Malignant Gliomas...

So yesterday when I heard about Ted Kennedy, I didn't need the CNN announcer to tell me the prognosis. You see some of our research is related to this terrible disease. (opening the door to my anonymity just a crack...) It is difficult to treat for three reasons. First, it is in the brain. As my neurosurgery collaborator often says, "if it was your leg, we would just amputate it, but we can't do that in the brain." Second, the tumor does not visually look any different from neighboring tissue. The tumor can be visualized on MRI because of the leaky blood vessels present in tumors (which compromise the blood brain barrier). These blood vessels permit imaging agents to enter the tumor, but not other parts of the brain, so the tumor can be seen. Unfortunately, when a surgeon goes in to remove the tumor, the MRI is only mildly helpful to guide them to the tumor location. You see the brain floats in fluid within the skill and is also very soft, so as soon as the skull is opened the brain can shift in position making it difficult to locate the tumor and remove it. Finally, for whatever reason, and there is debate about it, these tumors are fast growing and extremely diffuse. They do not present as a solid mass, but rather as fibrils spread throughout the brain. How do you remove a fibril surgically, especially when you can't even see it?

The reason that I am telling you all this is that for the last month or so I have really been struggling, with what my group "does". I have been thinking a lot about what kind of research we do, what interests me, what seems promising (both from a funding and a scientific perspective), and most importantly where can I make the greatest impact. I have been vacillating among the many different disease and conditions that we can focus on. But, the news yesterday really served as a wake-up call. The work that we are doing is already making a difference, and if we can make even a small impact on a disease that at best gives you a five year survival (there is almost no true survival only life extension), then we will have done a lot.