CLL plus Tumours to Spine and Brain - Chronic Lymphatic Leukaemia

Notes for Oncologist Meeting

1.    Ask for a second opinion from another oncologist and another neurologist.  You also want to see a neuro-oncologist (brain tumour specialist).

2.    What type of tumour is it, what grade is it and where is it located?  Need to know exactly what these tumours are and how they have formed.

3.    When discussing treatment (such as PDT), especially if he is dismissive, ask him what experience he has etc with this treatment.

4.    Request to be considered for any clinical trials.

Potential Non-invasive, Low Risk, Few Side Effect Treatments

Tumour(s)

PhotoDynamic Therapy

It’s suitable for ‘near’ surface tumours including brain tumours and is available on the NHS.

http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Othertreatments/Photodynamictherapy.aspx#DynamicJumpMenuManager_6_Anchor_7

It has been used to treat early cancers and to help reduce more advanced tumours.

There is a clinic in London, The Dove Clinic, offering this treatment coupled with sonic waves to help reach deeper tumours.  It may be possible if your GP agrees to have this treatment funded by the NHS.

I believe the closest NHS hospital offering this treatment is Leeds.

Temozolomide

An oral alkylating agent used for brain tumours.  Not without long term side effects – it is a form of chemo taken orally.

Bevacizumab (Avastin)

A type of monoclonal antibody used to treat brain tumours (glioblastoma). No long term side effects.

Immune Therapy

Immunepheresis and other immune therapies remove the cancer cell's inhibitors, allowing the body's natural immune system to rid the tumor / cancer cells.  Can help to reduce solid tumours and can be more effective than chemo and radiation without the side effects.

http://en.wikipedia.org/wiki/Immunotherapy

Dendritic Cell Vaccine is a type of immune therapy used for brain tumours - http://www.cancer.ucla.edu/index.aspx?recordid=446&page=644

Tumour Treating Fields

Approved by the FDA it uses alternating current to create an electric field which interrupts rapid cell division displayed by cancer cells.

http://en.wikipedia.org/wiki/Tumor_Treating_Fields

Leukaemia

Monoclonal Antibodies

They work by targeting a protein on white blood cells this triggers the immune system into destroying them.

Alemtuzumab (Mabcampath – brand name) is approved to be used on its own where a patient is not suitable for fludarabine (chemo).

 Alemtuzumab – info on Macmillan website

More Aggressive Treatments

Tumour(s)

Stereotactic Radiotherapy

Used for secondary brain tumours, it’s a more targeted radiotherapy regime that damages much less healthy brain cells.

http://www.cancerresearchuk.org/cancer-help/type/brain-tumour/treatment/radiotherapy/stereotactic-radiotherapy-for-brain-tumours

A type of stereotactic radio therapy is radiosurgery used for early brain tumours.

http://www.cancerresearchuk.org/cancer-help/type/brain-tumour/treatment/radiotherapy/radiosurgery-for-brain-tumours

Leukaemia

Autologous transplant (full or mini transplant)

During an autologous stem cell transplant, stem cells are harvested from the patient before they receive chemotherapy and/or radiation therapy to treat a cancer. These stem cells may be purified and purged of any tumour cells that might be collected with them. After undergoing therapy, the patient receives his/her own stem cells.

General – Biological & Gene Therapies

List of biological therapies can be found at:

http://www.cancerresearchuk.org/cancer-help/about-cancer/treatment/biological/types/

Includes:

·         Biological Response Modifiers (BRMs)

·         Biologic agents

·         Biologics

·         Targeted therapies

·         Immunotherapy

Information for gene therapy can be found at

http://www.cancerresearchuk.org/cancer-help/about-cancer/treatment/biological/types/gene-therapy

I think they are only available as a clinical trial.

Would be worth discussing biological/gene therapy as a general discussion.