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The expert explains: the way to fight brain metastases - voila! health

2022-11-28T09:09:05.890Z


Brain metastases are common among lung cancer patients. The treatment of these patients is challenging, but in recent years new therapeutic approaches have been developed that manage to achieve control of the disease for a long time


In the video: Prof. Amichai Meirovich on the brain metastases (edited by: Dina Mahfuts)

The treatment of lung cancer patients has undergone a revolution in recent years.

Diagnostic capabilities have improved, new therapeutic approaches have been added to the doctor's toolbox, and treatments adapted to different types and stages of disease have been developed.

Thanks to this, there has been an improvement in the life expectancy of lung cancer patients, even in those with brain metastases.



In lung cancer, brain metastases are more common than in other tumors and appear at diagnosis in about 30% of patients.

Among patients with certain mutations such as EGFR or ALK, the incidence is even higher.



"Every tumor tends to send some of its cells into the bloodstream and we know today how to follow these cells. Sometimes these cells are able to develop independent growth and this is called metastasis," explains Prof. Amichai Meirovich, director of the oncology department at Soroka Hospital.

"Once there is cancer in the lung, the suspicion that brain metastases can develop is high."



In the past, the brain metastases would only be diagnosed based on symptoms such as paralysis on one side, weakness in the hand, leg or face, signs of confusion, vague consciousness, injury to a healthy body, etc. and then the patient would be sent for brain imaging and try to locate the metastases.

"In 20% of the cases, it will be discovered as a brain symptom. That is, the patient will come with complaints of a brain problem and they will be diagnosed with lung cancer," explains Dr. Mayirovich. In order to detect small and treatable metastases even before the patient becomes symptomatic.



" "The brain is a closed box.

The brain is encased in bone and any increase in volume inside the brain can harm the patient," explains Prof. Meirovich. "When there is a metastasis, it can cause an increase in volume, pushing the normal brain tissues.

The brain is our control box and therefore the metastasis may damage cognitive-thinking functions."



The treatment of lung cancer with brain metastases is challenging in several aspects.

The brain is a sensitive organ and first and foremost it is necessary to avoid harming it during the treatment of metastases.

In addition, most drug treatments fail to penetrate the brain tissue, due to the presence of the blood-brain barrier (Blood Brain Barrier). This mechanism is designed to protect the brain tissue from the penetration of toxins, but works to our detriment, when it prevents the passage of most of the drugs used to treat cancer.

"Not everything that flows in the blood can reach the brain," explains Prof. Meyerovich.

"The brain is protected by the body to receive only substances that need to be accessed. Unfortunately, large molecules do not manage to penetrate the brain."

The good news is that in recent years a number of treatments have been developed that have the ability to penetrate the brain, which have resulted in an improvement in the response to drug treatment and in the patients' life expectancy.

Biological drugs for lung cancer patients with mutations, especially EGFR or ALK are a significant new line in the treatment of brain metastases.

Some of these drugs have proven

Unlike most existing treatments, you were able to penetrate the blood-brain barrier.

In fact, with those drugs, the effectiveness in the treatment of brain metastases is no less than the effectiveness in the treatment of the rest of the body.



Brain metastasis can cause functional impairment and edema, therefore it is very important to treat brain metastases.

Planning the treatment of brain metastases includes a number of approaches adapted to each individual case: surgery, radiation therapy (radiotherapy) and, as mentioned, treatments with new generation biological drugs that can penetrate the brain.

The treatment is done with one of the approaches or a combination of them.



"In the past, in cases of brain metastases, it was customary to operate, if it was possible, and then to irradiate the entire brain," explains Prof. Meirovich, "One of the limitations of this method is that you cannot reach very high levels of radiation and you have to make do with a medium level of radiation, which is not always effective. In addition The patients may pay the price of cognitive impairment for this, such as a decrease in short-term memory, impaired thinking, and the like."

Today, there is another treatment option for brain metastases, which is through focused radiation to the brain.

This is a treatment that is usually provided in a one-time, non-invasive manner, in which a small volume of the brain is irradiated at a high intensity.

With this method, only metastases that can be seen on imaging are treated, and in most cases the risk of cognitive impairment is low.



So can we say that there is significant progress in the treatment of brain metastases?



Unequivocally yes," says Prof. Meirovich. "Both the radiation treatments and the drugs that penetrate the blood-brain barrier are certainly significant news that contribute a lot to our treatment and this is something that was not the case before."



To join the Facebook group "Friends of breathing" of the Israeli lung cancer association - Click here


to read news and publications, receive support and useful information on the website of the Israeli Lung Cancer Association - click here



sponsored by AstraZeneca. No involvement in the content

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Source: walla

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