“I think it’s time we shift a bit. Not saying that we stop focusing on those important cancers, but recognize that there are other forms of cancer, albeit more rare, that still need attention, funding, and brilliant minds for research.” Dr. Ricardo Komotar knew he wanted to study neuroscience as early as the 9th grade. He is a member of the Glioblastoma Research Organization’s Medical Advisory Board, and a prolific, internationally recognized leader in the field of brain tumors. Dr. Komotar is joining Amber Barbach on Glioblastoma aka GBM to share a neurosurgeon’s perspective and expertise on glioblastoma. 

Hear us talk about:

How people make their way to neurosurgeons. Most of the referrals neurosurgeons get, Dr. Komotar says, are at their endpoint. Neurosurgeons are typically not the ones making the diagnosis or ordering the MRI scans: about 95% of patients develop symptoms such as a seizure, visual changes, or confusion headaches, and they get worked up by their primary care doctor, neurologist, or oncologist, who orders the MRI. Once there is a tumor, patients typically get sent to the neurosurgeon for evaluation to see if they need surgery.

The protocol for a GBM diagnosis. When discussing a glioblastoma diagnosis with a patient out of surgery, the care team needs to take a team-based approach. If the patient has a potentially malignant glioma, they meet with the neurosurgeon, the radiation oncologist, and the medical neuro-oncologist, who is the one who breaks the news. This is because the medical neuro-oncologist has the most expertise in the treatment, and can answer all the questions a family is going to have.

The challenge in tracking GBM. Identifying the key mutations that lead to glioblastoma multiforme is difficult because there are so many different types. Glioblastoma is a catch-all term for people who have this type of disease, but the reality is each patient’s glioblastoma is unique. Until doctors and scientists discover why that is, there’s going to be a problem - because the same treatment is being used for different tumors. “I think as soon as we can figure out what makes each person's tumor so specific and we can give targeted therapy, that’s when we’re gonna have breakthroughs.”

Mutations. Given enough time, all gliomas will eventually degenerate into a grade four. A glioma is a primary brain tumor - it starts in the brain and stays in the brain. Even the low-grade tumors are mutating, albeit slower than a grade three or four. Over time, they mutate into a more malignant form.

Why other cancers get more attention than brain cancer. Other cancers like lung cancer, breast cancer, and colon cancer are the most common types of cancer, and as such, affect the most people. They get large amounts of funding because they constitute a public health issue. Research and treatment of these common cancers have advanced because of the amount of funding, attention, and brilliant minds that have gone into it. 


What’s Next?
Dr. Ricardo Komotar is a member of the Glioblastoma Research Organization’s Medical Advisory Board, and a professor of Clinical Neurological Surgery, director of Neurosurgery Residency program, director of the Brain Tumor Initiative, and director of Surgical Neuro-Oncology program at the University of Miami Health Systems Sylvester Comprehensive Cancer Center.

Resources
Dr. Ricardo Komotar on the Web | Instagram

As always, the information that is discussed in Glioblastoma AKA GBM is not meant to treat or diagnose any disease. What we and our guests share are personal stories of what has worked for the individuals in question, and should not be taken as medical advice or opinion, and is not a substitute for medical advice. If you have any questions about your own situation, always consult with your medical provider and healthcare team.