All about cancer and tumor

Sick American dogs get first shot at cancer drugs

2009-12-09T22:25:00.000-08:00

Dogs with cancer in the US are now entitled to receive experimental drugs – before the drugs are available for humans. Twelve trials are under way on groups of 15 to 60 dogs, and in several of them cancers have disappeared.

"We've had dramatic remissions in dogs with really aggressive cancers," says Chand Khanna, head of the Comparative Oncology Trials Consortium newly formed in Bethesda, Maryland, by the US National Cancer Institute. "We've also had responses allowing dogs to have their original cancers surgically removed," he says.
Forget mice and rats

The rationale is that unlike mice and rats, which are kept in a highly regimented experimental setting, pet dogs experience cancer in a similar way to humans. As in people, cancers in dogs spread to form secondaries and can become resistant to drugs, and the animals can have relapses.

Not only that, but dogs suffer from cancers as variable as those affecting humans, so treating them gives us a much better idea of what would happen in a cross-section of humans than we could gain from lab studies of mice.

The consortium consists of 19 veterinary schools, and there are plans to extend it to Europe. Owners can opt for conventional drugs or experimental ones, including some that are untested in humans and others that are already undergoing trials, but that need additional animal data – for example on dosing – before they can proceed to the next stage.

As well as looking after their sick dog, owners can help gather data for the researchers. "They're given notebooks so that they can complete assessments of quality of life, appetite, demeanour and perhaps even collect some specimens," says Khanna.
Sensitive area

Because owners carry on caring for the dogs, and because the hope is that pet dogs will get better as a result of the treatment, the approach also challenges claims by antivivisectionists that all experimentation on animals is wrong. "I understand their sensitivities, and we've had informed discussions with individuals, and some do see the value of helping dogs with cancer in this way," says Khanna.

"This raises serious concerns with respect to what the dogs may have to endure," says Nedim Buyukmihci, a vet consultant to the British Union for the Abolition of Vivisection.
Every dog matters

Khanna says, however, that the top priority for every dog is their well-being. "It's important that the trials are designed with the care of the animals as priority, and also that there's an informed consent process each time," he says.

Cancer researchers in Europe are watching closely to see whether to join the consortium. "Studying dogs, with their owners' consent and following ethical guidelines, after they have naturally developed cancer, is an interesting approach to learning more about the disease," says Joanna Owens, communications manager at the Cancer Research UK charity in London. "We look forward to following the progress of this initiative and the findings that come out of their research."

www.newscientist.com

Cancer

2009-01-20T16:40:00.000-08:00

Defining cancer

Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems.

Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start -- for example, cancer that begins in the colon is called colon cancer; cancer that begins in basal cells of the skin is called basal cell carcinoma.

Cancer types can be grouped into broader categories. The main categories of cancer include:

* Carcinoma - cancer that begins in the skin or in tissues that line or cover internal organs.

* Sarcoma - cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

* Leukemia - cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.

* Lymphoma and myeloma - cancers that begin in the cells of the immune system.

* Central nervous system cancers - cancers that begin in the tissues of the brain and spinal cord.

Origins of cancer

All cancers begin in cells, the body's basic unit of life. To understand cancer, it's helpful to know what happens when normal cells become cancer cells.

The body is made up of many types of cells. These cells grow and divide in a controlled way to produce more cells as they are needed to keep the body healthy. When cells become old or damaged, they die and are replaced with new cells.

However, sometimes this orderly process goes wrong. The genetic material (DNA) of a cell can become damaged or changed, producing mutations that affect normal cell growth and division. When this happens, cells do not die when they should and new cells form when the body does not need them. The extra cells may form a mass of tissue called a tumor.

Not all tumors are cancerous; tumors can be benign or malignant.

* Benign tumors aren't cancerous. They can often be removed, and, in most cases, they do not come back. Cells in benign tumors do not spread to other parts of the body.

* Malignant tumors are cancerous. Cells in these tumors can invade nearby tissues and spread to other parts of the body. The spread of cancer from one part of the body to another is called metastasis.

Some cancers do not form tumors. For example, leukemia is a cancer of the bone marrow and blood.

Definition of Tumor

2009-01-14T17:35:00.000-08:00

Tumor: An abnormal mass of tissue. Tumors are a classic sign of inflammation, and can be benign or malignant (cancerous). There are dozens of different types of tumors. Their names usually reflect the kind of tissue they arise in, and may also tell you something about their shape or how they grow. For example, a medulloblastoma is a tumor that arises from embryonic cells (a blastoma) in the inner part of the brain (the medulla). Diagnosis depends on the type and location of the tumor. Tumor marker tests and imaging may be used; some tumors can be seen (for example, tumors on the exterior of the skin) or felt (palpated with the hands).

Treatment is also specific to the location and type of the tumor. Benign tumors can sometimes simply be ignored, or they may be reduced in size (debulked) or removed entirely via surgery. For cancerous tumors, options include chemotherapy, radiation, and surgery. See also blastoma, carcinoembryonic antigen test, desmoid tumor, ear tumor, epidermoid carcinoma, epithelial carcinoma, esophageal cancer, syringoma, fibroid, tumor marker.

breast cancer

2009-01-13T17:28:00.000-08:00

Definition of breast cancer: Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.

Estimated new cases and deaths from breast cancer in the United States in 2008:

New cases: 182,460 (female); 1,990 (male)
Deaths: 40,480 (female); 450 (male)

See the online booklet What You Need To Know About™ Breast Cancer to learn about breast cancer symptoms, diagnosis, treatment, and questions to ask the doctor.

bladder cancer

2009-01-12T17:43:00.000-08:00

Definition of bladder cancer: Cancer that forms in tissues of the bladder (the organ that stores urine). Most bladder cancers are transitional cell carcinomas (cancer that begins in cells that normally make up the inner lining of the bladder). Other types include squamous cell carcinoma (cancer that begins in thin, flat cells) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). The cells that form squamous cell carcinoma and adenocarcinoma develop in the inner lining of the bladder as a result of chronic irritation and inflammation.

Estimated new cases and deaths from bladder cancer in the United States in 2008:

New cases: 68,810
Deaths: 14,100

See the online booklet What You Need To Know About™ Bladder Cancer to learn about bladder cancer symptoms, diagnosis, treatment, and questions to ask the doctor.

Brain tumor

2009-01-08T18:13:00.000-08:00

A brain tumor (brain tumour in the UK and Canada; see spelling differences) is any intracranial tumor created by abnormal and uncontrolled cell division, normally either in the brain itself (neurons, glial cells (astrocytes, oligodendrocytes, ependymal cells), lymphatic tissue, blood vessels), in the cranial nerves (myelin-producing Schwann cells), in the brain envelopes (meninges), skull, pituitary and pineal gland, or spread from cancers primarily located in other organs (metastatic tumors). Primary (true) brain tumors are commonly located in the posterior cranial fossa in children and in the anterior two-thirds of the cerebral hemispheres in adults, although they can affect any part of the brain. In the United States in the year 2005, it was estimated that there were 43,800 new cases of brain tumors (Central Brain Tumor Registry of the United States, Primary Brain Tumors in the United States, Statistical Report, 2005–2006),[1] which accounted for 1.4 percent of all cancers, 2.4 percent of all cancer deaths,[2] and 20–25 percent of pediatric cancers.[2][3] Ultimately, it is estimated that there are 13,000 deaths per year in the United States alone as a result of brain tumors.

In infants and children
Brain stem glioma in 4 year old. MRI sagittal, without contrast.

In the US, approximately 2000 children and adolescents younger than 20 years of age are diagnosed with malignant brain tumors each year. Higher incidence rates were reported in 1985–94 than in 1975–84. There is some debate as to possible reasons; one theory is that the trend is the result of improved diagnosis and reporting, since the jump occured at the same time as MRIs became available widely, and since there was no coincident jump in mortality. The CNS cancer survival rate in children is approximately 60%. The rate varies with the age of onset (younger has higher mortality) and cancer type.[4]

In children under 2, about 70% of brain tumors are medulloblastoma, ependymoma, and low-grade glioma. Less commonly, and seen usually in infants, are teratoma and atypical teratoid rhabdoid tumor.[5] Germ cell tumors, including teratoma, make up just 3% of pediatric primary brain tumors, but the worldwide incidence varies significantly

Signs and symptoms

Symptoms of brain tumors may depend on two factors: tumor size (volume) and tumor location. The time point of symptom onset in the course of disease correlates in many cases with the nature of the tumor ("benign", i.e. slow-growing/late symptom onset, or malignant, fast growing/early symptom onset).

Many low-grade (benign) tumors can remain asymptomatic (symptom-free) for years and they may accidentally be discovered by imaging exams for unrelated reasons (such as a minor trauma).

New onset of epilepsy[7] is a frequent reason for seeking medical attention in brain tumor cases.

Large tumors or tumors with extensive perifocal swelling edema inevitably lead to elevated intracranial pressure (intracranial hypertension), which translates clinically into headaches, vomiting (sometimes without nausea), altered state of consciousness (somnolence, coma), dilatation of the pupil on the side of the lesion (anisocoria), papilledema (prominent optic disc at the funduscopic examination). However, even small tumors obstructing the passage of cerebrospinal fluid (CSF) may cause early signs of increased intracranial pressure. Increased intracranial pressure may result in herniation (i.e. displacement) of certain parts of the brain, such as the cerebellar tonsils or the temporal uncus, resulting in lethal brainstem compression. In young children, elevated intracranial pressure may cause an increase in the diameter of the skull and bulging of the fontanelles.

Depending on the tumor location and the damage it may have caused to surrounding brain structures, either through compression or infiltration, any type of focal neurologic symptoms may occur, such as cognitive and behavioral impairment, personality changes, hemiparesis, hypesthesia, aphasia, ataxia, visual field impairment, facial paralysis, double vision, tremor etc. These symptoms are not specific for brain tumors - they may be caused by a large variety of neurologic conditions (e.g. stroke, traumatic brain injury). What counts, however, is the location of the lesion and the functional systems (e.g. motor, sensory, visual, etc.) it affects.

A bilateral temporal visual field defect (bitemporal hemianopia—due to compression of the optic chiasm), often associated with endocrine disfunction—either hypopituitarism or hyperproduction of pituitary hormones and hyperprolactinemia is suggestive of a pituitary tumor.

Diagnosis

Although there is no specific clinical symptom or sign for brain tumors, slowly progressive focal neurologic signs and signs of elevated intracranial pressure, as well as epilepsy in a patient with a negative history for epilepsy should raise red flags. However, a sudden onset of symptoms, such as an epileptic seizure in a patient with no prior history of epilepsy, sudden intracranial hypertension (this may be due to bleeding within the tumour, brain swelling or obstruction of cerebrospinal fluid's passage) is also possible.

Glioblastoma multiforme and anaplastic astrocytoma have been associated in case reports on Pubmed with the genetic acute hepatic porphyrias, including positive testing associated with drug refractory seizures. Unexplained complications associated with drug treatments with these tumors should alert physicians to an undiagnosed neurological porphyria.

Imaging plays a central role in the diagnosis of brain tumors. Early imaging methods—invasive and sometimes dangerous—such as pneumoencephalography and cerebral angiography, have been abandoned in recent times in favor of non-invasive, high-resolution modalities, such as computed tomography (CT) and especially magnetic resonance imaging (MRI). Benign brain tumors often show up as hypodense (darker than brain tissue) mass lesions on cranial CT-scans. On MRI, they appear either hypo- (darker than brain tissue) or isointense (same intensity as brain tissue) on T1-weighted scans, or hyperintense (brighter than brain tissue) on T2-weighted MRI. Perifocal edema also appears hyperintense on T2-weighted MRI. Contrast agent uptake, sometimes in characteristic patterns, can be demonstrated on either CT or MRI-scans in most malignant primary and metastatic brain tumors. This is because these tumors disrupt the normal functioning of the blood-brain barrier and lead to an increase in its permeability.

Electrophysiological exams, such as electroencephalography (EEG) play a marginal role in the diagnosis of brain tumors.

The definitive diagnosis of brain tumor can only be confirmed by histological examination of tumor tissue samples obtained either by means of brain biopsy or open surgery. The histological examination is essential for determining the appropriate treatment and the correct prognosis. This examination, performed by a pathologist, typically has three stages: interoperative examination of fresh tissue, preliminary microscopic examination of prepared tissues, and followup examination of prepared tissues after immunohistochemical staining or genetic analysis.

Another possible diagnonsis would be Neurofibromatosis which can be in type one or type two.

Treatment and prognosis

Many meningiomas, with the exception of some tumors located at the skull base, can be successfully removed surgically. In more difficult cases, stereotactic radiosurgery, such as gamma knife radiosurgery, remains a viable option.

Most pituitary adenomas can be removed surgically, often using a minimally invasive approach through the nasal cavity and skull base (trans-nasal, trans-sphenoidal approach). Large pituitary adenomas require a craniotomy (opening of the skull) for their removal. Radiotherapy, including stereotactic approaches, is reserved for the inoperable cases.

Although there is no generally accepted therapeutic management for primary brain tumors, a surgical attempt at tumor removal or at least cytoreduction (that is, removal of as much tumor as possible, in order to reduce the number of tumor cells available for proliferation) is considered in most cases.[8] However, due to the infiltrative nature of these lesions, tumor recurrence, even following an apparently complete surgical removal, is not uncommon. Several current research studies aim to improve the surgical removal of brain tumors by labeling tumor cells with a chemical (5-aminolevulinic acid) that causes them to fluoresce [9]. Postoperative radiotherapy and chemotherapy are integral parts of the therapeutic standard for malignant tumors. Radiotherapy may also be administered in cases of "low-grade" gliomas, when a significant tumor burden reduction could not be achieved surgically.

Survival rates in primary brain tumors depend on the type of tumor, age, functional status of the patient, the extent of surgical tumor removal, to mention just a few factors.[10]

UCLA Neuro-Oncology publishes real-time survival data for patients with this diagnosis. They are the only institution in the United States that shows how brain tumor patients are performing on current therapies. They also show a listing of chemotherapy agents used to treat high grade glioma tumors.

Patients with benign gliomas may survive for many years,[11][12] while survival in most cases of glioblastoma multiforme is limited to a few months after diagnosis if treatment is ignored.

The main treatment option for single metastatic tumors is surgical removal, followed by radiotherapy and/or chemotherapy. Multiple metastatic tumors are generally treated with radiotherapy and chemotherapy. Stereotactic radiosurgery, such as Gamma Knife radiosurgery, remains a viable option. However, the prognosis in such cases is determined by the primary tumor, and it is generally poor.

A shunt operation is used not as a cure but to relieve the symptoms.[1] The hydrocephalus caused by the blocking drainage of the cerebrospinal fluid can be removed with this operation.

Research to treatment with the vesicular stomatitis virus

In 2000, researchers at the University of Ottawa, led by John Bell M.D., have discovered that the vesicular stomatitis virus, or VSV, can infect and kill cancer cells, without affecting healthy cells if coadministered with interferon. [13]

The initial discovery of the virus' oncolytic properties were limited to only a few types of cancer. Several independent studies have indentified many more types susceptible to the virus, including glioblastoma multiforme cancer cells, which account for the majority of brain tumors.

In 2008, researchers at Yale University, led by Dr. Anthony van den Pol, artificially engineered strains of VSV that were less cytotoxic to normal cells. This advance allows administration of the virus without coadministration with interferon. Consequently administration of the virus can be given intravenously or through the olfactory nerve. In the research, a human brain tumor was implanted into mice brains. The VSV was injected via their tails and within 3 days all tumor cells were either dead or dying.

Research on virus treatment like this has been conducted for some years, but no other viruses have been shown to be as efficient or specific as the VSV mutant strains. Future research will focus on the risks of this treatment, before it can be applied to humans.

Brain Tumor Symptoms

2009-01-08T18:05:00.000-08:00

Brain tumor symptoms vary from patient to patient, and most of these symptoms can also be found in people who do NOT have brain tumors. Therefore, the only sure way to tell if you have a brain tumor or not is to see your doctor and get a brain scan.

I did a survey of about 375 brain tumor patients to learn what symptoms they had that caused them to seek medical care. You can see the full results by clicking here. The survey is ongoing, and you can participate by going to symptomssurvey.cfm. The results below are as of 2/25/2003.

They reported:

* Headaches: This was the most common symptom, with 46% of the patients reporting having headaches. They described the headaches in many different ways, with no one pattern being a sure sign of brain tumor. Many - perhaps most - people get headaches at some point in their life, so this is not a definite sign of brain tumors. You should mention it to your doctors if the headaches are: different from those you ever had before, are accompanied by nausea / vomiting, are made worse by bending over or straining when going to the bathroom.(1)

* Seizures: This was the second most common symptom reported, with 33% of the patients reporting a seizure before the diagnosis was made. Seizures can also be caused by other things, like epilepsy, high fevers, stroke, trauma, and other disorders. (3) This is a symptom that should never be ignored, whatever the cause. In a person who never had a seizure before, it usually indicates something serious and you must get a brain scan.

A seizure is a sudden, involuntary change in behavior, muscle control, consciousness, and/or sensation. Symptoms of a seizure can range from sudden, violent shaking and total loss of consciousness to muscle twitching or slight shaking of a limb. Staring into space, altered vision, and difficulty in speaking are some of the other behaviors that a person may exhibit while having a seizure. Approximately 10% of the U.S. population will experience a single seizure in their lifetime.

* Nausea and Vomiting: As with headaches, these are non-specific - which means that most people who have nausea and vomiting do NOT have a brain tumor. Twenty-two percent of the people in our survey reported that they had nausea and /or vomiting as a symptom.

Nausea and / or vomiting is more likely to point towards a brain tumor if it is accompanied by the other symptoms mentioned here.

* Vision or hearing problems: Twenty-five percent reported vision problems. This one is easy - if you notice any problem with your hearing or vision, it must be checked out. I commonly hear that the eye doctor is the first one to make the diagnosis - because when they look in your eyes, they can sometimes see signs of increased intracranial pressure. This must be investigated.

* Problems with weakness of the arms, legs or face muscles, and strange sensations in your head or hands. Twenty-five percent reported weakness of the arms and/or legs. Sixteen percent reported strange feelings in the head, and 9% reported strange feelings in the hands. This may result in an altered gait, dropping objects, falling, or an asymmetric facial expression. These could also be symptoms of a stroke. Sudden onset of these symptoms is an emergency - you should go to the emergency room. If you notice a gradual change over time, you must report it to your doctor.

* Behavioral and cognitive problems: Many reported behavioral and cognitive changes, such as: problems with recent memory, inability to concentrate or finding the right words, acting out - no patience or tolerance, and loss of inhibitions - saying or doing things that are not appropriate for the situation.

IF you think something is wrong, go see your doctor. Explain that you are worried it is a brain tumor. Keep in mind that brain tumors are relatively rare compared to most other disorders, so the primary care doctor is not usually going to be thinking it is a brain tumor. They first think of more common causes of the symptoms. Sixty-four percent of the time, the doctor thought it was NOT a brain tumor when respondents first went to the doctor. More than half of the people reported that they had the symptoms for more than a month before the correct diagnosis of brain tumor was made. With the malignant brain tumors, a delay of a month in starting treatment can make a major impact on the outcome.

There is a more detailed paper on brain tumor symptoms at: http://virtualtrials.com/symptoms.pdf

What is leukemia?

2008-12-31T00:21:00.000-08:00

Leukemia is a type of cancer. Cancer is a group of many related diseases. All cancers begin in cells, which make up blood and other tissues. Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place.

Sometimes this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. Leukemia is cancer that begins in blood cells.

Normal blood cells

Blood cells form in the bone marrow. Bone marrow is the soft material in the center of most bones.

Immature blood cells are called stem cells and blasts. Most blood cells mature in the bone marrow and then move into the blood vessels. Blood that flows through the blood vessels and heart is called the peripheral blood.

The bone marrow makes different types of blood cells. Each type has a special function:

White Blood Cells
White blood cells help fight infection.

Red Blood Cells
Red blood cells carry oxygen to tissues throughout the body.

Platelets
Platelets help form blood clots that control bleeding.

Picture of Leukemia

Leukemia cells

In people with leukemia, the bone marrow produces abnormal white blood cells. The abnormal cells are leukemia cells. At first, leukemia cells function almost normally. In time, they may crowd out normal white blood cells, red blood cells, and platelets. This makes it hard for blood to do its work.

Defining cancer

2008-12-31T00:19:00.001-08:00

Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems.

Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start -- for example, cancer that begins in the colon is called colon cancer; cancer that begins in basal cells of the skin is called basal cell carcinoma.

Cancer types can be grouped into broader categories. The main categories of cancer include:

* Carcinoma - cancer that begins in the skin or in tissues that line or cover internal organs.

* Sarcoma - cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

* Leukemia - cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.

* Lymphoma and myeloma - cancers that begin in the cells of the immune system.

* Central nervous system cancers - cancers that begin in the tissues of the brain and spinal cord.

Origins of cancer

All cancers begin in cells, the body's basic unit of life. To understand cancer, it's helpful to know what happens when normal cells become cancer cells.

The body is made up of many types of cells. These cells grow and divide in a controlled way to produce more cells as they are needed to keep the body healthy. When cells become old or damaged, they die and are replaced with new cells.

However, sometimes this orderly process goes wrong. The genetic material (DNA) of a cell can become damaged or changed, producing mutations that affect normal cell growth and division. When this happens, cells do not die when they should and new cells form when the body does not need them. The extra cells may form a mass of tissue called a tumor.

What about rehabilitation after treatment for brain tumors?

2008-12-30T19:40:00.000-08:00

Rehabilitation can be a very important part of the treatment plan. The goals of rehabilitation depend on the person's needs and how the tumor has affected daily activities. The health care team makes every effort to help the patient return to normal activities as soon as possible. Several types of therapists can help:

* Physical therapists - Brain tumors and their treatment may cause paralysis. They may also cause weakness and problems with balance. Physical therapists help patients regain strength and balance.

* Speech therapists - Speech therapists help patients who have trouble speaking, expressing thoughts, or swallowing.

* Occupational therapists - Occupational therapists help patients learn to manage activities of daily living, such as eating, using the toilet, bathing, and dressing.

Children with brain tumors may have special needs. Sometimes children have tutors in the hospital or at home. Children who have problems learning or remembering what they learn may need tutors or special classes when they return to school.

What happens after treatment for brain tumors?

Regular followup is very important after treatment for a brain tumor. The doctor checks closely to make sure that the tumor has not returned. Checkups may include careful physical and neurologic exams. From time to time, the patient may have MRI or CT scans. If the patient has a shunt, the doctor checks to see that it is working well. The doctor can explain the followup plan - how often the patient must visit the doctor and what tests will be needed.

What support is available to patients with brain tumors?

Living with a serious disease such as a brain tumor is not easy. Some people find they need help coping with the emotional and practical aspects of their disease. Support groups can help. In these groups, patients or their family members get together to share what they have learned about coping with the disease and the effects of treatment. Patients may want to talk with a member of their health care team about finding a support group. Groups may offer support in person, over the telephone, or on the Internet.

People living with a brain tumor may worry about caring for their families, keeping their jobs, or continuing daily activities. Concerns about treatments and managing side effects, hospital stays, and medical bills are also common. Doctors, nurses, and other members of the health care team can answer questions about treatment, working, or other activities. Meeting with a social worker, counselor, or member of the clergy can be helpful to those who want to talk about their feelings or discuss their concerns. Often, a social worker can suggest resources for financial aid, transportation, home care, or emotional support.

The Cancer Information Service can provide information to help patients and their families locate programs, services, and publications.

The promise of cancer research

Doctors all over the country are conducting many types of clinical trials. These are research studies in which people take part voluntarily. Studies include new ways to treat brain tumors. Research has already led to advances, and researchers continue to search for more effective approaches.

Patients who join these studies have the first chance to benefit from treatments that have shown promise in earlier research. They also make an important contribution to medical science by helping doctors learn more about the disease. Although clinical trials may pose some risks, researchers take very careful steps to protect their patients.

Researchers are testing new anticancer drugs, doses, and treatment schedules. They are working with various drugs and drug combinations, as well as combinations of drugs and radiation therapy. They also are testing new methods and schedules of radiation therapy.

Patients who are interested in being part of a clinical trial should talk with their doctor. NCI's Web site includes a section on clinical trials at http://www.cancer.gov/clinicaltrials. This section of the Web site provides general information about clinical trials. It also offers detailed information about ongoing studies of treatment for brain tumors. The Cancer Information Service at 1-800-4-CANCER can answer questions and provide information about clinical trials.