Times of India
04 January 2009
By Malathy Iyer
Mumbai, India

It’s not terrific news, but it sure does spell hope for a dismal diagnosis. Doctors and researchers are cheering a new finding in the cruel of world of gliomas, considered the most virulent form of brain cancer. While the median survival rate for glioma patients is one year, new medical protocols are ensuring an 11% survival rate of more than five years for patients diagnosed with grade-IV gliomas.

Fifty-nine-year-old Hitesh (name changed) is one of the few lucky ones who was treated using the new protocol at Tata Memorial Hospital in Parel eight years back. Diagnosed with glioma in March 2001, he was the third patient to be put on the new protocol of Temozolomide along with surgery and aggressive radiotherapy.

On Wednesday, Hitesh who teaches at one of the prestigious Indian Institutes of Technology told TOI that apart from the rigours of the disease, he was glad that the treatment had worked well. “Brain tumours leave behind scars that take a toll on people’s faculties,” he said.

But his doctor, neuro-oncologist Rakesh Jalali at Tata Memorial Hospital in Parel, considers Hitesh one of the best examples of the triumph of medicine. “He is cured. In India we can now boast of 11% survival rates, unheard of a few years back,” says the doctor, whose team presented the hospital’s research at the American Society of Clinical Oncology meeting in May 2009. In March 2009, data from a multi-centre European study published in the Lancet Oncology journal showed 9.8% survival rate of over five years for glioma patients.

Indeed, gliomas that usually strike Indians in their 50s (in the West, it strikes people in their mid-60s) are worrisome, say doctors. Consider their biochemistry. Most brain tumours that develop from cancerous glial cells are called gliomas. Unlike other cancers, glioma tumours grow in the confined space inside the head. In order to grow, most cancers push healthy cells aside, but due to space constraints, glioma tumors destroy normal brain cells. They do so by releasing large quantities of the neurotransmitter glutamate that is toxic to neurons and causes seizures in up to 80% of people with gliomas. Depending on the tumour’s size and location, other symptoms could include paralysis, behaviour changes and dizziness. A glioma tumor is particularly damaging because it tends to quickly sprout and spread within the brain.

Neurosurgeon Dr Anandh Balasubramaniam, formerly with Kokilaben Dhirubhai Ambani Hospital, believes a five-year survival rate for glioma patients is indeed a significant development.