Cancer is complex – there is no routine gliomas, nor is there ever a routine way to treat it.
The OSUCCC – James physicians 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.
At the OSUCCC – James, gliomas patients have a team of experts that includes medical oncologists, surgical oncologists, radiation oncologists, geneticists, nutritionists and more. Also on that team are gliomas 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. Many of our experts also help write the national clinical guidelines for treatments.
As one of only a few cancer centers in the country funded by the National Cancer Institute to conduct both phase I and phase II clinical trials, the OSUCCC – James offers patients access to more clinical trials than nearly any other cancer hospital in the region and more of the latest, most targeted, most effective treatment options.
There are several types of treatment for gliomas. The OSUCCC – James team of subspecialists determine the best treatment for each patient based on his or her specific, individual glioma. Patients may receive one treatment or a combination of treatments.
Treatment Options
At the OSUCCC – James, in addition to considering the type and stage of a disease, our team of specialists analyze the molecular and genetic composition of your individual cancer to create a targeted treatment plan just for you.
You may receive one treatment or a combination of treatments and may benefit from new therapies available in clinical trials.
Treatment of gliomas is based on the following:
- The type of tumor.
- Where the tumor formed in the brain or spinal cord.
- The amount of cancer left after surgery.
- The grade of the tumor.
- The molecular make up.
The following treatments are available to treat gliomas:
Surgery
Surgery is the initial treatment chosen for most gliomas. This is important because it allows a diagnosis to be made by microscopic examination of the tissue obtained. Surgery may consist of a biopsy when a small piece of tumor is removed or a tumor resection when a larger portion of the tumor is removed. Sometimes the neurosurgeon manages to remove the entire visible tumor noted on brain MRI. However, gliomas always have microscopic cells that invade the normal surrounding brain and that are not visible on brain MRI.
Radiation Therapy
Radiation therapy uses X-rays to reach and destroy cancer cells. Radiation is often used to treat specific areas of the body. Radiation therapy is always necessary with certain types of glioma such as Grade III and Grade IV gliomas (including anaplastic glioma and glioblastoma respectively). Radiation may also be necessary for Grade II glioma. Radiation is delivered to the area of the tumor only to prevent damage to other, normal parts of the brain.
Chemotherapy
Chemotherapy uses specialized drugs to stop the growth of cancer cells, either by destroying the cells or by preventing them from making new cells.
The way the chemotherapy is given depends on the type and grade of the cancer being treated. Many chemotherapy drugs are not able to cross the blood-brain barrier so sometimes chemotherapy drugs are chosen for their ability to cross this barrier or are placed or injected directly into the brain during surgery.
The most common type of chemotherapy used to treat gliomas is a medication taken by mouth called temozolomide which kills dividing cells. In the case of glioblastoma, it is given when the tumor is first diagnosed along with and after radiation. It is also used to treat anaplastic astrocytoma when it grows back after radiation. Another combination of chemotherapy drugs called PCV (procarbazine, CCNU and vincristine) is also given after radiation for Grade III oligodendrogliomas that possess specific genetic mutations and for Grade II glioma.
Targeted Therapy
Targeted therapy is a type of drug treatment designed to target cancer cells, leaving healthy or normal cells unharmed. These drugs tend to have less severe side effects and are usually tolerated better than traditional chemotherapy drugs.
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
In some instances, the doctor may decide to hold off on treatment until symptoms appear. If signs appear, treatment may include surgery or nonsurgical treatment, 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 hundreds of 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 glioma, 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 U.S. 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, metastasize 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.
If you have received a gliomas cancer diagnosis, or if you want a second opinion or just want to speak to a brain cancer specialist, we are here to help you. Call 800-293-5066 or 614-293-5066 to make an appointment.