When Arnaldo Dacruz was diagnosed with brain cancer, he and his wife, Dorothy, were blindsided.
Now they have hope with the help of a treatment available at Rhode Island Hospital.
Dacruz, 76, had been feeling light-headed for a while and mentioned it to his doctor several times, but no one thought anything of it. When he began losing his memory, Dorothy Dacruz suspected it was an early symptom of dementia or Alzheimer’s disease and took her husband to get an MRI in October 2024.
The results were shocking.
“The doctor came out and told us, ‘Your husband has a really large mass and this is not good,’ ” Dorothy Dacruz said. “We didn’t know what to do.”
Dacruz, who lives in Cambridge, Mass., was treated at Beth Israel Deaconess Medical Center, where surgeons were able to remove a portion of his tumor. Then the couple heard about GammaTile, a therapy that’s been used in recent years to target newly diagnosed malignant brain tumors.
Within weeks, Arnaldo Dacruz was at Rhode Island Hospital, where the innovative treatment has been offered for the first time in the state since last fall.
“With this kind of illness, you sort of have no choice. You either go the traditional route, which hasn’t been all that promising, or you reach out to someone, like we did, and hope that it’s going to work,” Dorothy Dacruz said.
GammaTile is a biodegradable implant about the size of a postage stamp that’s placed directly into the surgical cavity after a brain tumor is removed. Once in place, the GammaTile delivers radiation directly to the site of a brain tumor, a much stronger, more targeted dose than traditional methods.
The radiation is delivered by radioactive seeds embedded into the GammaTile, which is made of collagen – a protein known as the building block of skin, muscles and bones. Radiation lasts for about a month and the body naturally breaks down the GammaTile, says Dr. Clark Chen, director of the brain tumor program at Rhode Island Hospital. He notes that surgeons already use collagen sponges during regular surgeries to stop bleeding.
“The invention of GammaTile is taking advantage of that [use of collagen sponges] and saying, ‘Hey, you’re using these collagen sponges anyway. Why not put something therapeutic in it?’ ” said Chen, who operated on Dacruz.
The GammaTile received clearance from the Food and Drug Administration in 2018 for recurrent brain tumors and expanded clearance in 2020 to include upfront use in any malignant brain tumor, such as Dacruz’s.
Before GammaTile’s approval, patients with operable brain tumors would have surgery to remove the cancer and then have to wait four to six weeks before starting radiation so the surgical wound could heal. But there are usually microscopic cancer cells left after surgery, meaning a patient’s cancer can grow back before they begin radiation and chemotherapy.
In fact, Chen has seen patients whose cancer grew back to the point they needed a second surgery.
The GammaTile can be implanted immediately and delivers radiation in a short range, so it keeps the tumor from growing for a month and doesn’t affect wound healing. Chen says some patients may need to return for radiation after the GammaTile is implanted. But they’re spending much less time in the hospital for radiation than they would without the GammaTile.
Chen says implanting the GammaTile takes just two to five minutes and is not very risky. Also, because the radiation is sent directly to one spot, patients usually don’t feel as many side effects as they would during traditional radiation treatments.
The GammaTile has been implanted more than 1,000 times in the U.S., says Chen, who performed the first such procedure in the U.S. in 2018.
The procedure is a team effort. Chen says a hospital must have a program where neurosurgeons, radiation specialists and neuro-oncologists are able to collaborate. In fact, a radiation oncologist must be able to take time away from their daily responsibilities to help with the surgery.
“You must have an institution enlightened enough to be able to say, ‘Yes, this is so important, we’re going to let a radiation oncologist take three or four hours a day to go into the operating room rather than just cranking out clinical visits,’ ” Chen said.
After the GammaTile was implanted in Dacruz’s skull, the remaining portion of the brain tumor shrank to a microscopic size. He’s also completed a round of radiation and chemotherapy. While Dacruz’s prognosis remains uncertain until he gets another MRI scan, the couple is now much more hopeful than they were a few months ago.
In the meantime, Chen believes the use of collagen-made “tiles” to deliver therapies will only increase from here.
His research is focused on placing radioactive materials directly into a tumor site while it’s being removed, and he believes similar technology can be used to treat other kinds of cancers.
“I think GammaTile is just the first step toward delivering more therapies at the time of surgery,” Chen said. “In the future, it won’t just be GammaTile – it will be collagen, plus this therapy or that therapy.”
