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David and Andrea Dumont - “We feel blessed to have had over twelve extra months so far, and that something wonderful has come out of this tragedy.”

When Andrea Dumont awoke in a hospital one day in November 2005, a friend offered to tell her boss not to expect her at work that week. “Oh, I’ll be fine by Thursday,” Andrea assured her. The friend responded, “You don’t know why you’re here, do you?” Andrea did not remember blacking out in her garage in Ashland, Massachusetts, after driving her young son Dylan to school, or the ambulance transferring her to Massachusetts General Hospital for emergency brain surgery. With life-long migraines, she had attributed her increasingly severe pain and nausea to them. At 45, she had never worried about brain cancer, yet now she learned she had undergone surgery for glioblastoma (also known as glioblastoma multiforme), an aggressive brain cancer with few treatment options. “I had never heard of glioblastoma,” recalls Andrea. “Then boom.”

Following surgery, Andrea’s neuro-oncologist at the Massachusetts General Hospital Cancer Center, Fred Hochberg, MD, prescribed radiation and chemotherapy. But one of the hallmarks of glioblastoma is that, after a short retreat, it always recurs. Andrea’s tumor returned and grew rapidly, leading her to decide to enter a clinical trial of a new medication, AZD2171 (cediranib), led by oncologist Tracy Batchelor, MD, MPH, executive director of the Stephen E. and Catherine Pappas Center for Neuro-Oncology at the Cancer Center. A year after starting treatment, Andrea’s tumor had shrunk significantly.

Cediranib’s success arises from its ability to impact both the tumor and its side effects. Glioblastomas arise within brain cells and then create their own blood supply, explains Batchelor. The blood vessels grow abnormally, but they supply the extra nourishment the tumor needs to grow. Also, all tumors cause swelling.
In the brain, the skull encases the swelling and leaves no room to spare, causing as many symptoms as the tumor itself.

Both swelling and tumor exert pressure, compress brain tissue, and disrupt connections among brain regions. Symptoms vary, depending on the affected region of the brain. If the tumor lodges in a center for speech, movement, memory or respiration, symptoms can be devastating. The only treatment for swelling is steroids, which has a list of negative side effects that Batchelor says “extends from ceiling to floor.”

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