When Life Tips Upside Down
Brain and spine tumor program provides personalized treatment
July 19, 2024
4 minute read
Brain and spine tumor program provides personalized treatment
Ted Schrubbe, of Elm Grove, initially chalked up his extreme fatigue and headaches to a cold. On Dec. 5, 2022, at the age of 39, the dentist made the rounds in his practice and struggled to get out the right words, drawing puzzled looks from patients and colleagues. A concerned hygienist urged him to seek medical care right away.
Later that night, Ted was shocked when a CT scan revealed a mass in his brain — what he would later learn was glioblastoma, an aggressive brain tumor.
“Ted is like so many of my patients — an otherwise healthy guy living life and feeling completely fine when all of a sudden, he experiences some neurologic changes and life tips upside down,” said Jennifer Connelly, MD, neuro-oncologist and Medical College of Wisconsin faculty member.
Ted was first evaluated at a hospital outside the Froedtert & MCW health network. Staff there recommended immediate surgery, but Ted decided to get a second opinion through the Froedtert & MCW Cancer Network and its Brain and Spine Tumor Program.
“I’m grateful I did,” Ted said. “The environment had a totally different feel. It was a patient-centered experience that I was in control of, and I felt a lot more comfortable with the treatment plan.”
“While Ted’s disease is not curable, it is treatable,” said Max Krucoff, MD, neurosurgeon and MCW faculty member. “The treatment goals are to maximize survival and quality of life. That involves removing as much of the tumor as we can safely and then following with radiation therapy and chemotherapy to keep it from coming back as long as possible.”
The avocado-shaped tumor was lodged in Ted’s left frontal lobe, the speech area of the brain. After giving Ted steroids for a week to reduce inflammation, Dr. Krucoff performed an awake craniotomy. That allowed the surgical team to monitor Ted’s speech and preserve critical brain tissue. Even though Ted was awake at times during the surgery, he was kept comfortable with anesthesia.
“I could see evidence that his brain had remapped because of the tumor, so it was important for him to be awake during the surgery,” Dr. Krucoff said. “Otherwise, he could have developed permanent speech deficits.”
Before the procedure, Ted was given 5-ALA — known as the “pink drink” — which made his tumor cells glow pink under blue light. Guided by the fluorescence, electromagnetic neuronavigation and intraoperative MRI, Dr. Krucoff was able to remove 95% of Ted’s tumor.
Ted also participated in a clinical trial to help researchers understand how tumors affect the brain’s functioning and interconnections. The trial involved a functional MRI and fine motor skill testing before surgery and then again three months later. After surgery, Ted had six weeks of radiation therapy and a year of chemotherapy. Michael Straza, MD, PhD, radiation oncologist and MCW faculty member, used a volumetric modulated arc therapy technique.
“This technique guides the treatment precisely to where the tumor is and where any microscopic tumor cells may be hiding,” Dr. Straza said. “It also bends and shapes the radiation beam so it avoids healthy brain tissues.”
Ted’s treatment plan also included tumor-treating fields therapy (TTFields), a wearable device that creates electrical fields that disrupt cancer cell division. Patients are encouraged to wear the device at least 75% of the time, but Ted wears his almost constantly to stave off a tumor recurrence as long as he can.
Through it all, Ted’s wife, Darcie, has been a constant support in navigating the challenges.
“I have an amazing wife,” Ted said. “This would be hard to do alone.”
Brain and Spine Tumor Program experts meet weekly to discuss optimal ways to treat each patient.
“This multidisciplinary team has decades of experience in managing brain tumors, which are rare diseases,” Dr. Connelly said. “That makes a difference in patient outcomes — not only in terms of quality of life, but also in overall survival.”
“The real power of having a neurooncology team is being able to map out for patients not just the next several weeks or months, but how we approach something we know will likely come back someday,” Dr. Straza said. “We offer several investigator-initiated studies unique to our Cancer Network, as well as national studies, for people in that position.”
In the meantime, Ted is doing everything he can to take care of himself — and loving life too much to stress about his next brain scan. He lost 50 pounds and embraced a healthier diet, sleep and exercise regimen. He decided not to return to work and is instead enjoying time with Darcie and their two daughters, as well as hobbies like biking and yoga.
“I’m in a good place now,” Ted said. “I feel the best I’ve ever felt.”
