Friday, March 14, 2014

Helping people with brain cancer live longer

Human brains stored at the Illinois Anatomical Gift Association
    I like writing medical stories, or used to. Then the pace of the paper got more frantic and I stopped taking the time. While I've done a number with the University of Chicago Hospitals, Illinois Masonic, Michael Reese, Christ Hospital, and especially Loyola, Northwestern Memorial was in a realm of unapproachability all its own. For reasons I never quite fathomed, they just didn't want to be in the newspaper. So whenever I would meet someone from Northwestern, a trustee, a board member, who would airily inform me they were with the hospital, I would shock them by saying, "Northwestern Memorial? I HATE Northwestern Memorial...." I don't know if that had an effect, though I did it twice in the past year with two highly placed NU bigwigs, or they just brought on a new PR team, but they actually pitched this research at me, and it sounded new and significant enough to write something about. I had wanted to spend time delving deeply into this process, but got sidetracked, and this more superficial look had to do. 

     ‘Here’s the thing with brain cancer,” said Dr. Andrew Parsa, chairman of neurological surgery at Northwestern Memorial Hospital, “it’s relatively rare — 30,000 to 40,000 people get it every year. Yet it’s a very significant health care cost, per patient, because of all the chemo, all the treatments, the MRI scans.”
     An expensive, deadly illness, one that kills patients quickly, usually within a year to 16 months after it’s detected.
     “We have made no progress in this disease in the 20 years I have been in neurology,” Parsa said. “We haven’t moved things forward in terms of therapies. We have made some minor advances, but haven’t found any home run drugs or approaches.”
     Not yet. But that might change soon.
     Parsa is conducting a major study for the National Cancer Institute, treating brain tumors not just with the traditional surgery, radiation and chemotherapy, but with a vaccine formed from material taken from the cancerous tumors themselves, which range from the size of a cherry to a grapefruit. The vaccine is designed to keep cancer from recurring and shift it from a terminal to a treatable chronic condition, like diabetes.
“When we talk about vaccines, we think mumps, measles, rubella,” Parsa said. “With this type of vaccine, what we can do is disrupt the tumor from coming back, in a specific, nontoxic way. We [cut out] the tumor, ship it to a laboratory, they make a vaccine that is tumor-specific, patient-specific.”
The vaccine process is not new. Scientists have created anticancer vaccines using a variety of substances — the patient’s blood, for instance, or particular proteins. But this approach creates a wider-ranging vaccine, providing hundreds of antigens to provoke an immune response against this cancer.
     Since 2006, Parsa has been conducting the largest randomized brain tumor study ever funded by the NCI. “It’s a tribute to the validity of the approach,” he said.
     In February, Parsa gave the first injection to Phil Ashbach, 67, a hot dog stand owner — Phil’s Last Stand, 2258 W. Chicago — who last summer noticed something odd.
     “Smells,” Ashbach said, “that weren’t accurate. Smelling things that didn’t exist.”
     Phantom smells can be a form of seizure. After experiencing eight or 10, he phoned his brother, a doctor, who told him to go to the emergency room immediately.
     Ashbach was diagnosed with glioblastoma multiforme, a particularly fast-moving, deadly, treatment-resistant brain tumor that usually kills in three to nine months.
     He had two surgeries to remove the cancer, then began the experimental treatment.
     Is facing brain cancer scary?
     “I’m not really scared much,” Ashbach said. “I get melancholy a fair amount. I get sad. I worry about my family. ” He has four sons; his ex-wife died of cancer 18 years ago. “I’ve had a little bit of bad luck lately.”
     It is still early to know whether his luck is about to change. In phase II of the Northwestern clinical study, only 30 percent of the patients receiving the new vaccine lived a year which, considering the lethal form of cancer, Medical News Today considered a “promising” outcome.
     “This is the final step in getting the drug approved by the FDA,” Parsa said. “It’s safe to say that in two years we will have some results. We will have an answer one way or another.”
     The hope is they will have a treatment that works better and isn’t as toxic as chemo or radiation.
     “That’s part of the reason why we’re so excited about it,” Parsa said. “Our hope is that people move forward, that we create long-term quality of life with minimal toxicity. This is a clinical trial, we don’t know yet the result. This particular therapy, this vaccine, it’s like climbing a mountain. As we get higher up, we set up a new base camp, then we regroup and climb even higher. This particular vaccine gets us a base camp high in the mountain.
     “This vaccine has the potential to be part of a treatment that will be a home run,” he continued. “This vaccine can turn a terminal disease into a chronic disease. I don’t say ‘cure,’ but just like diabetes, just like heart disease, something we can live with.”
     I assumed that brain cancer patients, facing swift death, might be eager to take part in his study and thought I should give Parsa a chance to wave them off, because of course he wouldn’t want to be inundated. Wrong.
     “We need more brain cancer patients,” he said. “Tell them to call Dr. Parsa.”
     I warned him that if I wrote this, people would call him for help.
     “They do it every day,” he said.

1 comment:

  1. Parsa just passed in april 2015, just saw it in obit today- you'd think they could save him


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