A chemical dye that lights up brain tumours during surgery should be available to more NHS patients in England, according to the National Institute for Health and Care and Excellence (NICE).
The final recommendation states that certain patients should be given the dye, called 5-amino levulinic acid (5-ALA), as a drink before their first surgery. The pink drink causes tumour cells in the brain to glow under a special light.
The light helps surgeons distinguish between brain tumour and healthy tissue. This allows them to remove more of the tumour.
Dr Paul Brennan, a Cancer Research UK-funded neurosurgeon from the University of Edinburgh, said: “Where surgeons are aiming to remove as much tumour as possible, 5-ALA can help the surgeon to identify tumour that may have otherwise been missed.”
“Not all tumours can be safely removed because they are near important bits of brain, but for tumours where this is possible, 5-ALA should provide a better outcome for patients.”
Tom Roques, a consultant clinical oncologist, said that these new guidelines would mean patients across England will now receive the highest quality of care available.
“The roll out of 5-ALA will see more patients treated to a gold standard level of care and will help delay the recurrence of brain tumours,” he said.
Who gets the drink?
Around 11,000 people are diagnosed with a brain tumour in the UK each year. NICE estimates that around a third of these people would be eligible to receive the drink as part of their treatment.
Patients with a certain type of glioblastoma, an aggressive brain tumour, are already given the drink. But the new guidelines extend its use to people with other types of aggressive brain tumours and for people with cancer that has spread to the brain. It also recommends 5-ALA for those with meningiomas, tumours in the soft tissue around the brain and nervous system.
Dame Tessa Jowell pressed the Government to make 5-ALA available across the NHS in one of her final speeches in the House of Lords. Jowell died of glioblastoma in May.
Emma Greenwood, Cancer Research UK’s director of policy and public affairs, said the new guidance from NICE is “a positive step for people with brain cancer.”
“We’re pleased to see the 5-ALA dye rolled out, following Dame Tessa Jowell’s inspirational campaigning – one of her many legacies.”
She added NICE has also announced that more patients will benefit from the chemotherapy drug temozolomide. This drug is being used to treat some types of brain tumours.
“Improving outcomes for people with brain cancer is a major priority for Cancer Research UK and we recently announced a £25 million funding boost for brain tumour research, over the next five years.”
Final guidelines also included recommendations to ensure patients with brain tumours get more targeted radiotherapy and support from neurological rehabilitation throughout their treatment.
NICE guideline (July 2018) Brain tumours (primary) and brain metastases in adults