Renowned Senator draws attention to glioma


Glioblastoma is in the headlines these days thanks to a certain Senator from Arizona recently diagnosed with the disease.

John McCain, 80, arrived in Washington, D.C., to place a key vote last week, bandage still affixed to the site where surgeons worked to removed a brain tumor.

Exact details of Sen. McCain’s treatment regimen are unknown. But glioblastoma is a good candidate for a new set of therapies that allow patients to be treated for the disease and maintain good quality of life.

Glioblastoma is one of four grades of gliomas. Gliomas are highly malignant tumors that originate in the brain. Referred to as primary cancer, they don’t metastasize from cancer elsewhere in the body. Grade 2 and 3 tumors tend to be found in younger adult patients. Grade 1 gliomas are typically a pediatric disease. Grade 4 tumors, also known as glioblastoma, are more likely to be found among older men. Glioblastomas make up about 15 percent of all primary brain tumors.

Patients typically undergo surgery to remove the primary part of the tumor. This is followed by radiation and chemotherapy. Testing for the cancer’s genomic classification is also becoming part of the standard of care. It is a good way to anticipate how the cancer will respond to chemotherapy and helps us determine appropriate treatment.

Proton therapy ideal for glioma

Gliomas usually infiltrate surrounding tissue in the brain. As a result, doctors must treat a significant area outside the primary tumor. Proton therapy works well for gliomas because the targeted nature of protons prevents radiation from affecting more parts of the brain than needed. For example, in one of my patients, the cancer’s reach requires treatment of approximately half the brain. Conventional treatment could expose nearly the entire brain to the effects of radiation. With protons, we target radiation treatment to exactly where it is needed.

This reduced radiation exposure affects how a patient feels during treatment. With proton therapy patients experience fewer side effects such as short-term memory loss and hair loss.

The American Society for Radiation Oncology has recently issued recommendations that gliomas be covered for proton therapy by commercial insurance. This is an important step toward making the treatment available for everyone diagnosed with gliomas. Treatment is now covered for all Medicare patients as well as some who have private policies, depending on the insurer.

At Provision, glioma patients undergo six weeks of proton therapy combined with oral chemotherapy. Afterward, they continue to take in monthly cycles, while we monitor their progress.

Option therapy a new option

In addition, Provision patients with glioma have the option of choosing another innovative treatment called Optune. With this noninvasive technology, patients wear a lightweight headpiece and carry a binocular-sized device that generates alternating electric current. The current prevents cancer cells from dividing in the brain and helps keep cancer regrowth at bay.

Like proton therapy, Optune treatment targets cancer and spares healthy cells. Provision is the only cancer center in in our area offering these two innovative treatments together.

Provision CARES Proton Therapy Center features state-of-the-art technology including pencil beam scanning, which allows more precise targeting of the tumor or cancer, sophisticated treatment planning and management software and innovations. Proton treatment can be combined with chemotherapy and biological treatments, depending on the cancer type, to provide better outcomes with less tissue damage. Provision CARES Proton Therapy Center is located in Knoxville, Tennessee on the Dowell Springs Campus.