Brain Cancer Patient: Can Access to Medical Data Save Lives?

Posted by Brigham and Women's Hospital May 24, 2016

The MRI image above shows a tumor in Steven Keating’s frontal left lobe.

The MRI image above shows a tumor in Steven Keating’s frontal left lobe.

After participating in a brain research study, Steven Keating avidly collected and examined his personal medical data. Steven’s curiosity ultimately helped to identify his own brain tumor, a glioma, which was removed in the Advanced Multimodality Image Guided Operating Suite (AMIGO) at Brigham and Women’s Hospital in 2014.  Based on this experience, Steven is now a vocal advocate of providing patients with open access to their medical information. In this video, Steven shares the incredible story of how his life-long curiosity helped identify his brain tumor – and how curiosity about medical data also can help others.

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Understanding Meningiomas and Surgical Treatment

Posted by Brigham and Women's Hospital May 26, 2015

Pre-operative MRI of a meningioma

Authors: Tracy Ansay, MD, neurosurgeon, and Stanley Mui, physician assistant, of the Department of Neurosurgery at Brigham and Women’s Hospital. Dr. Ansay is also an Instructor in Neurosurgery at Brigham and Women’s Hospital.

We recently cared for a patient who was experiencing seizures despite being prescribed anti-seizure medications. He also was experiencing bouts of confusion. Both the seizures and episodes of confusion were very debilitating and impacted his performance at work. He was not able to drive and also was experiencing side effects from the anti-seizure medications, including irritability, cloudy thinking, and fatigue. An MRI indicated he had a brain tumor called a meningioma located in an area deep within the brain, next to an area called the cavernous sinus. His seizures were the result of pressure to the temporal lobe caused by the meningioma.

How Common are Meningiomas?

MRI after skull base surgery to remove the meningioma

Meningiomas are among the most common brain tumors. They are more common among women and occur with increasing frequency as people get older. Meningiomas are found in about three percent of people over the age of sixty.

Meninigiomas are typically attached to the covering of the brain called the dura, and they originate from cells within it. Approximately 90 percent of meningiomas are benign tumors. They also are slow-growing, with a diameter growth of about one millimeter per year. Atypical meningiomas, which grow more quickly, make up about seven percent of meningiomas. Malignant meningiomas, which are very rare, account for about two percent of meningiomas. Because meningiomas are usually benign and slow-growing, most patients can expect good outcomes after treatment.

Due to their attachment to the dura, meningiomas typically cause pressure on the brain, but do not actually invade brain tissue. Symptoms vary depending on where they are they located and may include weakness, numbness, or seizures. Most patients, however, do not experience any symptoms.

Restoring Quality of Life

Despite the challenging tumor location, our team was able to successfully remove this patient’s meningioma, with minimal disruption to the surrounding brain tissues, using a modified skull base surgical procedure. By using a less invasive surgical approach, our patient was able to return home two days after his surgery. Examination of the patient’s tumor indicated that it was benign. Follow-up MRI scans confirmed the tumor was completely gone and had not regrown. Our patient was tapered off his anti-epileptic medications, and his bouts of confusion and seizures stopped. Most importantly, he has been able to resume his normal activities and enjoy life once again

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Reaching Areas Deep in the Brain

Posted by Brigham and Women's Hospital June 30, 2014

Celebrating Life: Jill Colter (right) celebrates her 50th birthday with her mom, Elizabeth (left), two months after undergoing an innovative procedure to treat a brain tumor resulting from Stage IV melanoma.

For many patients with brain tumors or other abnormal tissue located deep in the brain, treatment options have been limited. Last year, Jill Colter, now 50, discovered that a brain tumor resulting from Stage IV melanoma had returned. “Several years earlier, I had treatment with surgery and radiation, but the tumor came back,” Jill says. Due to the location of Jill’s tumor and her prior radiation, surgery and further radiation weren’t possible to treat her tumor.

Jill was referred to neurosurgeon Alexandra Golby, MD, Director of Image-guided Neurosurgery and Clinical Co-director of the Advanced Multimodality Image Guided Operating (AMIGO) Suite at Brigham and Women’s Hospital and a key member of the Center for Neuro-Oncology team at Dana-Farber/Brigham and Women’s Cancer Center.

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Meningiomas: Five Things You Should Know

Posted by Brigham and Women's Hospital April 30, 2014

A meningioma may reach a relatively large size before it causes symptoms.

Contributor: Ian Dunn, MD, is a neurosurgeon in the Department of Neurosurgery at Brigham and Women’s Hospital and an Associate Professor of Neurosurgery at Harvard Medical School. Dr. Dunn’s interests include surgery for meningiomas, chordomas, and other skull base tumors.

A meningioma is a type of tumor that develops from the meninges, the membrane that surrounds the brain and spinal cord. Most meningiomas (90 percent) are categorized as benign tumors, with the remaining 10 percent being atypical or malignant. In many cases, benign meningiomas grow slowly. This means that depending upon where it is located, a meningioma may reach a relatively large size before it causes symptoms.

Meningiomas account for about 27 percent of primary brain tumors, making them the most common tumor of that type. Here are some common questions about meningiomas, with answers from our neurosurgeons at Brigham and Women’s Hospital (BWH):

What are the risk factors of meningiomas?

Meningiomas are most common in people between the ages of 40 and 70, and are more common in women than in men. Meningiomas are very rare in children, with pediatric cases accounting for only 1.5 percent of the total. There are not many predisposing factors associated with the development of meningiomas, but a few include:

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New Test May Help Brain Tumor Patients During and After Surgery

Posted by Brigham and Women's Hospital March 21, 2013

A new brain imaging tool may, in a matter of seconds, classify tumors and identify their boundaries.

Dr. Harvey Cushing, regarded as the founder of modern neurosurgery, was appointed Surgeon-in-Chief at Brigham and Women’s Hospital (then Peter Bent Brigham Hospital) in 1911. He is recognized for developing new surgical techniques that improved the care and survival of brain tumor patients. Since Dr. Cushing’s time, Brigham and Women’s Hospital (BWH) physicians have continued to advance new treatments for brain tumor patients. The latest is a new test that promises to improve the precision of brain tumor removal.

“Tumor tissue within the brain often closely resembles normal brain tissue and may have indistinct boundaries, so it is difficult to determine where tumors end and brain tissue begins,” says Dr. Alexandra Golby, Director of Image-Guided Neurosurgery in the Department of Neurosurgery at BWH, and Clinical Co-Director of BWH’s Advanced Multi-Modality Image Guided Operating (AMIGO) suite.

When removing brain tumors, surgeons want to preserve as much normal brain tissue as possible in their patients, especially when tumors are located in areas of the brain that control important functions like movement, speaking, or vision. However, determining the border between normal brain tissue and areas of brain tumor can often be difficult and uncertain.

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Using Sound Waves to Treat Cancer – and Much More

Posted by Blog Administrator June 1, 2012

focused ultrasound image

Doctors are using high-intensity focused ultrasound to treat major diseases, including cancer.

Most of us have seen an ultrasound image of a growing fetus. The use of sound waves to generate images in medicine is a widely employed technique that has been around for many years. More recently, however, doctors and researchers have been looking at ways to use high-intensity focused ultrasound to actually treat major diseases, including cancer.

High-intensity focused ultrasound generates tissue-killing levels of heat using narrowly targeted spots of ultrasonic waves, and the technique is being employed to treat brain tumors, tremors, uterine fibroids, breast and bone tumors, and many other conditions. There are no surgical incisions involved in the treatment, and other imaging techniques, like magnetic resonance (MR) imaging, are used to precisely guide treatment and measure temperature changes in the tissue.

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New Developments in Treating Brain Tumors

Posted by Blog Administrator May 24, 2012

David A. Reardon

David Reardon: "Analysis of tumors means we can recommend clinical trials that offer patients the most promise and hope."

More than 600,000 people in the United States are living with a primary brain tumor – one that begins and stays in the brain – and over 60,000 adults and children will be diagnosed with a brain tumor this year. In recognition of May as Brain Tumor Awareness Month, we asked Dr. David Reardon, clinical director of the Center for Neuro-Oncology at Dana-Farber/Brigham and Women’sCancerCenter, for the latest advances in brain tumor research and patient care.

Q. What are some of the challenges in treating brain tumors that you’re researching?

A.  For one thing, glioblastomas – the most common and aggressive primary brain tumors – are genetically very complex. The tumor cells are driven by multiple abnormal gene pathways, so we’re starting to use combinations of targeted drugs in “cocktails” that can block several pathways at once.

In addition, glioblastoma cells are adept at developing resistance to chemotherapy. We can now measure some enzymes whose levels predict which patients are more likely to develop resistance to a given drug.

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