Treatments for brain tumors are falling short. Here’s what’s being done to change that

The chance of a person developing a malignant brain tumor in his or her lifetime is less than 1%, but for the people who do develop these tumors, treatment options are limited, and advancements are needed to help improve their outcomes and survival.

Each year, the organization Head for the Cure hosts 5K run/walk events across the country to raise hope, awareness and funding for brain cancer research and to celebrate and remember those who have been affected by the disease. This year, a portion of the proceeds raised during the Charleston 5K event, which will be held virtually on Feb. 27, will go directly to MUSC Hollings Cancer Center to help researchers understand brain cancer better in hopes of developing better treatments.

Here, David Cachia, M.D., a neuro-oncologist at Hollings who specializes in brain and spine tumors, discusses the barriers that exist in treating brain tumors, the research that’s being done to improve patient outcomes and why events like this are so important in the fight to save lives.

In what ways do current treatments for brain tumors fall short?

We currently have limited treatment options for brain tumors. Treatment typically consists of surgery followed by either radiation, chemotherapy or both depending on what tumor type is being treated. For glioblastoma, which is the most common malignant primary brain tumor in adults, the last medication approved by the FDA that increased overall survival was in 2006. Since then, despite multiple trials, we have not managed to move the bar.

What work is being done at Hollings to change these shortcomings?

Clearly, we need to develop a better understanding of these tumors, despite all the challenges to improve treatment options and outcomes for our patients. Here at Hollings, we are currently running and enrolling patients in multiple clinical trials looking at innovative approaches to treating these tumors. We also are actively involved in basic science research that looks at studying drugs in a preclinical setting. The idea is that if any of those drugs look promising in animal models, we can then move them to clinical trials in our patients.

Julian Smith and Dr. David Cachia
Dr. David Cachia

Can brain tumors be found early?

It is not uncommon for brain tumors to be found relatively early in the course of the disease. The reason is that whenever there is growth in the brain, especially in areas known as eloquent areas of the brain that control important body functions such as strength, sensation and speech, a patient will develop symptoms. In other areas of the brain and for slower-growing tumors, symptoms might not develop as quickly. However, patients who develop persistent symptoms such as headaches, nausea and vomiting should always seek the care of a physician.

What factors determine a patient’s prognosis?

A patient’s prognosis depends on a number of factors, but some of the more important factors include age, how much of the tumor can be safely removed, the type of brain tumor (more aggressive brain tumors have a worse prognosis) and the molecular profile of the tumor. These are all evaluated when the patient is seen in the neuro-oncology clinic at Hollings. Then, treatment options are recommended.

What is the blood-brain barrier, and how does it play a role in treating brain cancers?

The blood-brain barrier is an important mechanism that is in place to protect the brain environment. It allows the brain to function in a very tightly regulated environment. However, when we want to deliver medications to the brain, as we do in brain tumor patients, this works against us, limiting the amount of drug that gets to where we need it to go, which is to the tumor. We are also limited in how much we can increase doses of chemotherapy to overcome this barrier due to the side effects from these drugs.

Research is always looking at how to overcome this barrier. Some ways include injecting the chemotherapy or drugs into the surgical cavity at the time of surgery, temporarily opening the blood-brain barrier using ultrasound, packaging the drugs in a lipid coating since this allows them to penetrate this barrier more effectively or making drugs or delivery systems smaller using nanotechnology.

What is one thing most people don’t know about brain cancer that might surprise them?

Unlike other cancers that spread from their original tissue of origin to different organs and sites in the body, brain tumors typically do not spread outside of the central nervous system.

Why is funding for brain cancer research so important?

In order to run trials and perform basic science research, funding for these projects is needed. Hollings is a part of some of the largest organizations for brain tumor research that help to support this work, but if we want to make a difference, we need the support to fund innovative research and change the course of these diseases.

Why do you plan to participate in this year’s Head for the Cure?

Head for the Cure is a nationwide organization devoted to improving care for patients with brain tumors by raising awareness, raising funds for brain tumor research and helping to develop clinical trials for neuro-oncology patients. The organization also supports the more than 30 institutions, including MUSC, that are a part of the Brain Tumor Trials Collaborative (BTTC) in their goal for research in the field of brain tumors. I plan to attend to support this worthy cause but also to support our patients and caregivers.

To learn more about this event or to register for the virtual Charleston 5K, visit the Head for the Cure website. If you can’t participate but would still like to donate to brain cancer research at Hollings, click here to make a gift by selecting “neuro-oncology” under “My gift supports.” Don’t forget to snap a selfie on race day and share it with us by tagging @muschollings and @headforthecure on social media.

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