ISIS and Brain Tumors

What in the world do brain tumors have to do with ISIS? Be patient and I will explain. The similarities make defeating either foe extremely challenging. Skeptical? Ask brain surgeon Ben Carson who has managed a lifetime of brain tumors.

Glioblastoma Multiforme (GBM) is an aggressive malignant brain tumor. It has no interest in politics, taking the lives of a former Republican National Committee chairman Lee Atwater and a longstanding Democrat U.S. senator, Ted Kennedy. It also takes no prisoners, with a median survival of 12 months, few patients surviving 5 years or longer. There are tumors and there are tumors, but this is a bad one, without a cure. Instead treatment is directed at delaying the inevitable.

Why is GBM so bad and what’s the connection to ISIS? GBM has some unique treatment challenges, many similar to the difficulties combating ISIS.  

“Localization of tumors in the brain” is the first challenge. Where is ISIS? What’s their country? Iraq, Syria, Libya, Afghanistan? Where is their capitol? Where is the head of the snake? In WWII there was Berlin and Tokyo. Not so with Isis. GBM is multiform, hence its name. Existing in many forms or kinds. Different nationalities – Syrian, Iraqi, and other Middle East countries. Not to mention home-grown ISIS members from France, Germany, Belgium, Colorado, or wherever. How can a surgeon treat a tumor without knowing its origin? Remove a tentacle of an octopus and a new one grows back. Same with GBM and ISIS.

“Inherent resistance to conventional therapy.” GBM can’t be removed, as it is everywhere. Radiation and chemotherapy may shrink the tumor, surgery may remove a portion of it, but eventually it grows back. Much like ISIS. Kill one of the “leaders” and ten more replace him. Bomb one ISIS stronghold and another one pops up. Tumor cells die frequently due to their high metabolic demand. No problem. Others are there to replace the dead ones. Just like suicide bombers. Happy to die for the cause, with replacements at the ready.

“Limited capacity of the brain to repair itself.” Brain tissue, unlike skin or muscle, doesn’t regrow. Once a portion of the brain dies, whether due to a tumor or a stroke, it’s gone. Equate the brain to Europe. Can Europe replace itself or regrow? Europe’s native population is in decline, reproduction well below the replacement rate. If people are neurons, it’s the Muslim neurons that are growing, not the native European ones. With a low birth rate, Europe has a limited ability to repair itself. One baby replacing four elderly grandparents means little societal repair and a population in decline.

“Migration of malignant cells into adjacent brain tissue.” GBM does this well, growing and spreading into all areas of the brain. How about ISIS? Refugees from Syria to Greece, migrating north, eventually populating all European countries. Look at the distribution of Syrian refugees in the U.S., spreading into adjacent cities and states. Are they all malignant cells? Probably not, but cancer starts with one bad cell, even if all the others are perfectly fine. Like ISIS, leave a few bad cells behind and soon there are more.

“A limited response to therapy.” Chemo and radiation don’t work very well on GBM. Conventional warfare doesn’t work so well again ISIS. Ask Donald Rumsfeld how it worked against Iraq, or in Afghanistan. Ask the Soviets the same question. Bombs and troops are the Pentagon’s equivalent of radiation and chemotherapy. Is this the best therapy?

“The neurotoxicity of treatments.” Another name for neurotoxicity could be collateral damage. Cancer treatment directed toward a brain tumor, such as radiation or surgery, kills healthy brain tissue too. Bombing ISIS controlled cities kills many innocents along with the terrorists. This does have precedent however. Nuclear weapons used on Hiroshima and Nagasaki killed thousands of innocents, but the purpose was to send a message to Japanese leadership. A brain tumor doesn’t think, meaning you can’t send it a message. Cutting out most of someone’s brain will certainly eliminate the tumor, but will also decimate the brain’s owner.

GBM, like ISIS, is insidious and aggressive. It spreads quickly and quietly, making it difficult to attack. It is everywhere and nowhere at the same time, like a ghost. Removing part of the disease does little as there is much more elsewhere. Conventional remedies work poorly and risk collateral damage. So what can be done? Keeping the patient comfortable until they die is one approach. Not so good for Europe, the U.S., or Western civilization. John Lennon’s wistful song may come to pass, “Imagine there's no countries.”

Cancer researchers are looking at novel approaches for GBM, “outside the box thinking” to borrow a hackneyed phrase. Are such options needed for ISIS? Or is the problem one more fundamental?

How about prevention? Stopping smoking reduces the risk of many cancers. Sensible limits or even cessation of immigration may reduce the risk of Paris-in-America. Half of U.S. governors, including one Democrat, are refusing Syrian refugees.  

Or taking the fight to Syria. As the French are doing. Chemo and radiation delivered via French jets. Attempting to cut off ISIS supply lines, much like choking off the blood supply of a tumor.

The cancer is growing and soon the patient will be critical. Instead of treating it aggressively with all available tools, surgeon Obama chooses to dither and delay. Paris was just a “setback” according to Obama, like a GBM patient losing the ability to move half their body would be a “setback.”

Perhaps the President is choosing to use one his ObamaCare death panels, leaving his patient with an aggressive brain tumor to the forces of nature. But it’s more than one patient. It’s America, Europe, and everywhere else in the ISIS crosshairs. Cancer treatment is rough with nasty side effects. As is beating back ISIS. What choice do we have?

Brian C Joondeph, MD, MPS, a Denver based retina surgeon and writer. Follow him on Facebook  and Twitter