More Precise Diagnosis Leads to More Precise Treatment for Patients with Brain Tumors

Posted by Brigham and Women's Hospital May 21, 2015

Members of the brain tumor diagnostic board

The information used in diagnosing a brain tumor takes many forms. At Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC), a patient’s brain tumor tissue undergoes a broad range of diagnostic tests: not only standard pathology exams in which tumor cells are viewed under a microscope, but also next-generation scans looking for mutated genes and misassembled chromosomes, as well as whole-genome searches for extra or missing copies of genes.

Such extensive testing helps pinpoint the exact type and characteristics of a particular tumor. The more specific the diagnosis, the more precise the therapy can be.

But test results are only as valuable as the ability of pathologists and physicians to interpret them. As the diagnosis of brain tumors becomes more complex, DF/BWCC pathologists and cytogeneticists (specialists who focus on chromosome structure) routinely consult one another, compare notes, and present physicians with a unified report on their diagnostic findings.

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Advancing the Treatment of Malignant Gliomas

Posted by Brigham and Women's Hospital May 14, 2015

Gliomas can arise anywhere in the brain.

Malignant gliomas are a set of tumors that can arise anywhere in the brain. Tumor cells divide to create a mass, as well as infiltrate into normal brain tissue. The current standard of treatment for malignant gliomas is surgery to remove as much of the tumor as possible, often followed by chemotherapy and radiation. There are, however, many new treatment approaches being evaluated for malignant gliomas.

In the following video, Dr. E. Antonio Chiocca, Chair of the Department of Neurosurgery and Co-Director of the Institute for the Neurosciences at Brigham and Women’s Hospital, describes a promising new approach called oncolytic virotherapy. This involves the use of common viruses to treat malignant gliomas. Studies of the herpes simplex virus type 1 have shown that the virus invades tumor cells and destroys them, while also stimulating the immune system to create a vaccine-like effect against the tumor.

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New Immunotherapy Vaccines Show Promise in Treating Brain Tumors

Posted by Brigham and Women's Hospital May 7, 2015

Dr. David Reardon

Researchers in the Center for Neuro-Oncology at Dana-Farber/Brigham and Women’s Cancer Center are now launching attacks on glioblastomas from a new angle – by turning the patient’s immune system against the cancer cells. Where targeted chemotherapy uses drugs to disable proteins that cancer cells need to grow, immunotherapy drugs stimulate the patient’s immune system to recognize and kill cancer cells.

Traditional drugs and even targeted chemotherapy agents have had little success in treating glioblastoma – a very aggressive type of brain tumor.

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Don’t Leave Women’s Health to Chance

Posted by Brigham and Women's Hospital April 30, 2015

Dr. Paula Johnson

The author of today’s post is Paula A. Johnson, MD, MPH, Executive Director of the Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital and Professor of Medicine at Harvard Medical School.

Did you know that, 20 years ago, women and minorities were not routinely included in federally funded clinical trials? That changed in 1993 when President Bill Clinton signed into law the historic NIH Revitalization Act, making inclusion of women in health research a national priority.

Today, we know that women are different from men down to the cellular and molecular level. We see these differences across all organ systems — from our hearts to our joints, lungs, and brains. The Mary Horrigan Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital is dedicated to exploring and discovering why these differences occur, and translating those differences into clinical care. However, roadblocks remain in research and clinical care. Here are just a few examples:

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Patient Turned Researcher Helps Advance Understanding of Brain Tumors

Posted by Brigham and Women's Hospital April 13, 2015

Steven Keating (right) holds a 3-D printed model of his brain.

Interested in seeing images of his brain, Steven Keating, currently a graduate student at the MIT Media Lab, volunteered for a research study while attending school in Canada in 2007. When researchers returned his brain scans, they delivered some startling news.

“The researchers told me I had an abnormality near the smell center in my brain, but that lots of people have abnormalities and I shouldn’t be alarmed,” says Steven. However, as a precaution, researchers advised Steven to get his brain re-scanned in a few years.

Steven’s next set of brain scans, performed in 2010, showed no changes. But in July 2014, he started smelling a strange vinegar scent for about 30 seconds each day. He immediately had his brain scanned and learned that the strange smell was associated with small seizures due to the presence of a brain tumor called a glioma. Steven’s glioma had grown to the size of a baseball.

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Five Things You Should Know about Precision Medicine

Posted by Brigham and Women's Hospital April 2, 2015

Precision medicine involves testing DNA from patients’ tumors to identify the mutations or other genetic changes that drive their cancer.

When President Barack Obama rolled out his Precision Medicine Initiative, it included increased funding in the 2016 federal budget. Precision medicine is changing the way cancer is studied and treated. Here are five important things to know about it.

1. Precision medicine can improve diagnosis and treatment 

Physicians have long recognized that the same disease can behave differently from one patient to another, and that there is no one-size-fits-all treatment. Precision cancer medicine makes diagnosis of cancer and other diseases more accurate and evaluates the specific genetic makeup of patients (and, in cancer, of their tumors) to select the safest and most-effective treatments for them.

In cancer, precision medicine involves testing DNA from patients’ tumors to identify the mutations or other genetic changes that drive their cancer. Physicians then may be able to select a treatment for a particular patient’s cancer that best matches, or targets, the culprit mutations in the tumor DNA. While such therapies are not widespread yet, many cancer specialists believe precision treatments will be central to the future of cancer care.

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Countdown to the New Year – Top Ten Posts for 2014

Posted by Brigham and Women's Hospital December 31, 2014

The blog team at Brigham and Women’s Hospital (BWH) is counting down to the New Year by revisiting our top 10 blog posts published in 2014, beginning with number ten. We’d also love to hear from you – what were your favorites? Thank you for your comments, questions, and continued interest in HealthHub. We wish you a healthy and happy New Year.

#10 – Video – Comprehensive Spine Care

Certain spinal conditions, such as back pain, are very common. However, treating these conditions can require the expertise and coordination of more than one medical specialty. Often, the first step is conservative, non-operative treatment by physiatrists, pain management physicians, and other specialists. Learn how our surgical and non-surgical spine specialists collaborate on care for patients with spinal disorders.

#9 – Improving Joint Replacement:  Consultation through Recovery

Based on the work of the Care Improvement Team, led by orthopedic surgeon Dr. John Wright, Brigham and Women’s Hospital uses a standardized approach to total knee replacement that guides how patients should be treated, from the time they arrive at the hospital for a consultation to the care they receive after discharge. This process has improved patient outcomes.

#8 – Colorectal Cancer: Do Men and Women Have Different Symptoms

Risk factors for colorectal cancer — which include age, family history of the disease, or having Crohn’s disease or ulcerative colitis — are similar for men and women. However, lifestyle choices that may impact the risk can differ between men and women. These include obesity, lack of physical activity, low vitamin D, and consuming a high amount of red meat.

 

#7 – Should You Go without Gluten?

Many people are becoming increasingly concerned about eating foods containing gluten. Gluten is responsible for the reaction that damages the lining of the small intestine in celiac disease. It also has been linked to less serious gastrointestinal complaints, such as diarrhea and bloating. Read more about how gluten can affect your health and the benefits of avoiding it.

 

#6 – Keys to Preventing Lyme Disease

Dr. Nancy Shadick, a rheumatologist at Brigham and Women’s Hospital (BWH), and her team have developed entertaining, interactive programs to increase people’s knowledge about Lyme disease, the consequences of the disease, and prevention techniques. Play the game to learn how you can prevent Lyme disease, a tick-borne infection that can cause neurological and joint problems.

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Women and Lung Cancer

Posted by Brigham and Women's Hospital November 13, 2014

Lung cancer is the leading cause of cancer deaths among men and women in the United States. For women, it accounts for more deaths than breast, ovarian, and uterine cancer combined. Consequently, medical researchers have been working hard to increase our understanding of lung cancer and help us better prevent, diagnose, and treat the condition.

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Lung Cancer Screening Helps Current and Former Smokers

Posted by Brigham and Women's Hospital November 5, 2014

Dr. Francine Jacobson

Lung cancer, the most frequent cause of cancer death in this country and around the world, continues to be an important public health epidemic. The American Cancer Society projects that by the end of this year alone, there will have been 224,000 new cases of lung cancer diagnosed in the U.S., and 159,000 Americans will have died from the disease.

Most, but not all, cases of lung cancer are attributable to smoking. Thus, the most important thing that people can do to reduce their risk of developing lung cancer is to quit smoking, or better yet, never start.

For current or former long-term smokers, lung cancer screening should be a priority. Research has shown that new screening guidelines for the use of low-dose computed tomography (CT)  should significantly reduce the number of deaths from lung cancer by improving early detection. In the following video, thoracic radiologist Dr. Francine Jacobson provides more details about the benefits of low-dose CT scans and who should get screened.

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OR of the Future – Merging Precise Imaging with Precise Surgery

Posted by Brigham and Women's Hospital November 4, 2014

AMIGO houses a vast array of advanced imaging equipment and interventional (minimally invasive) surgical systems.

The Advanced Multimodality Image Guided Operating (AMIGO) suite at Brigham and Women’s Hospital is a state-of-the-art medical and surgical research environment that houses a vast array of advanced imaging equipment and interventional (minimally invasive) surgical systems. Multidisciplinary teams of specialists use the suite’s advanced technology and unique design to efficiently and precisely guide treatment — before, during, and after surgery — without the patient or medical team ever leaving the operating room.

The AMIGO suite gives physician-researchers an optimized setting for innovatively merging imaging and surgery to improve standard clinical procedures and to develop new therapeutic approaches. With the primary goal of improving the effectiveness of patient care, success already has been demonstrated in several treatment areas, including: image-guided therapy in open brain surgery, radiation treatment of prostate cancer and gynecological tumors, breast-conserving therapy, MRI-guided cryoablation (destroying diseased tissue via extreme cold), treatment of atrial and ventricular fibrillation, and brain tumor laser ablation (destroying diseased tissue with focused heat). In the following video, Dr. Steven Seltzer, Chair of the Department of Radiology at Brigham and Women’s Hospital (BWH) and Dr. Michael Zinner, Chair of the BWH Department of Surgery, offer an inside look at the AMIGO suite and detail its potential for improving the effectiveness of image-guided therapy.

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