Seattle’s Swedish opens new brain cancer center

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Dr Greg Foltz

Swedish Medical Center in Seattle has opened a new brain cancer treatment center, the first of its kind in the Northwest.

The facility, the Center for the Advanced Brain Tumor Treatment, will bring under one roof all the services needed for the treatment of brain cancer, including surgical, radiation, chemotherapy and social support services, said Dr. Greg Foltz, a neurosurgeon and director of the new center.

“All the tools you need to attack a disease like brain cancer are here,” Dr. Foltz said.

In the past, Seattle patients would have to travel medical centers out of the region to get the latest treatments, Dr. Foltz said, but because brain cancers can be so disabling and progress so quickly most of his patients are unable to travel to these centers.”

“My patients have been living in despair because they know there’s treatment just out of reach,” he said.

Now they will be able to get state-of-the-art care close to home, he said.

Despite decades of research most brain cancers remain deadly. Patients with the most common for of brain cancer, glioblastoma multiforme, for example, typically live no more than one to two years after diagnosis.

This is the kind of brain cancer that has struck Sen. Edward Kennedy of Massachusetts.

Until recently there had been little progress in finding better treatments, said Dr. John Henson, who will become the director of neuro-oncology at the new Swedish center.

Dr. Henson established the prestigious Pappas Center for Neuro-oncology at Massachusetts General Hospital in Boston.

More recently Dr. Henson moved into the field of neuroradiology and is now a senior neuro-oncologist and neuroradiologist at the hospital. He also has a faculty appointment at Harvard Medical School.

Dr. Henson says that despite 30 years of clinical trials, neither quality of life nor survival has improved significantly.

As the result of this lack of progress, many researchers had become discouraged and relatively few were focusing on brain cancer, he said.

Then a trial published in the New England Journal of Medicine in 2005, showed that treatment with radiation and drug called temozolomide prolonged lives of patients with glioblastoma multiforme.

At two years, nearly one in four of those patients treated with the drug and radiation was still alive compared to only one in ten of those who had receive radiation alone.

Of particular interest to researchers was the finding that the drug worked best in patients who had tumours in which a gene that coded for a DNA repair enzyme was turned off, Dr. Henson said.

It appeared that without this enzyme, the tumor cells were more vulnerable to the chemotherapy.

It was one of the first times that it was shown that by looking at the functioning of a particular gene in a tumor you could tell which patients would likely respond to a particular drug, Henson said.

Over the past decade it has become increasingly clear that tumors vary from person to person and that some tumors may be more susceptible to one treatment while others are more susceptible to other treatments, Dr. Henson said.

This has led to the idea that cancer treatments can be tailored to target each tumor’s vulnerabilities. “This is the direction all cancer treatment is headed,” Dr. Henson said.

At the new Swedish center, tumor tissue that is removed during surgery will be immediately taken to a new $3 million lab in the same building where the tumor’s genome will be analyzed.

This analysis will provide a genetic “fingerprint” of the tumor that will help the medical select the most promising treatments.

As part of the research, the Swedish center will also maintain a “tumor bank” where tumor tissue will be preserved for further study.

This will make it possible to grow cells from individual tumors so their vulnerability to different drugs can be tested in the test tube.

A major focus of the Swedish researchers work will be to identify drugs that can hit tumor stem cells. These cells tend not to be affected by current cancer treatments, and if they are not completely eradicated cause a cancer to return.

Dr. Foltz said that the new center is already making a difference: early treatment and a team approach is prolonging patients lives by several months.

And even a few months more life is important to these patients, Dr. Foltz said. “For these patients, time equals hope.”

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