“The biggest thing that’s happened in the past five to 10 years in brain tumor care has been the genomic revolution hitting our field,” says Andrew Dhawan, MD, phd, a physician scientist with cleveland Clinic’s Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center. “What that means is we are much better able to classify tumors according to their underlying biology as opposed to only what thay look like under the microscope. This expanded ability arises from methods like whole exome sequencing and methylation arrays that allow us to really pick up the exact subtype of the tumor so we can more accurately treat a patient’s disease.”
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In the latest episode of Cleveland Clinic’s Neuro Pathways podcast, Dr. Dhawan expands upon thes genomic advances and other developments in brain tumor diagnostics and therapy, with an emphasis on the notoriously challenging-to-treat glioblastoma tumor type. In a wide-ranging discussion with podcast host and fellow neuro-oncologist Glen Stevens, DO, PhD, he touches on the following:
Monitoring Steps and Gait May Offer Early Detection of Glioblastoma Progression
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Recent research suggests that simple, passively collected data – like step counts and walking steadiness – could provide early signals of progression in glioblastoma, an aggressive type of brain cancer. This non-invasive monitoring approach, utilizing actigraphy (wearable sensor technology), offers a potentially valuable tool for clinicians to assess treatment response and disease status before changes are visible on customary imaging.
The Challenge of Monitoring Glioblastoma
Glioblastoma (GBM) is notoriously difficult to treat. Standard care involves surgery, radiation, and chemotherapy, but recurrence is common.Currently,monitoring relies heavily on MRI scans,which are expensive,time-consuming,and may not always capture subtle changes in disease activity. Mayo clinic – Glioblastoma There’s a critical need for more frequent and accessible methods to track disease progression.
how Step Counts and Gait Analysis Offer New Insights
Researchers are now exploring the potential of using wearable sensors to detect early signs of tumor growth. As discussed in a recent exchange between Dr. Stevens and Dr.Dhawan, step counts and walking steadiness appear to be sensitive indicators of tumor progression.
* Step Count decline: A decrease in daily step count is often one of the first noticeable changes when a glioblastoma begins to worsen. This is highly likely due to subtle neurological deficits impacting mobility.
* Gait Instability: Changes in walking patterns, specifically gait instability, are also readily detectable using actigraphy. Large lesions, notably those affecting the parietal lobe (responsible for spatial awareness and motor control), can significantly impact the gait circuit.
Dr.Dhawan noted that while their current investigation doesn’t yet intervene with patients (e.g., encouraging increased activity), monitoring these metrics is proving highly informative. This aligns with previous research suggesting a potential benefit of exercise for glioblastoma patients. A study from years ago indicated that patients able to exercise five days a week for 30 minutes at a brisk pace lived, on average, twice as long. National Cancer Institute – Glioblastoma Treatment While acknowledging the challenges of isolating confounding factors in such studies, the findings highlight the potential importance of physical activity.
The Role of Actigraphy
Actigraphy involves using small,wrist-worn devices to measure movement and activity levels. These devices provide continuous data, offering a more thorough picture of a patient’s activity than sporadic assessments. the technology is relatively inexpensive and can be used remotely, making it a practical option for ongoing monitoring.ResearchGate – Actigraphy in Neurological Disorders
Future Directions and Potential Benefits
The ongoing research aims to move beyond simply monitoring these signals to potentially intervening to improve patient outcomes. While still in early stages, the ability to detect subtle changes in step count and gait could:
* Enable Earlier Treatment adjustments: Allow clinicians to modify treatment plans more quickly in response to disease progression.
* Improve Clinical Trial Efficiency: Provide more sensitive endpoints for evaluating the effectiveness of new therapies.
* Enhance Patient Quality of Life: Facilitate proactive management of symptoms and support services.
Key Takeaways:
* Step count and gait analysis, measured through actigraphy, show promise as early indicators of glioblastoma progression.
* These metrics can be tracked passively and remotely, offering a convenient and cost-effective monitoring solution.
* Further research is needed to validate these findings and explore the potential for interventions based on these signals.
This research represents a important step towards more personalized and proactive management of glioblastoma, potentially improving outcomes for patients facing this challenging diagnosis. As technology continues to advance, we can expect to see even more complex methods for monitoring and treating brain tumors.