Thursday, February 14, 2013

The Blood Brain Barrier

The brain is protected by allowing only some substances to enter it. Unfortunately, this barrier (BBB) does not stop cancer from spreading to it.
Herceptin has been a life saver to those with breast cancer with the gene that makes multiple copies of the oncogene Her2 (around 20-25%). In the past, this cancer was especially aggressive but early treatment with Herceptin has stopped it in its tracks. Herceptin does not prevent brain mets however. I believe there is an analog now used to treat brain mets.

Unfortunately most anticancer drugs do not go into the brain. It is possible to disrupt the BBB by introducing a reservoir that contains the treatment. Single tumors can now be cut out with the CyberKnife which focuses radiation on the tumor itself sparing the area around it. Traditional surgery is not so focused sometimes doing more damage than it solved.  CyberKnife would have saved my former boss who died from a benign brain tumor. (What is wrong with that statement? Medically benign is not the same as the traditional use of benign. Although benign tumors do not spread, they do grow causing damage).

In my Cooking for Survivors class last fall, there was a woman with a stage 4 cancer on her last resort experimental  drug to treat her. The side effects were intolerable and as it turns out, this drug did not stop brain mets. That day she had made the difficult decision to abandon treatment, which would mean death soon by her cancer. Then there was no back-up drug she could take. She seemed doomed and I didn't see her again until yesterday. A new experimental drug emerged since then. She is one of the first humans on it. So far her mets have not grown and there are no unpleasant side effects. Furthermore, it has kept her brain mets in check. She has enough energy for exercise classes. The drug is made by a very small American company. Should we invest in this company?An orally active drug that crosses the BBB is so rare in cancer treatment. I have to figure out how large the market is. I am not so familiar with her particular sub-type of lung cancer. Lung cancer kills more people than breast cancer but it does not seem to have its own month and ribbon color (that I am aware of) Maybe people just blame the victim.

The days are quickly getting longer and longer. Spring seems closer. I was able to run in relative warmth and sunshine yesterday. We had a visit from Josh yesterday as he needed help in dealing with negotiations for his new home. And Maya and Naomi were here too.

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