Despite significant advances in cancer research
and treatment, one form of cancer - brain tumours - remain particularly feared,
and for good reason. Because of their location, brain tumours can severely
impact an individual's personality, memories and basic motor skills, robbing
the patient of their very being. The impact on family and friends is felt
greatly, as their loved one may be "lost" to them even earlier than
feared. While there are more than 120 types of brain tumours, for the most
common and serious adult tumours, Glioblastoma multiforme (GBM), the chances of
living 5 years is less than 3%. Most patients will live no more than a year or
two despite aggressive therapy.
However, few maladies manage to both
simultaneously confound researchers in their mystery, yet hold such promise for
the cure and management as prominently as brain tumours. There is strong belief
that some significant breakthroughs in brain tumour treatment may only be 4-6
years away. Complementing traditional chemotherapeutic and surgical approaches,
four emerging breakthroughs are discussed here which are rapidly transforming
the treatment of brain tumours and related conditions.
Gene
Therapy
Gene therapy approaches involve the insertion
of genes into growing brain tumours, rendering them more sensitive to some
chemotherapeutic agents that are relatively non-toxic to the rest of the body.
Some promising experiments have demonstrated that with insertion of genes into
animal brain tumour cells and administration of chemotherapy, complete
destruction of the tumour may be possible without spread of the tumour. Other
approaches in gene therapy include substitution of abnormal genes for normal
genes, the repair of abnormal genes via selective reverse mutation, and gene
regulation (i.e., altering the instructions within a gene to "turn on or
off").
Vaccines
One area showing substantial promise in brain tumour treatment is based on an immunotherapeutic approach; that is, using a
patient's immune system as an instrument for cancer therapy. This approach is
premised on a body's immune response toward cells bearing tumour markers or
antigens. One major focus area has been "active immunotherapy",
described as the administration of the tumour antigenic material to help
"vaccinate" a patient against their own tumour. Other vaccine
approaches, including dendritic cell-based vaccines, Cytokine immunogene
therapy, Bacterial and viral tumour vaccines, and GBM-specific molecular pathway
vaccines are also being considered. The vaccine approach holds challenges that
need to be evaluated against other treatment options that may require crucial
patient choices, but they are continuing to emerge as an area of significant
promise.
Stereotactic
Radiosurgery/Radiotherapy
There is growing usage of stereotactic
radiosurgery and radiotherapy among neurosurgeons. The tools, used for the
non-invasive treatment of tumours and other brain, head, spine and neck
conditions, use sophisticated mechanical systems and image-guided technology to
treat tumours, using high, targeted doses of radiation (in a single session) to
attack the tumour and minimising contact with healthy tissue. The image
guidance systems direct the radiation to the tumour; some systems shape the
radiation beam to map to the exact shape of the tumour, and software can help
direct the ideal access points to the tumour.
Dual
Agent Drug Therapies
Some of the field's leading researchers have
concluded that traditional treatment for many brain tumours has started with a
faulty premise; namely, that interventions for brain tumours were simply a
palliative effort designed to decrease patient discomfort and increase stabilisation. The conclusion is that while these therapies have shown some success
on their own, when multiple therapeutic agents are combined, (an approach more
commonly used with cancers not as fatal) an increasing number of brain tumour patients are seeing increases in survival. Also, newer drugs are showing the
ability to block the growth of tumours by attempting to interfere with their
proteins that control tumour growth. And other, specialised treatment regimens
are being formulated for patients whose tumours are shown to grow at an
accelerated rate compared with typical tumours.
These are but four of the upcoming approaches
where we may continue to see major breakthroughs in treatment or management of
brain tumours. The hope in all these courses is that ultimately, brain tumours
may in some cases be curable or at least achieve status as a manageable
disease, as with many other serious and chronic conditions such as diabetes.
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