Innovative Therapy Keeps Brain Cancer in Check


Moakley in TImes SquareIn June 2015, while gearing up for a summer of socializing, golfing and boating, Jack Moakley was diagnosed with glioblastoma. The common, aggressive and difficult-to-treat brain cancer has no known cure.

Earlier that year, he had noticed that he’d begun to drift to the left side of the road while driving. There were other unexplained symptoms, too: anxiety, coordination issues and a ghost taste and smell.

Moakley, 61 and a Falmouth resident, saw a neurologist at BIDMC. After a series of tests that pointed to glioblastoma, neurosurgeon Ekkehard M. Kasper, Ph.D., M.D., Co-Director of the Brain Tumor Program at the Cancer Center at BIDMC, performed surgery to remove a “lemon-sized” tumor from Moakley’s brain. The surgery was followed by radiation and chemotherapy.

 

Common Brain Tumor Type

Glioblastoma is the most common type of primary brain cancer in adults, representing about a third of the 24,000 malignant tumors of the brain or spinal cord diagnosed each year. It may spread quickly because it’s close to a large network of blood vessels in the brain.

As often happens with glioblastoma, Moakley’s tumor had invaded the brain and could not be entirely removed. His care team discovered that the tumor was growing again.

Neuro-oncologist Eric T. Wong, MD, Co-Director of the Brain Tumor Program at the Cancer Center at BIDMC, suggested a change in tactics: Tumor Treatment Fields (TTFields). This form of electromagnetic therapy was approved by the FDA for use in recurrent glioblastoma in 2011.

Unlike chemo, which impacts the entire body--healthy cells and tumor cells, TTFields is a localized treatment with low-intensity electrical waves that in themselves cause virtually no side-effects. The electrical waves affect only tumor cells as they divide and reproduce. The waves are delivered through an unusual cap-like system, which contains wires and electrodes applied to a shaved head.

Extending Survival

Although some doctors debate the effectiveness of TTFields, research in which Wong has participated indicates that the therapy extends the median survival of people with glioblastoma by five months and can stabilize the disease for as much as two years.

The treatment sometimes concerns patients because it must be worn at least 75 percent of the time. It can cause skin irritation, difficulty sleeping and bathing and concern about one’s appearance.

“You just have to ask yourself, if this thing can save or extend your life, is it worth it?” said Dr. Wong. “I cannot make that decision for you, and some individuals cannot get over the inconveniences and impacts of the treatment. But that is okay, I will find other solutions for them.”

Moakley set the concerns aside and never looked back. After nearly two years, his condition is stable. He continues to have MRIs every three months to check for tumor growth and returns to BIDMC biweekly for chemo infusions. He developed a collection of cool skull caps and again works, socializes, walks, bikes and golfs. He has even returned to his ultimate “happy place,” his boat, suitably named All In.

Once you get used to TTFields, Moakley said, “Life can be anything you want it to be. The only limitation is your mind.”