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Old 04-24-2013, 09:21 PM   #1
Lani
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Lightbulb Yes, ma'am. Would you like your brain mets treated after I clear out your sinuses???

Can I clean your windows/glasses too? Sounds like someone @ a carwash?

It may turn out that they could get herceptin, pertuzumab and other monoclonal antibodies and complex compounds across the blood-brain barrier via the nasal sinuses.

WOW. I will post this with a different title to get the attention of those with brain and leptomeningeal mets.


Public release date: 24-Apr-2013
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Contact: Mary Leach
Mary_Leach@meei.harvard.edu
617-573-4170
Massachusetts Eye and Ear Infirmary
Researchers use nasal lining to breach blood/brain barrier

Discovery widens treatment options for neurodegenerative and central nervous system disease

BOSTON (April 24, 2013) – Neurodegenerative and central nervous system (CNS) diseases represent a major public health issue affecting at least 20 million children and adults in the United States alone. Multiple drugs exist to treat and potentially cure these debilitating diseases, but 98 percent of all potential pharmaceutical agents are prevented from reaching the CNS directly due to the blood-brain barrier.

Using mucosa, or the lining of the nose, researchers in the department of Otology and Laryngology at the Massachusetts Eye and Ear/Harvard Medical School and the Biomedical Engineering Department of Boston University have demonstrated what may be the first known method to permanently bypass the blood-brain barrier, thus opening the door to new treatment options for those with neurodegenerative and CNS disease. Their study is published on PLOS ONE.

Many attempts have been made to deliver drugs across the blood-brain barrier using methods such as osmotic disruption and implantation of catheters into the brain, however these methods are temporary and prone to infection and dislodgement.

"As an endoscopic skull base surgeon, I and many other researchers have helped to develop methods to reconstruct large defects between the nose and brain using the patient's own mucosa or nasal lining," said Benjamin S. Bleier, M.D., Otolaryngologist at Mass. Eye and Ear and HMS Assistant Professor.

Study co-author Xue Han, Ph.D., an assistant professor of Biomedical Engineering at Boston University, said, "The development of this model enables us to perform critical preclinical testing of novel therapies for neurological and psychiatric diseases."

Inspired by recent advances in human endoscopic transnasal skull based surgical techniques, the investigators went to work to develop an animal model of this technique and use it to evaluate transmucosal permeability for the purpose of direct drug delivery to the brain.

In this study using a mouse model, researchers describe a novel method of creating a semi-permeable window in the blood-brain barrier using purely autologous tissues to allow for higher molecular weight drug delivery to the CNS. They demonstrated for the first time that these membranes are capable of delivering molecules to the brain which are up to 1,000-times larger than those excluded by the blood-brain barrier.

"Since this is a proven surgical technique which is known to be safe and well tolerated, this data suggests that these membranes may represent the first known method to permanently bypass the blood-brain barrier using the patient's own tissue," Dr. Bleier said. "This method may open the door for the development of a variety of new therapies for neurodegenerative and CNS disease.

Future studies will be directed towards developing clinical trials to test this method in patients who have already undergone these endoscopic surgeries."

###
The study was supported by a grant from the Michael J. Fox Foundation for Parkinson's Research and represents a collaborative effort between Mass. Eye and Ear and Dr. Xue Han of the Biomedical Engineering Department at Boston University. Other authors include Richie E. Kohman, Rachel E. Feldman and Shrestha Ramanlal.

About Massachusetts Eye and Ear

Mass. Eye and Ear clinicians and scientists are driven by a mission to find cures for blindness, deafness and diseases of the head and neck. After uniting with Schepens Eye Research Institute Mass. Eye and Ear in Boston became the world's largest vision and hearing research center, offering hope and healing to patients everywhere through discovery and innovation. Mass. Eye and Ear is a Harvard Medical School teaching hospital and trains future medical leaders in ophthalmology and otolaryngology, through residency as well as clinical and research fellowships. Internationally acclaimed since its founding in 1824, Mass. Eye and Ear employs full-time, board-certified physicians who offer high-quality and affordable specialty care that ranges from the routine to the very complex. U.S. News & World Report's "Best Hospitals Survey" has consistently ranked the Mass. Eye and Ear Departments of Otolaryngology and Ophthalmology as top five in the nation.
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Old 04-24-2013, 10:16 PM   #2
'lizbeth
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Re: Yes, ma'am. Would you like your brain mets treated after I clear out your sinuse

Oh duh, smell is the only sense that has a direct connection to the brain, right?

Instead of an IV, we'll just get a box of "snuff" in the future. Amazing.
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Diagnosed 2007
Stage IIb Invasive Ductal Carcinoma, Pagets, 3 of 15 positive nodes

Traditional Treatment: Mastectomy and Axillary Node Dissection followed by Taxotere, 6 treatments and 1 year of Herceptin, no radiation
Former Chemo Ninja "Takizi Zukuchiri"

Additional treatments:
GP2 vaccine, San Antonio Med Ctr
Prescriptive Exercise for Cancer Patients
ENERGY Study, UCSD La Jolla

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The content of my posts are meant for informational purposes only. The medical information is intended for general information only and should not be used in any way to diagnose, treat, cure, or prevent disease
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Old 04-25-2013, 04:47 AM   #3
NEDenise
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Re: Yes, ma'am. Would you like your brain mets treated after I clear out your sinuse

Love it!
Clever thread title!

Very, very interesting theory...can't wait to hear more about this one!
Denise
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1/11-needle biopsy
2/11-Lumpectomy/axillary node dissection - Stage 3c, ER/PR-14/17 nodes
3/11 - Post-op staph infection,cellulitis, lymphedema,seroma,ARRRGH!
4/12/11-A/C x 4, then T/H x 4, H only,Q3 weeks
8/26/11 finished Taxol!!!
10/7/11 mastectomy/DIEP recon
11/11 radiation x28
1/12/12 1st CANCER-VERSARY!
1/12 Low EF/Herceptin "Holiday" :(
2/12 EF up - Back on Herceptin, heart meds
4/2/1212 surgery to repair separated incision from DIEP recon
6/8/12 Return to work :)
6/17/12 Fall, shatter wrist,surgery to repair/insert plate :(
7/10/12 last Herceptin
7/23/12 Brain Mets %$&#! 3cm and 1cm
8/10/12 Gamma knife surgery, LOTS of steroids;start H/Tykerb
8/23/12 Back to work
12/20/12 Injure back-3 weeks in wheel chair
1/12/13 2nd CANCER-VERSARY!
1/14/13 herniate disk in back - surgery to repair
1/27/13 Radiation necrosis - edema in brain - back on steroids - but not back to work - off balance, poor cordination in right arm
5/3/13 Start Avastin to shrink necrosis
5/10/13 begin weaning steroids
6/18/13 Brain MRI - Avastin seems to be working!
6/20/13 quarterly CT - chest, abdomen, pelvis - All Clear!
7/5/13 finally off steroids!!
7/7/13 joined the ranks of the CHEMO NINJAS I am now Tekuto Ki Ariku cancer assassin!
7/13/13 Symptoms return - back on steroids
7/26/13 Back on Avastin - try again!
8/26/13 Not ready to return to classroom yet :( But I CAN walk without holding onto things! :)
9/9/13 Brain MRI - fingers crossed
“ Life is a grindstone, and whether it grinds you down or polishes you up is for you, and you alone, to decide. ” – Cavett Robert
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Old 04-25-2013, 05:21 AM   #4
Lani
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Re: Yes, ma'am. Would you like your brain mets treated after I clear out your sinuse

actually your eyes and ears are connected as well--particularly your eyes.

As I understand it, peering into your eyes deeply(with an opthalmoscope), doctors can look at the only part of the brain visible without opening your skull.

That is one way to detect increased pressure in your brain without having to insert a pressure monitor through the skull

Sure happy about that!
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Old 04-25-2013, 01:11 PM   #5
dearjilly
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Re: Yes, ma'am. Would you like your brain mets treated after I clear out your sinuse

This is very interesting. It makes me very happy.
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Feb 2013 - NED
Mar 2013 - thought I had progression, watching brain.
April 2013 - GOT MARRIED!!!!
May 2013 - looks like no progression, but necrosis and bigger.
Oct-Dec 2013 - Avastin tx
Nov 2013 - MRI shows necrosis shrinkage!!!!
Jan 2014 - Lepto Mening. disease found
Feb 2014 - WBR
March - BLAHHHH
April 2014 - Liver mets found
April 2014 to present - Chemo again, whooohoo. Fun!
July 2014, scans look good.
Stay on Perjetand hercertin.
Nov. 2014 more lepto-mening disease more WBR.
Feb 2015 more lepto-mening disease in spine and neck. More radiation.
Start on TDM1 no more Perjeta stay on herceptin
March 2015 more radiation in my thoracic area, more lepto-meningial disease
April 2015 trying to walk again.
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Old 04-25-2013, 04:14 PM   #6
KsGal
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Re: Yes, ma'am. Would you like your brain mets treated after I clear out your sinuse

That is really interesting...My brain tumors and I are down for that! ((hugs)) Thanks for posting it.
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Diagnosed in October 2011 Stage IV with metastasis to liver.
January 2012 after double mastectomy, started taxotere, carboplatin and herceptin.
Clear.
December 2012 was diagnosed with five brain mets, and had whole brain radiation.
Around July 2014 two mets in brain, one a residual spot and one new one growing in size. Received Cyberknife on both areas
Clear/NED
April 2015 remain NED
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Old 04-25-2013, 04:59 PM   #7
dchips1
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Re: Yes, ma'am. Would you like your brain mets treated after I clear out your sinuse

very interesting about putting the drugs that way. I have had several sinus surgeries and office endoscopy of the sinus. They follow up a poyp that when pet/ct always seems to have uptake.


I got my 42 mg dose of IT Herceptin today, total of 6 doses.
I got asked today by another patient how long will do the IT /Iv treatments? I said till it gets rid of the cancer or forever as needed.

Thanks LANI for all your posts and advocating for us.

Peace and Prayers for all of us

Darita
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dx 1/06 IDC 2cm 38 at dx
2/06 L mast nodes 3/9+ SNB neg ER-/Pr - her2 + Stg 4 liver/pelvis
3/06-9/06Taxol/Carbo/zometa/Herceptin
3/07 6 brain mets WBR down to c-2
4/07 osteonecrosis jaw
1/08 mri new 9mm lesion right lower side
2/08 gamma knife 1 lesion 11/08 regamma
10/09 latent rad necrosis to brain met,
1/20/10 crani: lesion necrosis w active cells continue her add tykerb
1/11 NED just Ingrown toenail! YEAH GOD
8/11 Tykerb, herceptin weekly, elevated her2 levels, negative scans
oct -march 11 new neuro deficits lower legs
3/12 2 spinal metsTykerb, Herceptin
04/12 4050cGY rads T 2-4 & T7-9
5/12 Brain,cervical lumbar clear/thoracic slight decrease
10/12 t 2-4 shrunk t-9 grew start Xeloda, 02/13 stop xeloda,5/13 on metformin, decadron, Tykerb, iv and IT herceptin 5/30/13 total #11 #2 of 80mg dose weekly.
9/13 100mg of IT her, IV hern, 750 mg tykerb, 3mg dec.
last Mri T--3 SHRUNK t7-9 shrunk no edema. Left shift in CBC bone marrow BX negative.
10/13 Ct has shown Double left ureters with stones/cysts in them, after 3 births and lots and U/S iit takes cancer to figure out you have 2 smaller ureters going into 1 kidney!
12/13 Mri brain no new lesions, cervical and lumbar arthritis.
Tspine lesion at T3 stable, T 7-9 GROWTH lots of pain

1/29/14 HIHO HIHO its off to Neuro surgery I go





Life is Good when you wake up in the morning and take a breath and know that God has given me another day.


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