Brain Matters – Johns Hopkins Medicine Podcasts Johns Hopkins Medicine

This month Jon Weingart discusses a novel way to get past the blood-brain barrier.

Program notes:

0:20 Blood brain barrier keeps toxic substances out

1:20 Deliver ultrasound without opening the skin

2:21 Perhaps a skull implant

3:21 How long can it stay in place?

4:21 So many things implanted these days

5:16 No curative therapies for this tumor

6:55 End

This month Michael Lim, MD, talks about using viruses and other aspects of immunotherapy for brain tumors.

Program notes:

0:22 Polio virus and brain tumor treatment

1:21 Genetically modify viruses to attack tumors

2:21 Implanted melanoma tumors

3:22 Myeloid cells play an important role

4:23 May not need a neurotropic virus

5:25 Timeline relative to tumor development

6:28 At one point one drug cocktail but a different one at another

7:23 Building on fantastic data from other tumors

8:10 End

Program notes:

0:14 Large experience here at Hopkins

1:15 Contrast agents accumulates in certain places

2:15 Difference dramatic

3:05 Astrocytoma is an infiltrative tumor

4:07 Not always that a grade 3 becomes a grade 4

5:08 Grade 4 can be so infiltrative that it needs diffuse therapy

6:05 Don’t create a new neurological problem

6:37 End

Anchor lead:  Can a helmet using electrical fields improve survival from some brain tumors? Elizabeth Tracey reports

A helmet employing alternating electrical field pulses has been shown to improve survival from glioblastoma, one type of deadly brain tumor, a study published recently in the Journal of the American Medical Association found. Jon Weingart, a neurosurgeon at Johns Hopkins, explains the strategy.

Weingart:  It involves using what’s called tumor treating fields or low wave frequency electric fields that are applied to the scalp, which the mechanism is to disrupt cellular biology such that it keeps cells from being able to divide. So it’s a low intensity microwave in a way that disrupts cellular division and thus would affect any process that requires cellular division to progress, which is what tumors do.   :30

Weingart says the helmet is custom made and used alongside surgery and possibly also chemotherapy.  He says people wear the helmet for the majority of the day and must shave their heads to do so, but most have found the process tolerable and continue their activities.  At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead:  Can new techniques allow better monitoring of brain tumors? Elizabeth Tracey reports

All cells shed DNA into blood and bodily fluids when they break open, a fact that’s being exploited in discerning whether cancers have returned or metastasized.  Now the same technique has been used in looking at brain tumors, where the DNA is shed into the fluid surrounding the brain and spinal cord known as CSF or cerebrospinal fluid.  Jon Weingart, a neurosurgeon at Johns Hopkins, explains.

Weingart: This is a new concept that’s been developed in cancer research and in cancer monitoring where there’s evidence that cells as they die or break up in their natural growth or with treatment, that the DNA that’s within them gets shed out into the bloodstream or into other bodily fluids.  This DNA is different than the patient’s normal DNA.  There are unique fingerprints so to speak of the tumor DNA that can be detected elsewhere in the body.   :29

Weingart is one member of a group at Hopkins with a recent publication showing detection of over 70% of tumor markers using the technique. At Johns Hopkins, I’m Elizabeth Tracey.

Meningiomas are a common type of brain tumor that may be related to obesity, a recent study discussed in the inaugural production of Brain Matters, a monthly podcast series with Jon Weingart, a neurosurgeon at Johns Hopkins, concludes.

Program notes:

0:22 The risk of meningioma

1:23 Biological plausibility

2:25 It’s just not a number that you’re shooting for

3:26 Patient having symptoms needs more rapid evaluation

4:25 Hurdle to proposed intervention

5:25 In general no radiation given

6:25 Three grades of meningioma

7:25 Clear association with radiation

8:25 Multidisciplinary approach valuable

9:35 End