The dye that binds: Colors help doctors treat brain tumors

Published: Dec. 10, 2019 at 2:15 PM CST
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"When I'm in surgery, sometimes it's really difficult to tell what's tumor and what's brain," says Dr. Joseph Chabot, Prevea Health neurosurgeon in Green Bay.

But new technology is helping him remove complex brain tumors with greater ease.

It's happening with the help of a new medication taken before brain surgery that helps doctors see the tumor better because it changes the tumor's color.

Dr. Chabot spends long hours in deep concentration inside an operating room at HSHS St. Vincent Hospital in Green Bay operating on high grade gliomas -- some of the most challenging kinds of brain tumors.

He says they're so tricky because the cancer appears to disguise itself as healthy brain tissue.

"Brain tumors look like the tissue they come from," describes Dr. Chabot. "Sometimes the center of it can look dead and filled with fluid, but around the outside, it looks almost identical to the brain itself."

Neurosurgeons used to perform operations and see tumors and brain tissue under normal white lights.

But now when Dr. Chabot operates on high-grade gliomas, he sees the tumor appear to glow a bright pink color.

The unaffected brain tissue appears a bluish color.

"Anywhere where there's pink, I remove it," he says. "When I get closer to the edges, I start looking how close I am to critical structures."

Patients drink a dye called Gleolan about four hours before surgery.

The dye binds to a protein that's only in glioma tumors, making just the cancerous area glow when viewed under microscope using a special filter.

It gives Dr. Chabot a better opportunity to remove more of the tumor while still being careful not to remove tissue that would harm the patient by affecting their speech, movement, memory, understanding or vision.

"I can't be more clear that this does not cure the tumor. What we're trying to do with this type of surgery is give a patient the best possible outcome, which is quality of life and length of life," he stresses.

Prevea Health says Dr. Chabot was the first neurosurgeon in Wisconsin to use Gleolan during an operation in November. He's since used it on two more patients here, but he was very familiar with it long before that.

Dr. Chabot was part of a team of doctors in Minnesota who took part in clinical trials for the FDA to approve Gleolan in the first place.

While initially skeptical, that first surgery changed his mind.

"We thought, well this doesn't look different from normal brain, and we realized that if we went a few millimeters deeper, and there it was. Bright pink! And it was like, oh, I guess this does make a difference!" he says, recalling the first time he used Gleolan in the operating room.

The dye fades after a few hours, and he says it has little side effects other than a sunburn when a patient is under bright light for the first 48 hours after surgery.

While these cancers are generally not curable, Dr. Chabot hopes this is the first step in finding that cure, and he's glad patients have the option for this breakthrough science in the Green Bay area.

"You can get a high level of care here remaining close to home. You can stay right here in Northeast Wisconsin," adds Dr. Chabot.

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