IHC hotline to tackle brain cancer

Surgery remains the staple treatment for brain cancer and its success depends on many things, including location and size of the tumor. Most stage 1 and 2 tumors can be removed, although doctor and patient may opt for chemotherapy or radiation instead with these low-grade tumors, allowing surgery to be postponed.

Sometimes a brain tumor is destroyed with a device called a Gamma Knife, which uses tightly targeted radiation to "cut out" a tumor in a surgery that never opens the skull and involves no incision. A specially designed helmet is fixed to the patient's skull so the brain tumor is stationary at the target point of the gamma rays. The cancerous cells receive a killing dose of radiation in a single treatment, while surrounding brain tissue receives much less radiation.

But for high grade tumors, there are no really significant breakthroughs, according to Dr. Ali Choucair, Utah's only neuro-oncologist, who practices at LDS Hospital.

"Right now, there are a significant number of research projects going on trying to improve outcomes of these patients, so we do maybe minimally better than we did in the past with patients with malignant grade 3 or grade 4 tumors," he said.

Choucair and Dr. William T. Sause, who is director of cancer services for Intermountain Healthcare and chief of oncology at the Jon and Karen Huntsman Center at Intermountain Medical Center, are featured today on the Deseret Morning News/Intermountain Healthcare Hotline from 10 a.m. to noon. They'll answer questions about brain cancer symptoms and treatments.

Brain tumors are classified as low-grade, intermediate grade and high grade. "Within that big basket, there are a lot of different types," said Sause, "because every type of cell in the brain can become a malignant tumor," although brain tumors are relatively rare. Overall, the five-year survival rate for brain cancer is only about 30 percent.

Some tumors are inoperable. "The highly malignant ones are generally almost impossible to remove completely with surgery," Sause said. And some are located in parts of the brain that can't be reached without creating devastating damage from the surgery itself.

If there's a clinical trial that looks promising, both doctors are apt to enroll their patients in it. "LDS Hospital is one of the top 20 institutions in putting brain cancer patients on clinical trials to learn answers," he said.

Cure rates for high-grade tumors are still dismal, hovering around 5 percent. With low-grade tumors, a patient could live many years, even decades, said Choucair. "Some grade 2s are more favorable than others." With one type of glioma, for instance, "patients do remarkably well."