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Device can give glioblastoma patients extra months

The Ledger

Glioblastoma is an aggressive cancer with a high recurrence rate, even after surgery, radiation and chemotherapy. But Polk experts say a device called Optune can give patients more time, and with minimal side effects.

Glioblastoma is an aggressive cancer with a high recurrence rate — even after surgery, radiation and chemotherapy.

The length of life expected isn’t good for most people diagnosed with that highly malignant brain tumor.

By the time symptoms appear, the tumor typically is already entrenched. Symptoms appear when the tumor’s growth causes pressure in the brain.

Glioblastoma multiforme surfaced dramatically for Haines City resident Bruce Holt’s late wife, Janice, with whom he celebrated a 46-year anniversary before her death May 25 at age 67.

“One Monday she was working on her computer and she couldn’t think,” he said. “She didn’t know how to log in, didn’t know what town she lived in or her birthdate.”

Lack of early symptoms and the tumor’s tenacious spread make it difficult for surgeons to remove all the cancer.

“It’s out of control by the time we get to it,” said Dr. Inder Bhutiani, the radiation oncologist at Winter Haven Hospital who treated Holt.

“It’s pretty large. It has so many tentacles.”

About 13,000 glioblastomas or tumors that may grow into one are diagnosed each year.

Many who have it die in less than two years. The late Sen. John McCain fought it for 13 months before dying in August 2018.

Those bleak factors make each added month of life precious, especially if they can be obtained with minimal side effects.

That’s where Optune, a device creating low-intensity, wave-like electric fields called tumor treatment fields, comes in.

Delivered through patches attached to the scalp, in a pattern determined by the tumor’s location, the treatment interferes with tumor cells’ ability to divide and spread. The patches, called transducer arrays, are powered by a connection cable and box, which are powered by a battery, according to Novocure, the oncology company behind it.

This is in addition to the array of surgery, radiation and chemotherapy for first-time glioblastoma multiforme patients 22 or older.

Optune offers new hope by adding months, at times a year or more, of life without significant side effects, said Bhutiani and Dr. Nitesh Paryani, a radiation oncologist at Watson Clinic.

Their facilities are among 800 or so Optune centers nationwide.

Optune has made the biggest difference in survival rates since chemotherapy joined the treatment package, Paryani said, adding that he initially was “very skeptical” of Optune.

He used it in Jacksonville in 2016 before coming to Lakeland, where he urged Watson Clinic to let him make the device available. It became available at the clinic in November.

“My longest survivor went 2 ½ years,” Paryani said.

Bhutiani has made Optune available through Winter Haven Hospital since being certified in its use in July 2018.

One of Bhutiani’s patients, who went on Optune in October 2018, was alive in January 2020, 15 months later, he said.

A study of almost 695 first-time glioblastoma patients found those receiving chemotherapy and Optune together had a 13 percent survival rate at five years compared to 5 percent for chemotherapy alone.

After two years, 43 percent using Optune and chemotherapy were alive compared to 31 percent on chemotherapy alone.

Bruce Holt said he thinks Optune made a major difference for his wife. The couple were told she could expect to live 10 months to 12 months after surgery removed as much tumor as possible.

Instead, she lived from November 2017 until May 25, 2019, despite new glioblastomas being discovered in October 2018, Bruce Holt said.

“She lived 18 months, which is six months longer than the doctor (first) diagnosed,” said Holt, who moved to Haines City with his wife in 2014.

Not long before her death, she went to an amusement park in Orlando and on a trip to Clearwater, he said. She continued going out on their boat, complete with patches and the battery pack.

Optune needs to be used at least 18 hours a day, with longer times even more effective.

The system weighs 2.7 pounds. Its battery can be placed in a backpack or shoulder pack and the patches covered by a wig or cap.

Optune is paired with a chemotherapy drug called temozolomide for newly diagnosed GBM. If a tumor comes back, it can be used as an alternative if other treatments haven’t worked.

Patients tolerate it well, both radiation oncologists said.

The head needs to be shaved a couple of times a week and electrodes shifted every few days, Paryani said.

Some doctors remain skeptical of Optune’s long-term potential. Others, like these local doctors, find the results promising.

“The disease is so deadly anything that can improve it is well worth it,” Bhutiani said.

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