PITTSBURGH, PA - Brain surgeons are studying pills that turn cancer cells fluorescent colors, allowing surgeons to remove them with more accuracy than ever before. It's a procedure that may bring new hope to 14,000 people who are diagnosed each year with a malignant glioma, the most common form of a malignant brain tumor.
Joe Jonasen has spent most of his life behind the wheel. For this trucker, driving has been a great way to make a living. Earlier this year, doctors diagnosed him with glioblastoma, a deadly brain cancer that is often tough to treat.
"If they're going to operate, then maybe I have a chance. To take care of my family, and work, and that's what I did," said Jonasen.
For Jonasen to survive, doctors needed to remove 95 percent of the cancerous cells, which were very close to the area of the brain linked to speech.
"We have to maximize the resection, yet also make sure we have a functional outcome for the patient," said Khaled Aziz, M.D., Ph.D., assistant professor of neurosurgery at Allegheny General Hospital in Pittsburgh, PA.
Doctors are testing a technique that makes it easier to visualize cancer cells. Before surgery, patients swallow a pill, called five ALA, which reacts with the chemicals in the body. When surgeons look through a scope under ultraviolet light, healthy cells turn blue. Cancer cells light up hot pink.
"That's an advantage of the 5 ALA," Dr. Aziz explained. "That it allows us to track it, because as I told you, sometimes you can't differentiate between tumor cells and brain cells under the microscope."
Jonasen recovered from surgery with his vision, speech and motor skills intact. At 66, he can retire but won't hear of it.
"I'm not made that way," said Jonasen. "I've got to work, until, you know, a lot of people do…God bless them, but I don't want to do that."
The new technique may be giving Jonasen more time with family and maybe more time on the road.
Jonasen will also receive chemotherapy to treat the small percentage of cancerous cells surgeons had to leave in place. The oral dose of ALA is already approved for use in Germany. A United States study found six months after surgery, 40 percent of those receiving ALA prior to surgery had no progression in their tumor as opposed to 21 percent of the patients who did not have fluorescent-guided surgery.
BRAIN TUMOR BACKGROUND: The National Cancer Institute defines a brain tumor as: "the growth of abnormal cells in the tissues of the brain." They estimate in the year 2010, there will be 22,020 new cases diagnosed and a total of 13,140 deaths from brain tumors. Furthermore, brain tumors are more commonly found in men. The American Brain Tumor Association gives some signs and symptoms which include headaches, seizures, mental changes, personality changes, focal or localized symptoms, and increased pressure to the brain. The main risk factors for brain tumors are gender, race, age, family history, and radiation exposure.
MALIGNANT GLIOMA: According to WebMD, glioma cells are the cells associated with cancer development in the brain. Symptoms and treatment of malignant glioma (a type of tumor that starts in the brain or in the spine) depend on a few underlying factors such as the patient's age, type of tumor, and most importantly, the location of the tumor. As one ages, the risk of the severity of the brain tumor increases. Ages 75-84 are the most critical years when brain tumors are found and diagnosed. If a brain tumor is found in someone younger or even a child, the glioma is typically less severe. It is also important to note smoking, alcohol consumption and talking on cell phones have no relation to the development of brain tumors.
NEW RESEARCH: Doctors are currently testing a new technique that makes it easier to visually see the cancer cells in the brain. Before the operation, patients take a pill called 5-ALA. This pill reacts with natural chemicals in the body. Then, during the operation, as the surgeons look under the microscope, they are able to distinctly see cancerous cells. Healthy cells turn blue while cancerous cells light up hot pink to red. Physicians in Germany have reported that fluorescence-guided surgery using 5-ALA improves the chance that a cancer can be completely removed with surgery and improves progression-free survival in the treatment of patients with malignant glioma. A U.S. study found six months after the procedure was performed, 40 percent of the patients receiving ALA prior to the surgery had no progression in their tumor as opposed to 21 percent of the patients who did not have the fluorescent-guided surgery. Until now, no nanoparticle used for imaging has been able to cross the blood-brain barrier and specifically bind to brain-tumor cells. Research funded by the National Institutes of Health concluded that this new drug is the next generation of cancer imaging.
FOR MORE INFORMATION, PLEASE CONTACT: Dorothy Packer, R.N. Allegheny General Hospital Pittsburgh, PA (412) 359-6505 firstname.lastname@example.org
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