Patients with Brain Cancer Are Just a Click Away from a Second Opinion

Many patients, survivors and caregivers often advise people who are newly diagnosed with cancer to be their own best advocate. That involves asking questions, conducting research and, sometimes, seeking a second opinion.

For patients with brain cancer, time is of the essence. This year, more than 23,000 adults in the United States will receive a diagnosis of a primary cancerous tumor of the brain and spinal cord, according to Cancer.Net, the American Society of Clinical Oncology’s patient information website. The five-year survival rate is 34 percent for men and 36 percent for women. For patients with glioblastoma (GBM) — the most aggressive and malignant type of brain cancer — these numbers are even lower with a five-year survival rate of less than 10 percent.

Penn Medicine is now offering second opinions to patients, without them ever having to step foot inside the Penn Brain Tumor Center in Philadelphia. A new telemedicine second opinion program for brain tumors is being offered to patients in Florida, Georgia, Maryland, North Carolina, Pennsylvania (not in the Philadelphia region since these patients can receive an in-person second opinion), South Carolina, Virginia and Washington D.C. The institution hopes to expand the program to more states.

“All the scans and medical records can be digitized, so that would pave the way if they want to come to Penn for actual treatment or intervention,” Steven Brem, M.D., co-director of the Brain Tumor Center and director of Neurosurgical Oncology at UPenn, said in an interview with CURE. “I think we are in a position that if someone doesn’t have access to the latest innovative technologies I can find the experts here and give a group report.”

First, an online form must be filled out. Then, a team will review the patient’s documentation. After that, a neurosurgeon will review medical history, current diagnosis and available images with the patient’s health care provider to make a recommendation for the best treatment approach. A second opinion will likely be submitted to the referring physician within seven to 10 business days after receiving all documents.

“Patients with brain cancer often seek second opinions but usually there is a lot of travel involved and some delay. Hopefully this will make it faster and maybe better,” Brem said. “It’s meant to raise the bar, provide convenience and give people peace of mind.”

The Penn Brain Tumor Center has several clinical trials underway that are creating hope for patients with brain cancer that include therapies such as chimeric antigen receptor (CAR)-T cell therapy, immuno-oncology, a DNA vaccine and surgical technology like brain mapping and a dye that can help distinguish cancer cells from healthy tissue during surgery.

“Patients are living longer, so there is that light at the end of the tunnel,” Brem said. “We are on the verge of big breakthroughs because we see CAR-T cell, immuno and PD1 therapies that work and are really making incurable tumors treatable and curable.”

However, Brem acknowledged that the gap in cancer care is a problem throughout the world. He referenced a 2015 cover story in Time magazine, titled The Cancer Gap, that painted a picture of two women with GBM. One woman was treated with standard of care in North Dakota, while the other had access to cutting-edge technology in New York City — the latter women faring better. “I’m hoping this second opinion will level the playing field at a very high level,” Brem said.