Combined Treatments for Brain Tumors Give the Best Results

By Anastacia Mott Austin

Senator Ted Kennedy (D-Mass) underwent surgery this week to remove a malignant tumor, or "glioma," from his brain.

With the senator’s operation, curiosity has been aroused in the public about the treatments now available for brain tumors.

The senator was actually awake for part of his operation, which is quite common for his type of tumor surgery. The surgeons want to make absolutely sure they are not cutting into portions of the brain that control functions like speech, and need to engage the patient to ensure those functions remain.

The patient is kept unconscious for the part of surgery when the scalp and skull are cut into (which is a relief), then partially awakened while still under sedation but able to respond to questions.

For Ted Kennedy, the surgery was pronounced a success, though doctors say that a glioma can never be completely removed, as it is an invasive tumor and has probably spread to other areas.

"These tumors are very aggressive," said Dr. Mark Gilbert, a neuro-oncologist at M.D. Anderson Cancer Center in Houston, to reporters at The Boston Globe. "They cannot be treated by surgery alone."

The senator will now likely embark on a course of both radiation and chemotherapy, in hopes of further reducing the tumor’s size and granting him some time. Unfortunately, there is no complete cure for gliomas, and the goal in these cases is to prolong the patient’s quality of life. Most patients of Senator Kennedy’s age with his type of cancer will go on to live an average of 12-14 months.

However, new developments are occurring all the time, and promising new treatments are on the horizon. A new brain cancer drug, Temodar (for temozolamide) has been used with promise for several years. Temodar has been shown to double the survival rate time of patients with advanced gliomas.

Temodar can help shrink tumors on its own, but it is also known to increase the tumor’s susceptibility to radiation, which is why the two are often combined.

"Radiation provides some control of the tumor at and around where the original tumor was, but still there are individual tumor cells that might have migrated much further out," said Dr. Deepa Subramaniam, director of Washington’s Brain Tumor Center at Georgetown University's Lombardi Comprehensive Cancer Center. "And it is those cells that are targeted by chemotherapy."