<p>Dr. Greg Foltz (center) leads a demonstration during the recent Brain Surgeon for Day event at the Ivy Brain Tumor Center at Swedish Medical Center. Photo courtesy of Swedish Medical Center</p>

Dr. Greg Foltz (center) leads a demonstration during the recent Brain Surgeon for Day event at the Ivy Brain Tumor Center at Swedish Medical Center. Photo courtesy of Swedish Medical Center

<
1
2
>

Depending upon what it commemorates, the anniversary of a major event could be difficult emotionally, or inspiring and wonderful. For Kami Combes, a Queen Anne resident and married mother of two, the fifth anniversary of Swedish Medical Center’s Seattle Brain Cancer Walk this Saturday, Sept. 22, at the Seattle Center might creates a mixture of both feelings. 

“It’s been five years since my surgery, and this is the fifth-annual Brain Cancer Walk,” Combes said. 

Five years ago, Combes had a seizure, which led to an MRI scan that revealed a brain tumor. Her diagnosis was brain cancer, but she is a survivor. In fact, she considers herself and her family lucky: A biopsy showed that her tumor wasn’t the most deadly type (glioblastoma), and her neurosurgeon was Dr. Greg Foltz, director of the Ben and Catherine Ivy Center for Advanced Brain Tumor Treatment at the Neuroscience Institute at Swedish Medical Center on Cherry Hill. 

 

Smaller numbers, less funding

Foltz made it clear that Combes’ case is far from unique. More than 40,000 Americans are diagnosed with a malignant brain tumor each year, and the cause of brain cancer is an open question. There is no evidence that exposure to cell phones is a factor; in fact, no environmental causes for brain cancer have been identified. 

For patients like Combes, the first symptom is a seizure. Some patients may experience a neurologic problem, such as difficulty with vision or speech. If the cause is cancer, a biopsy determines the degree of malignancy of the patient’s tumor. 

As Foltz explained, brain cancer is particularly deadly because of its unusually rapid growth. While more common forms of cancer that progress slowly may affect several hundred thousand people each year, those diagnosed with brain cancer may live for just 18 months, the same prognosis that a brain-cancer patient had one hundred years ago. Brain cancer is so lethal that at any given time only 30,000 to 40,000 people fighting it may still be alive, Foltz said.

The smaller numbers of patients have a big effect on funding for research, Foltz said, with the lion’s share of federal dollars going to fight diseases affecting hundreds of thousands, such as lung cancer. While significant progress has been made in research to treat other cancers, Foltz reported that just three drugs to treat brain cancer have been federally approved in the last few decades, and these medications only slow the progress of the disease for a few months. 

As Foltz explained, removing the brain tumor itself, while a delicate operation, isn’t the toughest problem faced in treating this form of cancer. Inevitably, fugitive brain-cancer stem cells migrate from the tumor and are left behind after surgery, becoming resistant to treatment and stubbornly growing into new, even deadlier tumors. 

“It can be very hard to kill all of these cancer cells,” Foltz said. “We are really targeting these individual cells that are left behind, to try to develop new treatments that will either kill those cells — eradicate them, or at least inhibit them from forming new tumors. It is important for people to realize what a tremendous opportunity there is here to make a difference. All of our research right now is focused on this.” 

 

Current research

Developing effective treatment for malignant brain tumors isn’t easy. As Foltz emphasized, the genetic makeup of a brain tumor is unique to each patient. Effective treatment first requires a detailed understanding of the distinct genetic elements that make up an individual’s tumor.

“We have tools like gene sequencing that allows us to really look at how these tumors differ from patient to patient,” Foltz said. 

Foltz and his colleagues in the Ivy Brain Tumor Center at Swedish are now using gene-sequencing technology to create a massive gene atlas, a tool that will help scientists identify which genes may be active in stimulating a tumor’s growth. All data obtained by the Ivy Glioblastoma Atlas Project is being made freely available to all researchers for use in the fight against cancer.

Foltz and his team are also racing to develop a tumor vaccine that just might become a game-changer in the battle against brain cancer: a customized vaccine designed to train a patient’s immune system to target and attack specific cancer cells. 

To create this vaccine, genetically unique cancer stem cells taken from the patient’s tumor are pitted against the patient’s own natural cancer-fighting immune cells in the laboratory, “training” these immune cells to identify and attack their specific enemy. When re-injected into the patient, the trained immune cells can move through the body like attack dogs, to find hidden stem cells threatening to form another tumor and destroy them. 

Foltz is hopeful that this area of research will make a difference. 

“We have two vaccines that have been funded by the Brain Cancer Walk, and we are working on a third vaccine that we are very excited about…. We are getting a good feel for which drugs we want to bring to clinical trial, and that has been entirely funded from the Seattle Brain Cancer Walk — that’s been a real success story,” he said.

 

Ready for the Walk

In Combes’ case, the operation to remove her tumor was tricky. Foltz said that the cancer was located in the temporal area of her brain, a sensitive region where memories are stored. 

With the surgical area anesthetized, Combes was kept awake and talking during the operation as Foltz used high-tech instruments to carefully “map” safe areas so that he could avoid damaging her brain as her tumor was carefully resected. 

“Kami’s tumor was of a moderate size; it was definitely a challenge to remove that tumor entirely,” Foltz said. 

Now, five years after a long surgery, six weeks of radiation and months of chemotherapy, Combes and her family are looking forward to Saturday’s Brain Cancer Walk at the Seattle Center. 

“The walk has been a very important engine for research and discovery in brain cancer in the Pacific Northwest,” Foltz said. “It makes a significant contribution to research in the Seattle area. All of the money raised goes directly to research. It provides the seed money to enable grant-funded research projects to get off the ground. Historically, we have gained $9 in grant funds for every dollar raised in the walk.

“There are very few opportunities in life for a person to participate in something so inspiring, in which the simple act of being involved can become so meaningful,” he added. “What makes the Seattle Brain Cancer Walk truly wonderful is the direct impact that a person can make on that day in terms of what we can accomplish.” 

While the walk itself is uplifting, Combes agreed with Foltz, saying that that the money raised is crucial for progress to be made in the treatment of brain cancer.

“Not only does it bring people together, but also to be able to use the money that gets raised from the walk for more research is so important,” Combes said. “The changes that I have seen just in the last five years since I was a patient, back at the very beginning of the walk — now there is a huge difference. It’s just incredible how much they have progressed. It’s a good cause, and the fact that it has grown this much is amazing.” 

For more information about the 2012 Seattle Brain Cancer Walk, go to www.braincancerwalk.org.