{"id":77623,"date":"2025-01-02T10:35:16","date_gmt":"2025-01-02T17:35:16","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=77623"},"modified":"2025-01-08T09:48:22","modified_gmt":"2025-01-08T16:48:22","slug":"understanding-brain-cancer-tumors-and-treatments","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/understanding-brain-cancer-tumors-and-treatments\/","title":{"rendered":"Understanding brain cancer, tumors and treatments"},"content":{"rendered":"
<\/div>
\"Brain
Brain cancers remain as some of the toughest to treat, but new therapies and drug-delivery methods aim to change that. Photo: Getty Images.<\/figcaption><\/figure>\n

Brain cancer is many different diseases, all too often with the common denominator of being hard to treat. Just the names are intimidating \u2013 glioblastoma, astrocytoma, ependymoma, oligodendroglioma, meningioma \u2013 even when the prognoses aren\u2019t (meningiomas may be curable, for example).<\/p>\n

For many brain cancers, though, the outlook remains poor despite recent medical advances. They are often incurable, and so the goal of treatment is to extend lives while preserving quality of life. To understand the state of affairs in brain cancer treatment and help answer some common questions about brain cancer, UCHealth Today<\/em> caught up with Dr. Douglas Ney<\/a>, a University of Colorado School of Medicine neuro-oncologist who practices at UCHealth University of Colorado Hospital<\/a> on the Anschutz Medical Campus<\/a>.<\/p>\n

\"Dr.
Dr. Douglas Ney<\/figcaption><\/figure>\n

Does a brain tumor mean brain cancer?<\/strong><\/h2>\n

No \u2013 there are roughly 150<\/a> types of brain tumors, many of which are considered benign tumors \u2013 including many of the meningiomas mentioned above, which account for 10 to 15% of all brain tumors but a tiny percentage of brain cancers.<\/p>\n

What are some symptoms of brain cancer?<\/strong><\/h2>\n

They vary but include headaches severe enough to wake up a patient at night, seizures, difficulty communicating, personality changes, disorientation, confusion, partial body weakness or paralysis, changes in vision or hearing, balance difficulties, nausea, and facial numbness or tingling.<\/p>\n

How do doctors diagnose brain cancer?<\/strong><\/h2>\n

Typically, CT and MRI scans determine the locations and sizes of tumors, and then surgery is needed to characterize the tumor. If it\u2019s cancerous, a pathologist provides a tumor grade<\/a> and type. Gliomas, the most common malignant brain tumors, are typically graded on a 1-4 scale. Grade 1 brain cancers grow slowly and can be curable with successful surgery to remove the tumor. Grade 4 brain cancers grow quickly, resist treatment, and are typically incurable.<\/p>\n

What are some common types of brain cancer?<\/strong><\/h2>\n

First, there are two broad categories of brain cancer. The first involves cancers that originate in the brain, called primary brain tumors.<\/p>\n

The second category involves cancers that started elsewhere \u2013 such as lymphomas, breast cancers, prostate cancers, bone cancers, lung cancers, and others. These are called secondary, or metastatic, brain tumors. Primary brain tumors are the main focus of neuro-oncologists such as Ney, though neuro-oncologists also help patients with metastatic brain tumors by working with the doctors who specialize in those other cancers.<\/p>\n

What are the main types of primary brain tumors?<\/strong><\/h2>\n

Gliomas are, as mentioned, the most common primary brain cancer, comprising between a quarter and one-third of all brain tumors and about 80% of all malignant brain tumors. These originate in the glial cells that surround and support the brain\u2019s neurons. There are several types of gliomas.<\/p>\n

Glioblastomas account for 50% to 60% of gliomas and are the most common<\/a> primary brain cancer in adults. Gliomas and glioblastomas are incurable. His glioblastoma patients often survive 18-22 months, Ney says. That\u2019s not good, but it\u2019s better than the statistical average of eight months<\/a> or 14 months<\/a>, depending on the source.<\/p>\n

\u201cThere\u2019s a whole group of people who are doing much, much better than that,\u201d Ney says. \u201cWe go at it aggressively, we watch it closely, and we treat it with everything in our arsenal.\u201d<\/p>\n

Why are brain cancers so hard to treat?<\/strong><\/h2>\n

Many brain tumors, gliomas and glioblastomas among them, are not solid masses with clear boundaries, but rather \u201cdiffusely infiltrative,\u201d penetrating weblike into the surrounding tissues, Ney says. That makes complete surgical removal impossible, he says.<\/p>\n

Also, even single categories of brain cancers \u2013 glioblastomas, say \u2013 are in fact maddeningly diverse.<\/p>\n

\u201cI think of glioblastoma as hundreds of diseases, because they\u2019re so different in a molecular fashion,\u201d Ney says. \u201cThere are so many things driving the growth of these tumors, it\u2019s impossible to target them all.\u201d<\/p>\n

Another challenge is the blood-brain barrier<\/a>, which makes it hard to deliver medications directly to the brain.<\/p>\n

What are typical brain cancer treatments?<\/strong><\/h2>\n

Chemotherapy and radiation have been the mainline treatments, with surgery also an option when doable. Promising drugs are emerging, though. While whole-brain radiation therapy can be done, Ney describes it as \u201cvery toxic, and it also actually doesn\u2019t improve tumor control.\u201d Rather, focused radiation is the primary approach.<\/p>\n

Studies have not found Gamma Knife, CyberKnife, proton-beam, or other \u201cfancy forms of radiation,\u201d as Ney puts it, to be superior to standard radiation therapy, he says.<\/p>\n

For glioblastoma patients, there\u2019s also the option of wearing Novocure\u2019s Optune device, which sends alternating electric fields into to the brain and has been proven to disrupt the proliferation of the brain cancer\u2019s cells. Patients have survived for years<\/a> thanks to the device. Ney says about 50 UCHealth patients are wearing Optune devices at a given time.<\/p>\n

What are promising drugs for brain cancer?<\/strong><\/h2>\n

The U.S. Food and Drug Administration in August 2024 added<\/a> vorasidenib to the list<\/a> of U.S.-approved brain-cancer drugs. It\u2019s for patients with two common types of gliomas \u2013 grade 2 astrocytoma and oligodendroglioma. Most of these tumors contain a genetic mutation called IDH mutations. Vorasidenib targets IDH mutations and inhibits tumor growth.<\/p>\n

The study<\/a> that led to vorasidenib\u2019s approval found that those on the drug had a median progression-free survival of 27.7 months, versus 11.1 months in the control group that didn\u2019t take the drug.<\/p>\n

\u201cI think it\u2019s really going to move the needle in terms of outcomes,\u201d Ney says. \u201cIt\u2019s not for every patient, but it\u2019s a really good example of the sort of innovation that\u2019s on the horizon, and it\u2019s going to change how we think about the treatment of these tumors.\u201d<\/p>\n

Are new brain cancer treatments being developed?<\/strong><\/h2>\n

Several lines of early-stage research are afoot. Immunotherapies, in which drugs or genetic manipulation teach the immune system to attack cancer cells that otherwise hide themselves from our immune defenses, are one emphasis. Researchers are<\/a> studying<\/a> the use of CAR T-cell therapies<\/a> for glioblastomas, and the early results look promising. Also, the National Cancer Institute is in the early stages of testing<\/a> a vaccine that activates immune cells to recognize and attack glioblastoma cells.<\/p>\n

Another focus area of brain cancer research is in improving the delivery of drugs to the brain, which the blood-brain barrier hinders. One approach is to use low-intensity ultrasound<\/a> to disrupt the blood-brain barrier. Another is convection-enhanced delivery<\/a>, which places catheters to deliver drugs directly to the brain cancers doctors want to target. Researchers are even experimenting with genetically manipulating Toxoplasma gondii<\/em> parasites<\/a> to deliver large-molecule drugs straight to neurons.<\/p>\n

\u201cI think it\u2019s a pretty exciting time in the brain tumor field right now,\u201d Ney says. I\u2019m super-optimistic about the field.\u201d<\/p>\n

What\u2019s behind that optimism? There\u2019s still no cure for brain cancer for so many patients, right?<\/strong><\/h2>\n

\u201cWe don\u2019t always have the luxury where we can say, \u2018Hey, I\u2019ve taken it all out, mission accomplished,\u2019\u201d Ney says. \u201cIt doesn\u2019t just become about treating the disease. It becomes about, \u2018How do you help a patient have the best quality of life? How do you kind of walk that path with them \u2013 to help them understand their disease?\u2019\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Brain cancer is many different diseases, all too often with the common denominator of being hard to treat. Just the names are intimidating \u2013 glioblastoma, astrocytoma, ependymoma, oligodendroglioma, meningioma \u2013 even when the prognoses aren\u2019t (meningiomas may be curable, for example). For many brain cancers, though, the outlook remains poor despite recent medical advances. They […]<\/p>\n","protected":false},"author":23,"featured_media":77656,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[8],"tags":[9205,28,184],"class_list":["post-77623","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-brain-tumors","tag-cancer-care-oncology","tag-neurology"],"acf":[],"yoast_head":"\nUnderstanding brain cancer, tumors and treatments - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Brain cancer is many different diseases and is often hard to treat. 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