Cancer is complex – there is no routine brain cancer, nor is there ever a routine way to treat it.
The OSUCCC – James brain cancer specialists and subspecialists are nationally and internationally renowned in research and patient care for their one particular cancer. Because of that expertise and understanding of cancer’s complexities and how it acts and reacts differently in each person, the very best outcomes – and the most effective means of treating cancer patients – come from a team approach. In fact, our physician experts actually help write the national clinical guidelines for treating specific cancers.
At the OSUCCC – James, our brain cancer treatment team of experts includes internationally recognized medical oncologists, surgical oncologists, radiation oncologists, geneticists, nutritionists and more. Also on that team are glioma researchers who help sequence tumors to identify key molecules that fuel each patient’s cancer and who then develop drugs that target only those particular molecules. Working together and across medical disciplines, this super subspecialized team develops individualized, highly targeted treatment plans that specifically target the molecular and biological makeup of your individual brain cancer.
As one of only a few comprehensive cancer centers in the country funded by the National Cancer Institute to conduct both phase I and phase II clinical trials on novel anticancer drugs, the OSUCCC – James offers patients access to more clinical trials than nearly any other cancer hospital in the country and to more of the latest, most targeted, most effective treatment options – many that are available nowhere else but at the OSUCCC – James.
There are several types of treatment for brain cancers. The OSUCCC – James team of subspecialists determines the best treatment for each patient based on his or her specific, individual brain cancer. Patients may receive one treatment or a combination of treatments.
Treatment Options
As a National Cancer Institute (NCI)–designated comprehensive cancer center, the OSUCCC – James offers patients access to novel therapies that may not be available anywhere else in the United States. The James also leads some of the world’s most advanced, sophisticated clinical trials for brain cancers.
Every person’s disease is different, with individually unique genes and molecules driving that disorder. At the OSUCCC – James, our brain cancer subspecialists are world-renowned experts who focus solely on brain disorders and who reach across medical disciplines to design the very best treatment plan and therapies to target each patient’s specific cancer.
One or more of the following treatments may be recommended. (Patients may also benefit from new therapies available in clinical trials.)
Surgery
Surgery is the initial treatment chosen for most brain cancer. This is important because it allows the OSUCCC – James experts to examine tissue under a microscope and make the most accurate diagnosis. The brain cancer surgeon may perform a biopsy or resection to remove tissue. Sometimes the neurosurgeon is able to remove an entire tumor made visible on an MRI. Gliomas have microscopic cells, however, that can invade normal surrounding brain cells that are not visible on an MRI.
Radiation Therapy
Radiation therapy uses high-energy X-rays targeted directly at the cancer cells to destroy cancer cells or keep them from growing.
A patient with brain cancer may receive radiation therapy before or after a surgery to remove tissue or a tumor. Radiation can shrink a tumor to make surgery more successful, and it is delivered only to the tumor in order to prevent damage to surrounding, healthy brain tissue.
Radiation therapy may be needed for Grade II brain cancers, and it is always necessary with Grade III and Grade IV brain cancers.
The OSUCCC – James radiation experts are leaders in innovative radiation treatments, and The James is one of the few hospitals in Ohio to offer radiation treatments in the prone position (the patient is lying down).
The OSUCCC – James also offers other leading-edge radiation treatments, including imaging-based radiation therapy, intensity-modulated radiation therapy (IMRT), stereotactic radiosurgery and using a Varian TrueBeam Linear Accelerator.
Chemotherapy
Chemotherapy drugs stop cancer cell growth by either destroying the cells or by preventing them from dividing and making new cells.
How chemotherapy is given depends on the type of brain cancer being treated. Depending on that particular cancer, chemotherapy drugs can be taken by mouth or injected into a vein or muscle, and they may be given over a period of months.
When the drugs enter the bloodstream, they can reach cancer cells throughout the body (called systemic chemotherapy). Combination chemotherapy uses more than one anti-cancer drug.
The most frequently prescribed chemotherapy treatment for brain cancers is an oral drug called temozolomide, which kills dividing cells. For glioblastomas, this drug is given when the tumor is first diagnosed (along with and after radiation therapy). It is also used to treat anaplastic astrocytoma if it grows back after radiation.
Another chemotherapy drug combination, called PCV (procarbazine, CCNU and vincristine), is also given after radiation therapy for Grade II brain cancers and for Grade III oligodendrogliomas that have specific genetic mutations.
Chemotherapy treatment can take place in an outpatient part of the hospital, at your specialist’s office or in your home. Some people may need to stay in the hospital for treatment.
Targeted Therapy
Targeted therapies are drugs designed to attack cancer cells without destroying healthy surrounding cells. These drugs tend to have less severe side effects and are usually tolerated better than chemotherapy drugs.
Some targeted agents are antibodies that attach to the proteins that control blood vessel growth. These antibodies help constrict or stop blood vessels from forming in a tumor, and they close off the nutrient supply to the tumor. Bevacizumab is one such antibody, which prevents new blood vessels from growing into tumors. Other targeted agents, called kinase inhibitors, stop certain important proteins from working in cancer cells, causing them to die or stop growing.
The U.S. Food & Drug Administration has approved bevacizumab for glioblastoma treatment that recurs after radiation and chemotherapy.
Some targeted agents are antibodies that attach to proteins that control blood vessel growth and help constrict, or stop blood vessels from forming in a tumor, serving to close off the nutrient supply to the tumor. Bevacizumab is one such antibody which prevents new blood vessels from growing into tumors. Other targeted agents called kinase inhibitors stop certain important proteins from working in cancer cells, causing them to die or stop growing.
The Food & Drug Administration has approved bevacizumab for treatment of glioblastoma when it grows back after radiation and chemotherapy. Bevacziumab is an antibody to a protein that helps glioblastoma cells grow blood vessels for faster growth.
Watchful Waiting
Some brain cancer patients have no symptoms, and because of that, they often do not need immediate treatment. In these cases, the brain cancer experts may decide to wait to pursue treatment until symptoms actually appear.
These patients should, however, be regularly and closely monitored until signs or symptoms appear. This is called watchful waiting. If symptoms do appear, treatment may be surgical or nonsurgical, with the goal of relieving symptoms and improving the quality of life.
Brain Tumor Research and Clinical Trials
For cancer patients, clinical trials mean hope. Hope for a cancer-free world and for better, more targeted ways to prevent, detect, treat and cure individual cancers. Patients can enter clinical trials before, during or after starting their cancer treatment.
The OSUCCC – James has more than 500 open clinical trials at any given time, with some of the world’s latest discoveries available to clinical trial patients right here in Columbus, Ohio. In fact, patients have access to more cancer clinical trials here than at nearly any other hospital in the region as well as access to some of the most advanced, targeted treatments and drugs available. These include several novel brain tumor trials such as new vaccines against gliomas, viruses that divide in glioma cells and kill them, ways to overcome resistance to currently used treatments and antibodies that link to specific proteins and block tumor growth
The OSUCCC – James is one of only a few comprehensive cancer centers funded by the National Cancer Institute (NCI) to conduct phase I and phase II clinical trials on novel anticancer drugs. These trials go only to centers that demonstrate an exemplary capacity for research and clinical care, the expertise to deliver the latest in treatments and the infrastructure to interpret and track treatment results.
Additionally, Ohio State has more than 300 cancer researchers dedicated to understanding what makes each patient’s cancer grow, move, spread or reoccur. Because of the OSUCCC – James’ NCI phase I and phase II approvals, these experts can move research discoveries into clinical trials and make them available to patients sooner.
Who Should Participate in a Clinical Trial
For some patients, taking part in a clinical trial may be the best treatment choice. Patients can enter clinical trials before, during or after starting their cancer treatment.
The OSUCCC – James is one of only a few institutions funded by the National Cancer Institute (NCI) to conduct phase I and II clinical trials on novel anticancer drugs.
If you’ve been diagnosed with brain cancer, would like a second opinion or would like to speak with a brain cancer specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.