Brain Cancer Treatment: How ‘Awake Surgery’ and Other Innovations are Providing Hope


ISLAMABAD:Some say outer space is the final frontier. Others insist it is the sea.
But if you ask a cancer brain surgeon, he or she will likely tell you that the real final frontier is the human brain.

Brain cancer remains one of the most confounding cancers to understand and treat.
However, experts say that as researchers learn more about how the brain works, new modalities will follow and bring the brain cancer community new hope.
A brain cancer surgeon who is leading the way
Dr. Shawn Hervey-Jumper is a neurosurgeon at the University of California San Francisco (UCSF). His subspecialty is neuro-oncology.
A kind, patient man with a deep but soft-spoken voice, Hervey-Jumper is revered by colleagues. But he remains humble.

Brain cancer will do that to just about anyone.
Hervey-Jumper’s work is focused on the surgical management of people with brain tumors that are located in hard-to-reach areas of the brain that are responsible for language, motor, and cognition.
He also serves as the co-director of the Sheri Sobrato Brisson Brain Cancer Survivorship Program, which offers neurosurgery, neuro-oncology, physical medicine and rehabilitation, neuropsychology, and speech pathology multidisciplinary services to adult brain tumor patients.
Awake brain surgery
One of the things for which Hervey-Jumper is best known is something called “awake brain surgery.”
While it may sound frightening, the UCSF surgeon said that once he explains it, people with cancer actually embrace the idea.

“Doing the surgery while the patient is awake reduces the risk of damaging critical brain areas that control speech and other skills,” Hervey-Jumper told Healthline.
“My priority is to provide the best possible surgical care for patients, while also considering rehabilitative therapies to maximize survival and improve their quality of life,” he said.
Share on PinterestDr. Shawn Hervey-Jumper talks with a surgical team at the University of California San Francisco. Noah Berger for UCSF
Awake brain surgery allows the surgical team to map out important areas of the brain to avoid during the surgery to protect the patient’s language, sensory, and motor abilities as well as communicate with the patient.

“If the tumor is near the parts of your brain that control vision, movement, or speech, I will sometimes ask the patient questions and monitor the activity in the brain. We have seen a resurgence in this technique as we learn more about how the brain is organized,” Hervey-Jumper said.
“My patients are nervous when we tell them about this, but they are also enthusiastic. There are not a lot of cancer patients who get to participate in their own care. The patients do incredibly well. I do these operations 4 to 6 times a week.”

Changing times in brain cancer research
Dr. James Snyder, a neuro-oncologist with Henry Ford Health in Detroit, told Healthline that brain cancer innovation is accelerating at a rapid rate now because of the dire need for success.
“We had to become more creative,” said Snyder. “We are understanding brain cancer now from many new perspectives. The returns from genomic studies, computer science, machine learning, radiomics, and liquid biopsies, all of these and more are coming to a head and with all that data and insight we have seen a velocity of ingenuity.”
He also believes a big part of this progress is the result of the White House’s Cancer Moonshot program.

“I attribute many of these advances to the 2015 Cancer Moonshot for putting funding and energy into these new innovations to accelerate progress in cancer outcomes,” Snyder said.
Historically, brain cancer treatments have been limited and difficult to navigate in part because of the blood-brain barrier.Trusted Source
That is the network of blood vessels and tissue made up of closely spaced cells that help keep harmful substances from reaching the brain, according to the National Cancer Institute.
The barrier lets some substances, including water, oxygen, carbon dioxide, and general anesthetics, pass into the brain. It also keeps out bacteria and other substances, including some cancer treatment drugs.

Promising brain cancer research at Yale
A variety of new techniques are being developed to improve current treatment for brain cancer and other brain diseases.
One of those new modalities being developed by researchers at Yale University in Connecticut deploys tiny bioadhesive nanoparticles to the brain.
The nanoparticles adhere to the site of the tumor and then slowly release the synthesized peptide nucleic acids that they’re carrying, explained W. Mark Saltzman, PhD, a professor of biomedical and chemical engineering as well as cellular and molecular physiology at Yale.
Saltzman told Healthline that these nanoparticles can carry drug and gene delivery into tumors.
“On the good side, we’re seeing lots of good work going on at reputable labs around the world and they are showing advances in treatment in animals. The challenge is moving it to the next stage,” he said.