Tumor Treating Fields: A Unique Treatment Option for Glioblastoma

“There were no other treatment options that had been approved since [chemotherapy drug] temozolomide with the landmark study in 2005,” he says.

Since their initial approval in 2011, tumor treating fields have been incorporated into the National Comprehensive Cancer Network (NCCN) guidelines for managing both newly diagnosed and recurrent glioblastomas. Landmark clinical trials, EF-11 and EF-14, have demonstrated improved overall survival and progression-free survival for patients treated with tumor treating fields.

What are Tumor Treating Fields?

Tumor treating fields use cutting-edge technology to target glioblastoma cells while sparing healthy tissue. This therapy involves placing an array of transducers on the scalp, which emit non-ionizing electromagnetic waves at a specific frequency. These waves disrupt the division of cancer cells, slowing or even stopping tumor growth.

Unlike traditional cancer treatments, such as chemotherapy and radiation, which often affect the entire body, tumor treating fields are a localized therapy. This means they focus on the tumor without causing significant damage to surrounding healthy tissues. “This is a game-changer for cancer therapy because now you have an option where systemic treatment may not be the best option,” Dr. Ghiaseddin explains.

When are Tumor Treating Fields Recommended?

If you or a loved one has been diagnosed with glioblastoma, tumor treating fields may be an option to consider in specific situations, including:

• Newly Diagnosed Glioblastoma: Tumor treating fields are recommended for patients who have undergone surgical removal of the tumor (resected glioblastoma) and have completed initial chemotherapy and radiation therapy.
• Recurrent Glioblastoma: For patients whose glioblastoma has returned or progressed, tumor treating fields can offer an additional line of treatment.

Your healthcare team will evaluate your overall health, tumor characteristics, and treatment history to determine if tumor treating fields are right for you.

How Does the TTF Device Work?

Using the TTF device may seem daunting at first, but with proper guidance and support, most patients find it manageable.

Here is a step-by-step overview of how the process works:

• MRI Assessment: Your doctor will review a recent MRI of your brain to determine the optimal placement of the transducer arrays.
• Array Placement: The transducers are embedded in adhesive arrays that are applied to your scalp in a specific arrangement based on your tumor’s location. This requires shaving and cleaning the scalp to ensure proper adhesion.
• Device Setup: The arrays are connected to a portable generator, which creates the electromagnetic field. This generator is lightweight and designed to fit into a small pack that you can carry with you.
• Daily Use: For maximum effectiveness, tumor treating fields must be used continuously for at least 18 hours per day. Arrays are typically replaced every 2–3 days or sooner if they lose adhesion. A caregiver or trained professional can assist with array replacement and maintenance. While continuous use can be challenging, many patients find the effort worthwhile given the potential benefits.

What are the Side Effects?

One of the advantages of tumor treating fields is that they have fewer side effects compared to systemic treatments like chemotherapy.

However, there are still some important considerations to keep in mind, including:

• Skin Irritation: The most common side effect is scalp irritation, which can range from mild redness to more severe rash or ulceration in rare cases. Keeping the scalp clean and using over-the-counter ointments or moisturizers can help reduce discomfort.
• Adherence Challenges: The need for continuous use (18+ hours daily) can be difficult for some patients due to lifestyle or work constraints.

“The only things that the clinical trials really bore out with tumor treating fields in terms of toxicity were some skin itchiness and toxicity that led to rash. In the worst case, ulceration that would resolve when the treatment was stopped,” Dr. Ghiaseddin explains.

Your healthcare team can work with you to develop strategies to manage side effects and optimize your comfort during treatment.

Preparing for Tumor Treating Field Therapy

Starting this sort of therapy may require some adjustments to your daily routine, but with preparation and support, you can successfully incorporate it into your life.

Here are a few steps to consider as you get started:

• Shaving Your Scalp: Regular shaving ensures the arrays adhere properly to your skin. If you’re unsure about this step, ask your care team for guidance.
• Skin Care: Keep your scalp clean and moisturized to minimize irritation. Avoid harsh products that may dry out your skin.
• Plan for Mobility: The tumor treating fields device is designed to be portable, allowing you to continue daily activities. Invest in a comfortable bag or backpack to carry the generator.
• Ask for Support: Whether it’s a family member, friend, or professional caregiver, having someone assist with array replacement can make the process easier.

The Future of Tumor Treating Fields

Tumor treating fields represent a growing area of research and innovation in cancer treatment. As scientists continue to study and refine this technology, there is hope that it could be applied to other types of tumors beyond glioblastoma. Ongoing clinical trials are exploring the potential of tumor treating fields in other cancers, bringing new possibilities to patients worldwide.

If you or a loved one is considering tumor treating fields therapy, it’s essential to have open and honest conversations with your healthcare team. They can provide personalized guidance, address your concerns, and help you navigate this journey. Remember, you are not alone—support is available every step of the way.

With its ability to target cancer cells while sparing healthy tissue, tumor treating fields offer a promising option for glioblastoma patients. While the journey may have challenges, many find that the potential benefits outweigh the difficulties. Together with your care team, you can make an informed decision that aligns with your goals and priorities.

Questions to Ask Your Doctor

If you are facing a glioblastoma diagnosis, consider asking your doctor the following questions about your treatment path.

• Am I a candidate for tumor treating fields?
• How will we monitor if the treatment is working?
• What are the side effects I should look out for?
• What can I do to prepare for the treatment?

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