Episode 1: John Boockvar

Guest: Dr. John Boockvar, neurosurgeon at Lenox Hill Hospital in New York

For the initial episode of Game on Glio, presented by Brains for the Cure, host Shannon Traphagen talks to John Boockvar, a leading neurosurgeon and part of Northwell Health’s brain tumor program.

Listen to the episode below:


What is the blood-brain barrier?

The Blood-brain barrier is a structure inside the brain that prevents molecules from crossing from the bloodstream into the nerve tissue inside the brain. Under normal circumstances, it protects the vital tissue of the brain, but during brain tumor treatment, it can interfere with efforts to fight a tumor using chemotherapy drugs. To learn more about the blood-brain barrier, read our article.

Can immune therapy be used for brain cancer?

Many forms of cancer have become much more treatable thanks to advances in immune therapy, which is the use of drugs to help the body’s own immune system find and destroy tumor cells. For instance, a class of drugs called PD1 Inhibitors have seen a lot of success treating lung cancer and melanoma. Unfortunately, these drugs do not cross the blood-brain barrier, and therefore immune therapy is not yet widely used against brain cancer. However, scientists all over the world are currently working on efforts to develop immune therapy techniques for brain cancer.

Are PD1 inhibitors used in brain cancer treatment?

PD1 inhibitors do not cross the blood-brain barrier, and therefore they are not a major part of brain tumor treatment at this time.

Is Temodar good against brain cancer?

Temodar, also known as temozolamide, is approved by the FDA to fight glioblastoma and other forms of brain cancer. It is the most commonly prescribed chemotherapy drug for brain cancer and considered part of the standard of care. It crosses the blood-brain barrier and has been shown to improve survival for brain tumor patients.

Is Avastin good against brain cancer?

Avastin, also known as bevacizumab, is the most recently approved drug approved by the FDA for treatment of recurrent glioblastoma and other brain tumors. It was approved in 2009. It has been shown to increase the amount of time before patient’s tumors grow or spread.

Does surgery to remove a brain tumor work?

A successful tumor recision surgery, aka tumor removal, is one of the most important factors in surviving a brain tumor. Fortunately, surgical tools and techniques against brain cancer have continued to improve. Surgeons now use a range of dyes and imaging techniques that help them see tumor tissue and remove more of it, while safely avoiding healthy brain tissue.

What is 5-ALA surgical dye?

According to Dr. John Boockvar of Lenox Hill Hospital, 5-ALA surgical dye is a fluid that patients drink 4 hours before surgery, which gives him the ability to identify tumor cells more easily. It is absorbed by cells in the brain cancer, but not those in the normal brain. It temporarily turns the tumor cells pink, which is visible using surgical glasses or the exoscope, which is a 3D robotic microscope used in operating rooms.. Dr. Boockvar says 5-ALA dye allows him better delineate what’s tumor from what’s normal brain.

What is leptomeningeal disease?

Leptomeningeal (pronounced LEP-toh-meh-NIN-jee-ul) disease is a rare complication in which cancer spreads into the cerebrospinal fluid or the meninges, which are tissues that shield and cushion your spinal tissue. It may originate from a primary brain tumor, but it can also originate from a non-central nervous system tumor such as lung cancer, breast cancer, or melanoma. If you are have cancer and are showing worsening neurological symptoms, your doctor may want to check for leptomeningeal disease with an MRI or a spinal tap.

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