I realize I said that viruses and cancer was going to be the next topic but with all the news about Senator McCain and his new diagnosis of glioblastoma I thought I would briefly discuss this. So, what is glioblastoma? From an oncological standpoint, it is the most aggressive brain tumor there is. Think of it as an octopus that digs its tentacles deep into the brain. This type of cancer can arise from heritable conditions or low-grade brain cancers, however, most of the time it is unclear why it develops.
Common symptoms which are really non-specific in nature include: headaches, nausea, personality changes and even seizures. Of course, these are not the only symptoms but realize that these symptoms certainly do not mean you have a brain tumor. There are many other things that can cause them.
Can the disease be prevented? There is no reliable way that we are aware of at this time to prevent the diagnosis of glioblastoma. It is an unfortunate disease without any true cure. Most patients if diagnosed with this disease will regrettably die from it.
What about treatment? Glioblastoma is first approached surgically to remove as much as possible. Remember the tentacles? It is very difficult to remove all of it, however, there are things being studied to help surgeons resect more if not all of the disease. After surgery, the patient then usually undergoes an approximate 6 week course of chemotherapy combined with radiation. The chemotherapy agent is known as temodar, which has contributed to an improvement in overall survival and progression free survival. Together, these modalities of treatment have improved the outcome of this terrible disease.
There is another modality of treatment that is known as Optune. It uses tumor treating fields to disrupt dividing cancer cells. This therapy has been shown in studies to improve OS at 5 years to 13%. This is truly unheard of. The device has been shown to be most effective if worn 18+ hours per day. To be able to prescribe Optune one has to be certified. I am, as to date the only physician certified in Northern Michigan and look forward to providing my patients this benefit. Optune is given in combination with what is known as cyclic temodar. Cyclic temodar is given five days in a row every month.
We are making headway on this disease albeit slowly. Over time, I believe we will continue to improve overall survival on this terrible disease.
So, what about John McCain? Well, only time will tell how he does. He absolutely has an uphill battle but he is a warrior and deserves the utmost respect against a formidable opponent.