 85 institutions and randomly assigned eligible patients to receive either standard radiotherapy alone or radiotherapy plus concomitant and adjuvant TMZ. There was a 37% decrease in relative risk of death and a median increase in survival of 2.5 months in patients treated with TMZ and radiotherapy when compared to radiotherapy alone (P<0.001). There are adverse effects with both RT and chemotherapy, but hematologic toxicities are more likely to occur in patients treated with both TMZ and RT (M13). This study maintained its validity after accounting for recursive partitioning analysis classifications (L12). The current standard dose of TMZ is 75 mg per square meter of body surface area daily during radiotherapy and then a dose of 150-200 mg per square meter of body surface area for 5 days of each 28-day cycle following RT (G7,M13).
The current strategy for the treatment of Glioblastoma Multiforme is generally palliative treatment, including standard chemotherapy and surgical resection, and radiotherapy. GBM often exhibits a high resistance to both chemotherapy and radiotherapy. (2)
...e level for the high dose radiotherapy protocol. Also, the observations shows that patients that survive the treatments should be watched over a longer follow-up time [5].
Most patients treated with only chemotherapy will reach remission at some point but eventually will die. However, the development of new treatments where chemotherapy or radiotherapy are given in addition to monoclonal antibodies have a higher rate of success in defeating the cancer altogether. Monoclonal antibodies are laboratory engineered molecules that are engineered to attach to a specific protein that is found only in B cells. The immune system task is to fight invaders, however it does not always recognize the cancer as a harmful invader and does not attack it. The Monoclonal Antibody is directed to attach to a specific part of the cancer, marking the cancer cell as harmful and making it easy for the immune system to identify it and destroy it.
Brain metastases are a common complication of cancer. The incidence of brain metastases is increasing worldwide [2]. About 160,000 to 170,000 of new cases occur per year in the United States. The most frequent types of cancers that tend to develop brain metastases are lung cancer, breast cancer, and melanoma, which account for 67%-80% of all cancers [3]. The most recent population-based study was conducted by Barnholtz-Sloan et al. [4] who used the Metropolitan Detroit Cancer Surveillance System and found the incidence percentage of brain metastases to be 9.6% between 1973 and 2001. Overall, population-based studies show incidence rates of brain metastases ranging from 8.3 to 14.3 per 100,000 population and 8.5-9.6...
At this day in age we are constantly trying to improve the field of medicine in any way that we possibly can. We cherish every birthday and continually try to prolong life. Not only through every field of medicine, especially in terms of cancer. The American Cancer Society is “the official sponsor of birthdays” and is making leaps and bounds in the types of care that cancer patients receive. One of these many breakthroughs is the practice of Stereotactic (Body) Radiotherapy or S(B)RT. SBRT and other radiation therapies have the ability to greatly improve the way that we treat the issue of cancer and the variation of treatment options; however, they have raised the concerns of long term effects from radiation and cost-effectiveness. As research has begun to show, radiation therapies are having great success in curing cancer.
Do you have an abundant knowledge of brain tumors and cancer? Have you or a loved one ever had a brain tumor of any sort? If so, they are very harmful and deadly. Over the course of time with the improvement of technology, treatment will be easier and symptoms won't be as noticeable. Brain tumor research has improved exceedingly, therefore, if John Gunther’s son was alive today, he most likely could have been successfully treated or cured of his brain tumor without the struggle of a death sentence.
Schneider Uwe, Antony Lomax, and Beate Timmermann. 2008. “Second cancers in children treated with modern radiotherapy techniques.” Radiotherapy and Oncology 89 (2): 135-140. doi: 10.1016/j.radonc.2008.07.017
I was a child when my aunt got sick, and my fascination about the field of medicine began. She had brain cancer. While I watched the disease progress I was flooded, not only with sadness and grief, but with questions. With two psychologists for parents I had a lot of support and understanding of my feelings, but I was left curious about the medical aspect of the disease and why there was no cure. The notion that the brain could change someone’s entire personality and physical function was amazing to me. Spending a lot of time in hospitals, I observed so much about the impact of a cancer diagnosis on patients and their families, and about what happens to people through the disease process. I noticed the enormous influence that the medical professional’s
For many years the standard methods used for cancer treatment are chemotherapy, radiation therapy, or surgery. These treatments use drugs that are designed to kill the rapidly dividing cancerous cells aggressively and are effective, but they do however, kill many healthy cells of an individual and result in severe side affects. It wasn't until the past few decades that the emergence of a new approach to cancer therapy has gained attention. Researchers have been focusing on the idea of cancer immunotherapy. The first immunotherapy maneuver was done back in 1860. A man by the name of William Cooley decided to inject bacteria into tumors. He noticed that the bacteria were provoking an immune response in patients and it had caused tumor regression. This was the first example that showed we could use the patients immune response to fight a tumor. Scientists have been struggling and attempting to create effective cancer treatments based on Cooley's observations.
To explain, glioblastomas, or GBM for short, are tumors that come from astrocytes or the cells that make the supportive tissue of the brain. These tumors are common on the brain and the spinal cord, and are very cancerous. The exact cause for glioblastomas are not known, but only three percent of childhood tumors end up diagnosed as glioblastomas (American Brain Tumor Association). Sadly, Howard Inlet’s daughter was a part of that three percent.
The second most typical tumors found in children are brain tumors. Brain tumors are the primary cause of childhood death as they are escalating in frequency. Doctors have found ways to advance their imaging of these brain tumors to help pinpoint the exact location of the tumors, increasing the chance of the children’s survival (Conway, Asuncion, and DaRasso 1). The diagnosing procedure is a crucial process, helping to gain information about the child’s tumor. Brain tumors range in different types of tumors and forms of treatment that can lead to major effects on the children and their families.
Whether doctors solely use radiation therapy or use a combination of treatments, radiotherapy has been notoriously helpful in increasing the lifespan of many individuals worldwide.
Radiation therapists work closely with patients to fight cancer. According to Health Care Careers, Oncologists, Dosimetrists and nurses are some of the professionals that a radiation therapist works with while caring for a cancer patient. This group of professionals will determine a specialized treatment plan. The first step usually includes a CT scan performed by a radiologist to find the exact area that needs to be targeted with x-rays. Next, the therapist uses a special machine that emits radiation called a Linear Accelerator. They use this machine during a treatment called external beam therapy. During this process, the Linear Accelerator will project x-rays at targeted cancer cells or tumors. Another therapist will be in a different room monitoring the patient’s viral signs until the procedure is over. The external therapy l...
Cancer. A word that many people know as a reality. There are many different types of cancer that affect various amounts of people. One especially dangerous cancer is neuroblastoma. “Neuroblastoma . . . accounts for about 6% of all cancers in children . . . The average age at the time of diagnosis is about 1 to 2 years” ("What Are the Key Statistics about Neuroblastoma?"). Neuroblastoma is a devastating cancer found mostly in young children that is hard to terminate but learning the symptoms and most effective treatments can help with diagnosis and cure for an affected child.
According to SEER Statistics, 23,380 people are estimated to get a brain or nervous system cancer diagnosis. Out of those people, 14,320 people are estimated to die from their brain or nervous system cancer diagnosis (National Cancer Institute). Cancer is a type of dangerous tumor, or a buildup of extra cells that form a mass of tissue, that can be life threatening (National Cancer Institute). The term for a tumor that is cancerous is a malignat tumor, whereas a benign tumor does not contain cancer cells (National Cancer Institute). According to the National Cancer Institute, the causes of brain cancer are unknown, but risk factors include family history and excessive radiaton exposure. Although they are not always due to a brain tumor, comon symptoms include headaches, nausea, speech, hearing, vision, and mood changes, problems with balance and mamories, seizures, and numbness in arms and legs (National Cancer Institute). MRI and CT scans as well as surgical biposies (or the removal of part of the tumor to be examined) are used to diagnose brain cancer (National Cancer Institute). Different types of treatment options include radiation therapy, surgery to remove the tumor, and chemotherapy. According to Charles Davis, MD, PhD and Nitin Tandon, MD of WebMD.com, chemotherapy is “ the use of powerful drugs to kill tumor cells”. There are a few different types of chemotherapy, but all of which bring out the same kinds of side effects. Although the physical side effects of chemotherapy are commonly known, few people know of the emotional toll chemotherapy can take on a patient and his or her family as they go though this process.