Narcolepsy Drug Helps Brain Tumor Patients

Study found it improved cognitive function and mood

Amanda Gardner

Amanda Gardner

Updated on June 05, 2006

SUNDAY, June 4, 2006 (HealthDay News) -- A drug used for narcolepsy improved the quality of life for patients with malignant brain tumors, a new study shows.

"This is excellent information," said Dr. Robert Morgan, a medical oncologist at City of Hope, in Duarte, Calif. "Fatigue leading to poor quality of life is extremely common in patients with brain tumors, and we don't have that much to help right now."

That finding was among survivorship data presented Sunday at the American Society of Clinical Oncology annual meeting, in Atlanta.

The 10 million cancer survivors in the United States right now are equivalent to the population of Los Angeles, or 3.5 percent of the total U.S. population, said Dr. Patricia Ganz, director for cancer prevention and control research at Jonsson Comprehensive Cancer Center at UCLA. Ganz moderated a press conference on the survivorship findings.

"These people are really benefiting from the products of our new discoveries, but it's not without a cost," she said.

In addition to its use for various sleep disorders, modafinil, known as Provigil, is also being used to help treat depression and to fight the fatigue associated with multiple sclerosis, Parkinson's disease, stroke and HIV infection. It has also shown promise as a treatment for cocaine addiction.

The pilot study presented at ASCO looked at 30 patients with different types of brain tumors, most of whom had severe attention, memory and fatigue problems. All had undergone some combination of neurosurgery, radiation therapy and chemotherapy. All of the tumors were primary ones; there were no metastases of other cancers.

All participants took modafinil at the dose considered optimal for them every day for eight weeks.

Most of the participants showed "clinically meaningful" improvements in all the areas tested, including cognitive abilities (21 percent average improvement), mood (35 percent average improvement) and fatigue (average improvement of 47 percent).

"Modafinil was very effective in improving neurocognitive abilities, fatigue levels and depression symptoms in adult brain tumor patients," said study author Thomas A. Kaleita, an assistant professor of psychiatry at UCLA. "The improvement in depressive symptoms was quite a surprise for us."

Three patients had no response to the drug, possibly because of the site of the tumor or because of psychological factors. There were only mild to moderate side effects.

Quality of life was also the focus of research involving breast cancer patients who participated in a yoga program while undergoing radiation.

The Hatha yoga program of two sessions per week incorporated 60 minutes of yoga, breathing and loosening exercises, deep relaxation, alternate nostril breathing and specific meditation techniques, said study author Lorenzo Cohen, director of the Integrative Medicine Program at the M.D. Anderson Cancer Center at the University of Texas in Houston.

Sixty-two women who had not practiced yoga before were randomized either to participate in the yoga program (which Cohen referred to as a "body holiday") or to be on a waiting list.

One week after radiation and yoga were completed, women who had been in the yoga group reported significantly and clinically improved physical functioning along with lower levels of fatigue and sleep-related daytime dysfunction. There were marginal gains in social functioning.

"This is one of the few pilot programs looking at yoga in a cancer population," Cohen said. "It is feasible to do this kind of research, and we now have a grant from the National Cancer Institute to compare a yoga group with a general stretching group. Then we will be able to better gauge if it's something about yoga or something as simple as stretching."

"This is interesting data because it goes along with more and more research that suggests that physical activity is beneficial for at least quality of life," Morgan said. "As a doctor, I have something to tell patients who ask that there's even more data to suggest physical activity is beneficial."

A final study showed that gene variations that affect the metabolism of cancer drugs called anthracylines may explain why some patients who receive those drugs as children experience cardiac side effects later. These findings need to be replicated, said study author Dr. Richard Aplenc, an assistant professor of pediatrics at the University of Pennsylvania School of Medicine and an attending physician at Children's Hospital of Philadelphia.

More information

For more on life after cancer, visit People Living With Cancer.

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