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IMPROVING
THE ODDS - Expanding Options for Advanced Disease
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The
most common cancers in the brain are those that
spread (metastasize) from a primary tumor elsewhere
in the body. Because of the complex needs of people
with metastatic brain cancer, the Steven E. and
Catherine Pappas Center for Neuro-Oncology established
the Metastatic Disease Program, led by neuro-oncologist
April Eichler, MD. Working in collaboration with
radiation oncologist Helen Shih, MD, and neurosurgeon
Bob Carter, MD, PhD, Eichler offers patients a variety
of therapeutic options including radiation, chemotherapy
and surgery. The multidisciplinary clinic also provides
coordinated care for the neurological symptoms caused
by brain metastases.. |
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“Traditionally,
patients with brain metastases have been cared for
by their medical oncologist,” says Eichler.
“But many of these patients develop neurological
complications such as seizures, brain swelling,
and cognitive impairments that a neurooncologist
has the additional expertise to deal with.” |
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Determining
the best treatment depends on many factors.
“We take into account all aspects of the disease
including how active it is outside the brain,”
says Eichler. One state-of-the-art treatment is
stereotactic radiosurgery (SRS), a radiation therapy
(not surgery) that uses several converging beams
to concentrate a large dose of radiation on a solitary
site. Sometimes given following whole-brain radiation,
SRS is a common treatment for patients with a limited
number of newly diagnosed brain tumors less than
four centimeters in diameter (smaller than a golf
ball). |
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Expanding
treatment options for patients with metastatic disease
is a major goal of the program, which officially opened
in January 2007. Eichler explains that patients with lung
cancer, for example, who might otherwise be eligible for
a clinical trial, are often excluded if they have brain
metastases. As a result, “there’s a lack of
data on which chemotherapies might be useful for these
patients. Our clinic is a step toward identifying and
recruiting patients so that we can get trials up and running.” |
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Two
trials are slated to open over the next few
months. One will study epothilone B, a new class
of drug, in patients with non-small cell lung cancer
whose brain metastases have recurred following radiation.
The other will investigate the same drug in breast
cancer patients with brain metastases. |
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When
a primary tumor has spread to the brain, the
disease is already advanced, says Eichler, and survival
is generally poor. “But we all have patients
who are beating the odds.” She tells of one
woman with breast cancer who developed a tumor in
her pituitary (a gland at the base of the brain).
Shih treated her successfully with SRS and then
Eichler followed up with a specialized treatment
called intrathecal (into the spinal canal) chemotherapy,
clearing the patient’s spinal fluid of cancer
cells. “She’s someone we treated in a
multidisciplinary way and who is continuing to do
well.” - Lonnie Christiansen |
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Advancing
the Specialized Care of Individuals with Brain
Tumors
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MGH
Brain Tumor Center
Yawkey Building 9th Floor
Boston, Massachusetts, 02114
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Patients
& Families with questions about referrals, consultations
or appointments may contact:
Telephone: 617.724.8770
Fax: 617.724.8769
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Physicians
with
questions may contact:
Tracy Batchelor, M.D.
Executive Director,
MGH Brain Tumor Center
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| MassGeneral.org |
| MGH
Cancer Center |
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