Cap Uses Novel Treatment to Disrupt Growth of Cancer Cells in Glioblastoma

Unlike many cancer treatments, therapies for brain tumors have remained static over the last 60 years, consisting of surgery, radiation, and chemotherapy.

MUSC Health offers a fourth option for adults: tumor treating fields, a device that is worn on the patient’s head and uses electrical fields that slow, stop, or destroy cancer cells in glioblastoma, an aggressive form of brain cancer.

Dr. Alicia Zukas, an MUSC Health neuro-oncologist in the Department of Neurosurgery who has used the treatment on her patients for several years, says the device, while not new, remains a unique way to treat cancer. “The use of electrical fields to treat cancer is pretty novel,” she says. “Tumor treating fields are believed to be a great addition or alternative to chemotherapy, especially for people who have bad side effects with chemotherapy, such as nausea, vomiting, or low blood counts.”

Developed in Israel, the Optune device was shown in clinical trials to be as effective as chemotherapy for treating patients whose glioblastoma returned after standard treatment, she says. Additional studies then showed that, when combined with chemotherapy as a first-line treatment, Optune also produces favorable results.

“Depending on the tumor’s size and growth, the device is used as an upfront treatment with chemotherapy after surgery or instead of chemotherapy if a tumor returns.”

Optune is similar to an electrocardiogram. Four stickers containing ceramic disks and wires are placed directly onto the shaved scalp. The disks deliver the electrical field, which patients may feel as a gentle, warm sensation. The wires connect to a battery pack, similar to a binoculars case, which is worn around the waist or over the shoulder. Many patients wear a ball cap or a hat to cover the arrays.

Dr. Zukas encourages her patient to wear it at least 20 hours each day, including while sleeping. “The longer someone wears the cap, the better it works. The other 4 hours gives patients time to go to the gym, do yard work or whatever activities they want. They can wear it all the time if they can tolerate it. I find that if a patient has a tumor that is not growing, they should continue the device. If a tumor starts growing, despite the treatment, we might change paths.”

Dr. Zukas says patients appreciate the device’s advantages, specifically its low side effects. “The only real side effect is the warm sensation,” she says. “Patients like the idea of being in control of their care, and the freedom to make conscious decisions each day to use the treating fields. The only disadvantage is wearing a device. It’s not discreet, and patients must keep their head shaved. A ball cap or a hat, however, can be worn to conceal it. My male patients seem to be bothered more by keeping their head shaved than women.”

Brain tumors are among the most challenging cancers to treat, Dr. Zukas says. The skull is not flexible and provides little space for masses or swelling. Surgical removal is sometimes not an option because tumors can be located in areas responsible for critical function. Therapies delivered through the blood stream to the brain are often blocked by the blood brain barrier.

As a result, treatment strategies have not advanced much in the last 60 years when chemotherapy treatment was similar to mustard gas, used in combat during World War II, Dr. Zukas says. “We’re seeing changes that are the best outcomes that patients with brain tumors have had in 60 years. I try to explain all the different options to my patients and encourage them to select what is best for them. At MUSC, you can expect a neuro-oncology group that only treats patients with neuro-oncology needs. This means that we know our patients well, and they know us. We have a comprehensive team that works closely to address all aspects of care.”

Find out more about neuro-oncology at the MUSC Health Brain & Spine Tumor Program.