Ask the Expert: Questions and Answers about Brain Tumors

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Lakshmi Nayak, MD, with Dana-Farber's Center for Neuro-Oncology

Lakshmi Nayak, MD

Dana-Farber Cancer Institute recently partnered with CancerConnect and Lakshmi Nayak, MD, to answer questions about brain cancer. Nayak is a neuro-oncologist in the Center for Neuro-Oncology at Dana-Farber/Brigham and Women’s Cancer Center and an instructor in neurology at Harvard Medical School. 

Q: There seems to be some progress concerning treatment of brain tumors, especially immunotherapy. Do you think we will see further advancements in that area, or in other areas?

A: Immunotherapy is indeed a hot topic in gliomas. This is largely driven by advances we have seen in the treatment of melanoma. The way these drugs work is to release inhibition of the immune system so the immune cells can recognize cancer cells and attack the tumor. These advances are promising, and we hope this avenue of research will soon extend to gliomas. Development of trials in this direction is currently underway, and we anticipate the trials will open within the year or so.

In the last few years, we have seen a significant amount of progress in understanding glioma biology, including the mechanisms of tumor growth and resistance to treatments. Current research is focusing on treatment targeting specific pathways. It is difficult to envision which specific pathway or target will reveal the answer. It may be a combination of a few different targeted therapies, rather than one approach.

Q: Is it important for a neuropathologist to look at my pathology?

A: Glioblastomas are rare tumors, and it would be ideal for a neuropathologist who is familiar with looking at these types of tumors to review the pathology. I would definitely encourage review by a neuropathologist if it has not been done. I would suggest this be done in a large academic institution or cancer center with a division of neuro-oncology that has a dedicated neuropathologist.

Q: Can you point to any peer-reviewed articles on diets or foods that support brain health?

A: Articles published in the American Journal of Clinical Nutrition would be reliable and helpful to read. If you read of any trials that were conducted, please check and make sure they are registered in www.clinicaltrials.gov.

Most major cancer institutions have a dedicated integrative medicine department with nutritionists who can help guide and make individualized plans. There are typically several aspects to consider regarding diet and supplements for brain tumor patients, and it is helpful to get advice from a nutritionist who is familiar with this.

Some articles to read:

Q: If a parent had a glioblastoma multiforme, are their children at greater risk for a brain tumor? Are there any genetic or other tests that the children can take to see if they are at risk?

A: Only a small percentage of GBMs are familial; the majority are not. Are there other types of cancers in your family, such as breast or ovarian? If so, I think it would be worthwhile to get genetic testing and see a geneticist.

Read more questions and answers about brain cancer.

Please note that this Ask the Expert Q&A is not intended to be a substitute for medical advice, diagnosis, or treatment. Speak to your doctor or care team about any questions you may be having about your health.

4 comments

  1. Elaine says:

    My husband was just diagnosed with dementure caused from the radiation to the brain for his glioblastoma. Can you give me any information on this? Is this a different kind of dementure than what older people get? Will it get bad at a faster rate then regular dementure?

    • Dana-Farber says:

      Dear Elaine–

      Thank you for your comment. I’m sorry to hear of your husband’s challenges. Questions like the ones you ask are very important ones to bring up with his oncologist. Unfortunately, we can’t give out medical advice over email (or via this blog). You might request a second opinion from Dana-Farber. Or you could consider joining CancerConnect, a secure online community where patients share stories and tips. Through this community you might benefit from another patient’s experience managing glioblastoma.

      With very best wishes to you and your husband.

  2. Atdhetare says:

    Hello! My 13-year-old sister was diagnosed with a brain tumor this March in the third ventricle. The first pathology said it was a Typical Central Neurocytoma WHO Grade II. I wanted a second opinion so I sent the pathology slides to another center and their result was an Atypical Central Neurocytoma WHO Grade III. I then sent it to another well known center and their findings were that it was a Ganglioglioma WHO Grade I. I am very proactive in getting second opinions but I was very defeated when none of the pathology results agreed with each other, not even in the WHO Grade of the tumor. DO you have any advice?

    Thank you,

    Atdhetare

    • Dana-Farber says:

      Dear Atdhetare–

      Thank you for your comment. I’m so sorry to hear of your sister’s diagnosis. I understand your frustration, but unfortunately, we can’t give out medical advice over email (or via this blog). If would like another opinion, you can request a second opinion from Dana-Farber.

      With very best wishes to you and your sister.

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