Column: What to know about glioblastoma and other brain cancers

Courtesy Dr. Douglas Waite is chief medical officer at Saint Vincent Hospital in Worcester.

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By Dr. Douglas Waite

Arizona Sen. John McCain’s now-public fight with glioblastoma, a form of brain cancer, reminds us all how fragile we are. While the news is worrisome, knowing more about the disease – and how it is treated – can make it and our fears about brain cancer seem more manageable.

The brain and spinal cord make up the central nervous system. Tumors that start in the brain are called primary brain tumors. A tumor that starts in another part of the body and spreads to the brain is called a metastatic brain tumor. Brain and spinal cord tumors may be either benign (not cancer) or malignant (cancer). Both kinds of tumors require treatment.

Glioblastomas are tumors that grow from astrocytes - supportive cells that help make the brain work. These type of tumors usually result in malignancies because the cells from which they originate reproduce quickly and are supported by a large network of blood vessels. Glioblastomas are the most commonly diagnosed of the cancers found in the brain. But overall, brain cancer is rare. It accounts for only about 1.4 percent of all new cancer cases in the United States, according to the National Cancer Institute.

Many people with brain cancer do not know they have the disease because they have no obvious symptoms until the cancer has reached an advanced stage. Other people may experience an early onset of symptoms that can include new or increasingly strong headaches, blurred vision, loss of balance, confusion, and seizures. A person with these symptoms should see a doctor for evaluation and treatment as soon as possible. Successful treatment for this and most other kinds of cancers is more likely when detected early.

Tests that can be used to detect brain cancer include blood tests, which measure the presence of certain chemicals that can be altered by the presence of a brain tumor; imaging studies, such as an MRI, PET scan, or CAT scan to examine the head, neck, and spinal cord for abnormal growths or masses; and biopsies, where a surgeon uses a needle, endoscope, or surgery to remove the tumor for diagnostic testing.

Treatment options

Once a diagnosis of brain cancer has been made, treatment will depend on the tumor location, size, and stage of the disease. Treatments can vary and include: surgery; chemotherapy; radiation; precision therapy; stem cell transplant, and immunotherapy. Whichever treatment is best for the patient, fighting the cancer is an all-out war, and having a coordinated medical team is the best line of defense.

According to the American Brain Tumor Association, glioblastomas such as Sen. McCain’s are a highly malignant type of tumor that must be treated through a combination of surgery, radiation, and chemotherapy. But there is more to cancer care than treating the tumors. Patients also need help with psychological and nutritional needs, and ensuring social support, for example.

Providers, like Saint Vincent Hospital, often offer help manage the different facets of treatment. Healthcare caseworkers and providers help coordinate care on many fronts through patient navigator programs, for example. If you have been diagnosed with cancer, your best option may be working with a coordinated team of caregivers to help you navigate your way through illness, and hopefully return to good health. For more information, visit www.stvincenthospital.com/oncologylp.

Dr. Douglas C. Waite is chief medical officer at Saint Vincent Hospital in Worcester. He has practiced medicine in the Worcester area for more than twenty-five years, specializing in internal medicine and infectious disease. A graduate of Rutgers New Jersey Medical School, Dr. Waite is also an associate professor of medicine at the University of Massachusetts Medical School in Worcester.