SVMC adds new tool in treatment of brain cancer

Tumor-treating fields promises to increase length, quality of life

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BENNINGTON — A new way to treat brain cancer has arrived at the Southwestern Vermont Regional Cancer Center. The treatment is called tumor-treating fields, and it uses alternating electrical fields to target cancer cells. Although the treatment may seem like science fiction, its potential to help patients is an electrifying reality.

Tumor-treating fields treatment is "a whole new tool in the tool box," Dr. Matthew Vernon, the radiation oncologist at the Cancer Center. For decades, surgery, radiation and chemotherapy were used to treat brain cancer. Now, tumor-treating fields has been added to the mix.

Traditional cancer treatments, like chemotherapy and radiation, "[make] people live longer at the expense of horrible illness and toxicity," Vernon said. To Vernon, what's exciting about tumor-treating fields is how it can improve the quality of life for patients.

"[It] is so dramatically better than what was the previous standard of care" for brain cancer, he said.

In addition to increasing the quality of life, tumor-treating fields has the potential to increase the duration of someone's life, Vernon said.

Tumor-treating fields has been FDA approved to treat a specific type of brain cancer called glioblastoma multiforme, or GBM. The National Comprehensive Cancer Network guidelines adopted tumor-treating fields in 2015 to treat recurring glioblastoma multiforme and in 2016 to treat primary, or newly diagnosed, glioblastoma multiforme.

SSVRCC is the second center in the state to offer the treatment, after University of Vermont Medical Center, which began offering it in 2015. In the past few months, tumor-treating fields was used for the first time through Southwestern Vermont Regional Cancer Center. Vernon declined to comment on how the treatment is working, to protect patient privacy.

Glioblastoma multiforme is the most common and most deadly form of primary brain cancer in adults, according to the National Brain Tumor Society's website. For those diagnosed with GBM, the website cites the median survival rate of about 15 months.

"Each year, approximately 30 Vermonters are diagnosed with glioblastoma," wrote Jennifer Kachajian, a public health analyst with the Vermont Department of Health, in an email.

"On average, there is one newly diagnosed case of glioblastoma each year in Bennington County," Kachajian wrote.

Five years after a glioblastoma multiforme diagnosis, about 5 percent of patients remain alive, Vernon said. Citing the study that propelled tumor-treating fields into cancer treatment guidelines, Vernon said that using tumor-treating fields can increase the five-year survival rate to about 13 percent.

"There was a time where GBM was an absolute death sentence and we're starting to see some long-term survivors," Vernon said, adding that tumor-treating fields is a part of that change.

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Put on your electrical cap

Tumor-treating fields is a non-invasive treatment that consists of a series of low-intensity, alternating electrical fields that target and disrupt cell division. The electrical fields can target cancerous cells because they undergo cell division more rapidly than healthy brain cells, which do not undergo cell division frequently, Vernon said.

To receive treatment, patients wear a transducer array, or a cap made up of a collection of stickers that create electrical fields. The stickers are similar to those used in other medical procedures, like an electrocardiogram, or EKG.

"The tumor-treating fields continues until it's not working anymore," Vernon said, adding that according to a study, patients use the treatment for an average of eight months.

For the tumor-treating fields to be effective, he said, "the goal is that it's on 75 percent of the time."

The major negative side effect of tumor-treating fields is skin irritation where the stickers are placed, he said.

The electrical field is battery-operated and patients can wear the transducer array for many daily activities, except for showering.

Tackling the beast of brain cancer

Although there's a new treatment in the region, tumor-treating fields won't supplant existing options.

The most important part of brain cancer treatment is surgery, Vernon said, because "the more complete removal of the tumor [is], the more people live."

After surgery, patients receive a course of radiation and chemotherapy. After radiation treatment stops, patients continue with chemotherapy for an additional six months, he said. It is during this time that tumor-treating fields is added to patients' treatment, he said.

Vernon oversees patient progress with tumor-treating fields but does not deliver the therapy. After the patient has undergone surgery, he sends MRI images of the cancer to a company called NovoCure. NovoCure uses software and the patient's images to create a map of where the transducer arrays should be placed on a patient's head, Vernon said. NovoCure representatives visit patients at home to demonstrate how each individual needs to position his or her unique transducer array, he said.

Tumor-treating fields may not stop at targeting glioblastoma multiforme. According to the NovoCure website, tumor-treating fields is in clinical trials to treat different types of cancer, including non-small cell lung cancer, pancreatic cancer and ovarian cancer.


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