Navigation Links
Experts cite 'misconceptions' on brain metastases
Date:6/24/2014

June 24, 2014 "Key historical misconceptions" are hindering progress in research and treatment for patients with cancer metastases to the brain, suggests a special article in the July issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Dr. Douglas Kondziolka of NYU Langone Medical Center and coauthors identify some issues that may be standing in the way of optimal clinical management for patients with cancer that has spread to the brain from other sites.

'All Brain Metastases Are Created Equal'and Other Misconceptions

Brain metastases are an important problem in cancer treatment, but one for which there are relatively few well-designed clinical trials. That partly reflects an "often nihilistic" viewpoint, given that survival is relatively short for many patients with brain metastases.

But a few key studies provide answers to some important questions on the benefits of specific treatments. At a time of rapid progress in cancer care, Dr. Kondziolka and colleagues highlight five misconceptions that, in their view, must be overcome to advance treatment for patients with brain metastases.

The first misconception is assuming that "all histologies are created equal"that the type of cancer doesn't matter once it has spread to the brain. Historically, studies have included any and all patients with brain metastases. But that may overlook important differences between brain metastases from different types and sites of cancerfor example, lung cancer, breast cancer, or malignant melanoma.

Likewise, there's no basis for the assumption that the number of brain metastases is the sole factor determining patient outcome. Rather, Dr. Kondziolka and coauthors believe the focus should be on the total tumor burden, including the size as well as the number of metastases.

Similarly, some doctors hold the misconception that there's no such thing as a single metastasisthat if one lesion is present, there must be others as well. But that's contrary to strong evidence that treatment for single brain metastases can improve tumor control and patient survival.

Doctors may also believe that treatment with whole-brain radiation therapy (WBRT) inevitably leads to declines in cognitive (intellectual) function. Dr. Kondziolka and coauthors emphasize that, as for any treatment, the risks and benefits of WBRT must be considered for each individual patient. Studies are underway to clarify the cognitive effects of WBRT, with the goal of balancing cognitive functioning with tumor control.

Finally, there's an outdated assumption that since most brain metastases are symptomatic, there's no major benefit of screening tests for early detection. But with increased use of magnetic resonance imaging, metastases are now being detected before they cause any symptoms. Previous studies of larger, symptomatic metastases may not apply to these smaller, asymptomatic lesions.

"Especially in this era of increasingly personalized medicine, one-size-fits-all thinking is improper, especially for a diagnostic entity as wide and varied as brain metastasis," Dr. Kondziolka and coauthors write. Their article includes some recommendations for future trials of brain metastases, including patient-related factors, such as the need for formal measurement of cognitive function; and tumor-related factors, such as studies focusing on a single tumor type and considering the total tumor burden.


'/>"/>

Contact: Connie Hughes
Connie.Hughes@wolterskluwer.com
646-674-6348
Wolters Kluwer Health
Source:Eurekalert

Related medicine news :

1. Citing urgent, acute mental health issues, especially in Africa, experts petition govts to act
2. Experts recommend blood, urine testing to diagnose rare adrenal tumors
3. Nutrition experts: Debate over value of vitamin, mineral supplements is far from over
4. Nationally-recognized health policy researchers and experts convene in San Diego June 8-10
5. Could cannabis curb seizures? Experts weed through the evidence
6. Experts question routine mammograms in elderly
7. Eye health experts come together to boost fight against avoidable blindness
8. Sacramento Acupuncture Experts Tian Chao Herbs and Acupuncture Help Customers Stay Healthy With Herbal Medicine, Traditional Chinese Medicine, and Acupuncture
9. Pediatric HIV/AIDS experts to present at 17th Intl Conference on AIDS and STIs in Africa
10. Nutrition experts explore dietary approaches that influence type 2 diabetes risk
11. Quality of Healthcare Experts Continue To Try To Put A Square Peg Into A Round Hole
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 27, 2016 , ... Quality metrics are proliferating in cancer care, and ... in the eye of the beholder, according to experts who offered insights and commentary ... of Managed Care. For the full issue, click here . , For the ...
(Date:6/26/2016)... ... June 26, 2016 , ... Many women are ... with endometriosis. These women need a treatment plan to not only alleviate symptoms ... can help for preservation of fertility and ultimately achieving a pregnancy. The specialists ...
(Date:6/25/2016)... ... June 25, 2016 , ... First Choice Emergency Room , the largest ... as the Medical Director of its new Mesquite-Samuell Farm facility. , “We are ... Mesquite location,” said Dr. James M. Muzzarelli, Executive Medical Director of First Choice Emergency ...
(Date:6/24/2016)... ... June 24, 2016 , ... A recent article published ... unfamiliar with. The article goes on to state that individuals are now more comfortable ... less common operations such as calf and cheek reduction. The Los Angeles area medical ...
(Date:6/24/2016)... ... June 24, 2016 , ... Global law firm Greenberg Traurig, P.A. announced that ... chosen by their peers for this recognition are considered among the top 2 percent ... special honors as members of this year’s Legal Elite Hall of Fame: Miami ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... 24, 2016  Arkis BioSciences, a leading innovator ... more durable cerebrospinal fluid treatments, today announced it ... funding is led by Innova Memphis, followed by ... private investors.  Arkis, new financing will accelerate the ... market release of its in-licensed Endexo® technology. ...
(Date:6/23/2016)... DUBLIN , June 23, 2016 ... "Dialysis Devices Global Market - Forecast to 2022" report ... is the treatment method for the patients with kidney failure, ... and excess fluid from the patient,s blood and thus the ... sodium, potassium and chloride in balance. Increasing ...
(Date:6/23/2016)... 23, 2016 Research and Markets ... Market by Type (Organic Chemical (Sugar, Petrochemical, Glycerin), Inorganic ... Coating, Parenteral) - Global Forecast to 2021" report ... The global pharmaceutical excipients market is projected to ... of 6.1% in the forecast period 2016 to 2021. ...
Breaking Medicine Technology: