Drug that illuminates brain tissue advances treatment for cancer patients. By Crystal Chew
Last year, Shawn Monti and his wife, Kathy, drove two hours from their home in Port St Lucie, Florida, to the University of Miami Sylvester Comprehensive Cancer Center in complete silence.
Shawn, 46, father of five, had just been diagnosed with glioblastoma, a fast-growing brain tumour. Doctors told him he had six months to live.
Today the Palm Beach County sheriff’s deputy is alive and hopeful after undergoing surgery at Sylvester in which doctors injected sodium fluorescein, a US FDA-approved drug that illuminates brain tumour tissue, making it glow neon green under a UV light. This helps doctors delineate the good tissue from the cancerous tissue, which can be difficult to discern in the brain’s complex folds.
Dr Ricardo Komotar, the surgeon who performed the procedure on Monti, said this type of technology is a “game changer” for brain tumours, especially with tumours located in critical areas like Monti’s. His tumour was next to his motor strip, part of the brain’s frontal lobe that controls movement.
“The goal is to take out as much of the tumour as possible, while leaving as much healthy tissue (as possible) behind,” said Komotar, an assistant professor of neurological surgery and co-director of Surgical Neuro-oncology at Sylvester. “I think if you don’t have this technology, you’re not going to be as aggressive as you’d like.”
Sodium fluorescene has been used for more than a decade, primarily in eye treatments. Only recently, however, has it been used by surgeons for treating brain tumours. With recent studies showing success in this field, doctors at Sylvester believe it will become the standard of care for brain tumours.
Removing as much of the tumour as safely as possible is key to maintaining the quality of life.
“It’s just another piece of the pie,” said Komotar, who performed the three-hour operation while Monti was under conscious sedation, a combination of sedatives and anaesthetics to help the patient relax (sedative) and block pain (anesthetic). This allowed the doctors to monitor his motor functions and strengths. “You need to have a comprehensive approach to these tumours.”
Without the sodium fluorescein, Monti likely would not have undergone brain surgery, other than a biopsy, because Komotar said it would have been too difficult to differentiate between the healthy cells and the tumorous ones. As a result, chemotherapy would not have been that successful in eradicating the tumour.
Today, an MRI scan does not show any evidence of the tumour. But Monti’s battle with glioblastoma is not over. He will continue to receive radiation and chemotherapy to help prevent the tumour from recurring.
“I feel great,” said Monti, who jokes when he sees video footage of his surgery. “Here’s proof that I have a brain. It’s been called into question many times.” — Miami Herald/TNS
TURNING POINT: Palm Beach County Sheriff’s Deputy Shawn Monti was referred to Ricardo Komotar, assistant professor of neurological surgery and co-dire
