Newer treatment options for brain cancer could be nanoparticles to deliver chemotherapy agents to the tumour area. Another area is immunotherapy because it uses the body's own natural responses to get the immune system to recognize and fight cancer cells. Virus vectors for gene therapy and cancer vaccines are therapeutic modalities which are still under trials for this condition, said Dr. Sunil Furtado, Senior Consultant, Neurosurgery, Cytecare Hospitals.
Use of nanoparticles to deliver chemotherapy agents to the tumour area will change the way of cancer treatment. “Currently, there are a variety of treatments to treat brain tumors which depends on the size and type of the tumor, its growth rate, location and the general health of the patient. Some of them are: cytostatic drugs which alter the biological environment of the tumour like bevacizumab. Then there is Gliadel wafer laden with a chemotherapeutic agent known as Carmustine which diffuses into the operative region and kills residual tumour cells. Temazolamide is also used as a cytotoxic drug which alkylates DNA in tumour cells. Stereotactic radio surgery and cyberknife radiotherapy are the treatment options for localized brain cancer disease,” he added.
The incidence of brain tumours in India is about 2 to 3 patients per 100,000 population, while the mortality rate is a little less than 2 patients per 100,000 population. The incidence in pediatric population is about 0.8 to 1 case per 100,000 children.
“However the biggest challenge in brain cancer is early diagnosis. What makes this difficult in principle is the paucity of screening tests to detect brain and spinal cord tumors unlike cancers of the colon, breast etc. Most brain tumors are detected when a person consults a doctor due to persistent discomfort and experience severe headaches, blurred vision, loss of balance, confusion and seizures. The cause of brain cancer is largely unknown. There are both genetic and viral factors related to its cause, but it does not discriminate in terms of gender,” Dr. Furtado told Pharmabiz.
In India, there are a lot more centers which have come up to provide diagnosis and treatment of brain cancer in the last decade. Research into brain cancer genetics and targeted chemotherapy based on tumour genetics is carried out across the country including the Indian Institute of Science, Bengaluru.
A major issue that the treatment costs including diagnosis, surgery and adjuvant therapy like radiation and chemotherapy are beyond the reach of many. Insurance coverage in India is not universal, unlike the West. Therefore out of pocket payments in India leads to many treatment defaulters. Access to the latest technologies to manage such cases is limited to comprehensive oncology care centers. Psychological counselling of the patient and relative during and after treatment and hospice centers for palliative care are few and far between. To add to the challenge is that India currently accounts for 2,000 oncologists . The specialist-patient ratio is pegged at 1: 2000 cancer cases.