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Target: Tumors
Low-intensity current may stop growth of brain tumors

Written by Karen Carlson • Photography by Jason Johnson

“Every day is a gift," says, J.T. Rodgers. The 67-year-old former salesman and U.S. Navy veteran is a lively and optimistic fellow who loves to sing and is something of a local celebrity for inventing a Starbucks drink honoring his nickname, “Big Daddy Woo Woo."

J.T. Rodgers

Rodgers cuts such a charming figure, it’s easy to look past the net cap on his clean-shaven head. Wires protrude from under the cap, attached to a six-pound gray canvas bag he carries. The wires connect to electric arrays on his scalp. The device is an innovative new therapy to help Rodgers keep singing. Rodgers has a brain tumor.

The tumor is called a glioblastoma (GBM). It’s the most common form of brain tumor – and the most aggressive. An estimated 10,000 people are diagnosed with GBM each year in the United States. The five-year survival rate is less than 10 percent. “For decades, we had very little to offer that would truly impact survival and, perhaps more importantly, quality of life," says Ayman Omar, M.D. “Our only hope was in discovering the underlying molecular mechanisms that lead to brain cancer development and growth." U.S. Sen. Edward Kennedy was diagnosed with GBM and succumbed to the tumor in 2009.

Rodgers’ tumor was diagnosed 24 months ago, making his survival as remarkable as the man. “They told me I had about five or six months," he recalls. “That was two years ago, and I’m still here."

He’s still here thanks to the traditional methods of cancer treatment: surgery that removed a golf ball-sized tumor, chemotherapy and radiation. That treatments stopped the tumor growth in Rodgers’ brain, but they didn’t kill the tumor. It’s still there. But a new and innovative therapy may be the key to eradicating it.

For about a year, Ayman Omar, M.D., assistant professor of neurology and director of neuro-oncology at the SIU Simmons Cancer Institute, had his eye on an innovative therapy called NovoTTF™ (tumor treating fields). He knew that his patient, J.T. Rodgers, would be a good candidate.

The device had been used throughout Europe for a couple of years before the results of a joint U.S. and European clinical trial led to FDA approval. “The clinical trial showed that, in lieu of chemotherapy, patients did as well on this device as they did on chemotherapy but had a much better quality of life," says Peter Melnyk, Chief Commercial Officer for Novocure™, a private oncology company pioneering the therapy for solid tumors, which produces the device. “This was the key factor in FDA approval. Patients had fewer side effects: no nausea, vomiting or fevers."

Dr. Omar

"It's possible that we could treat other cancers the same way."
- - Dr. Omar

As soon as the therapy was approved by the FDA in April 2011, Dr. Omar immediately began the process to become trained and certified from Novocure™. He received certification in October 2012, and the next day, began treating two patients with the device, including Rodgers.

“We are the only provider of this therapy between Chicago and St. Louis," Dr. Omar says. He estimates between 500 to 1,000 patients could be treated with this therapy in the central and southern Illinois region. Only about 50 sites in the country offer this treatment. “This therapy offers new hope for our brain cancer patients," Dr. Omar says. “My goal was to ensure that our patients would receive the most advanced cancer care right next to their homes."

Neuro-Oncology

The Novo TTF™ treatment is the latest advance in the field of neuro-oncology. Dr. Omar completed a fellowship in neuro-oncology at the University of Toronto. There, he treated an average of 70-80 patients per day, partly because of a new standard of care for glioblastomas that followed the completion of an international, Phase 3 clinical trial. “We were treating a wide array of brain, spinal cord and peripheral nerve tumors, as well as managing neurologic complications of other types of cancers such as breast, lung, lymphoma and melanoma," Dr. Omar says.

The field of neuro-oncology is moving at a fast pace, as Dr. Omar explains. “In my opinion, one of the most significant areas of advancement in neuro-oncology is our improved understanding of the molecular ‘switches’ that control cell division and drive brain cancer development. This understanding has led to the development of numerous ‘molecular targeted agents’ that can specifically shut down these molecular switches and therefore kill cancer cells."

He is a proponent of a recently approved treatment for GBMs called Avastin™ (bevacizumab). “Avastin™ targets a molecule known to drive blood vessel formation within these tumors, he explains. By blocking these molecules, we are now able to effectively ‘choke off’ these tumors from their blood supply." Avastin™ is delivered by IV every two weeks, blocking the blood vessels that feed the tumor.

Although the new molecular treatments are promising, GBMs are tough tumors to beat. The NovoTTF™ therapy, combined with the molecular treatments and standard treatments, may be the powerhouse combination needed to destroy the tumors once and for all.

NOVO TTF™

The Novo TTF™ treatment is approved for patients aged 22 years and older with persistent and recurring glioblastoma. The non-invasive treatment administers a painless, low-intensity electrical current using electrodes called transducer arrays, which are placed on a patient’s scalp. Four ceramic discs fit onto the skull with adhesive tape. The arrays are connected to a pulse generator. A software program takes a patient’s MRI results and designs the placement of the arrays to precisely deliver the therapy to the patient’s tumor, using specific frequencies and intensities that stop the cancer cells from dividing, resulting in cell death. “The research found that if you exposed the cells to electric currents at a specific frequency and intensity, it stops them from dividing," Dr. Omar says. “A treatment layout is generated that conforms to the patient’s tumor to achieve the maximum cancer cell kill."

Patients carry a portable device with them, allowing for outpatient treatment and continuous therapy with minimal interference in daily activities. Patients wear the device as long as possible. The preferred length of time is 18 hours per day. An alarm sounds if the pulse generator is interrupted. “I’ve become an expert in troubleshooting this device," Rodgers says. Rodgers and Nurse

The length or course of treatment varies. “As long as the tumor responds," Dr. Omar says, which could be indefinitely.

Dr. Omar is planning to participate in several clinical trials that may lead to refinement and further innovation in the area of brain cancer treatment. “We are very excited about the rapid advances that are occurring in the field of neuro-oncology and are committed to remaining on the forefront of these advances in order to offer them to our cancer patients and will hopefully some day offer a cure for this deadly and often incurable disease."

The makers of the device are modifying it with patches that potentially could be used for breast and lung cancers. “Glioma cells respond to 200 khz frequency — and a certain intensity," Dr. Omar explains. “Other types of tumor cells respond to different frequencies and intensities. So it’s possible that we could treat other cancers this same way. Any dividing cell potentially could be responding to the currents."

Novocure™ representative Melnyk explains that work continues to refine the device, to make it lighter weight and smaller overall. “As technology improves, particularly with better batteries, the next generations of the device will be even better," he says. Rodgers even has a suggestion: to add an information panel to tell the patient what is wrong when the device’s alarm sounds.

Rodgers, who survived throat cancer 12 years ago, is approaching his brain cancer with great humor. “I’ve always had a big head," he jokes as Dr. Omar checks his scalp. Dr. Omar asks if he’s experienced any confusion, a common side effect of brain tumors. “All my life," Rodgers chuckles. No side effects to report, other than some stinging and sensitivity when his re-growing hair shifts the arrays out of place. “It takes a while to get used to the device," Rodgers admits. “But in my situation, I’m willing to try anything."

He began the TTF™ therapy in mid-October 2012. By the end of November, the swelling in his brain was gone, and the tumor growth had stopped, but not yet shrunk. “It’s a good sign," says Dr. Omar, who is also treating Rodgers with Avastin™.

As Rodgers puts it, “I’m using TTF™, Avastin™ and a lot of prayer." He’s still singing, still playing piano and entertaining the community with karaoke. “Karaoke has been the best therapy," he says. “I told God that if He kept me here, I would share this gift with people who need uplifting." He visits nursing homes and retirement homes, churches and St. John’s Hospital. He and his wife, Leona, have been married 22 years.

“I don’t fear death; I’m a winner either way," he says. “If I pass away, I will be with Jesus Christ and will be reunited with all the relatives and friends that I miss. And if I get a handle on my cancer, I win, too." • • •

Editors Note: J.T. Rodgers passed away on January 19, 2013