Risky Alzheimer's surgery could hold promise
From Rhonda Rowland
SAN DIEGO, California -- Lola Crosswhite has never been one to shy away from a challenge. At 72, she's an avid photographer, fitness buff, scuba diver and downhill skier.
She's also a pioneering Alzheimer's patient -- only the third in the world to undergo an experimental gene-therapy procedure designed to slow the progression of the disease.
Surgeons at the University of California at San Diego (UCSD), have implanted genetically modified tissue deep in Crosswhite's brain. The tissue contains proteins called growth factors, which doctors hope will prevent the death of memory and reasoning cells, which typically degenerate in Alzheimer's patients.
"This won't be a cure," says Dr. Mark Tuszynski, the associate professor of neuroscience at UCSD who developed the procedure. "This will, if we are fortunate, slow the decline of the disease."
That would be enough for Crosswhite.
"If I could just stay where I am today and not get any worse, even that would be pretty wonderful because I am still able to enjoy my life, I am still able to do a lot of things," she says.
'I want this to be better'
Crosswhite has always been active. In her career days, she handled contract management and international sales for the aerospace industry, then started a business of her own with a partner. She also raised two children by herself.
But in her early 60s, Crosswhite began to notice that "something was not quite right." The diagnosis of Alzheimer's, when it came, was not a surprise, she says.
"Obviously, I didn't like that all that much, but I think to know is better than to wonder and wonder why you have such a hard time remembering things, and so to some extent to me it was a sense of relief."
The 11-hour procedure held substantial risks, but Crosswhite says she was willing to take them. She remained awake throughout the entire surgery.
"I don't really think about its being brave or not," she says. "It's just, to some extent, being selfish. I want this to be better."
Doctors had to insert long needles directly into Crosswhite's brain, which could have triggered bleeding. There was also the possibility that the added tissue could cause tumors, pain and even weight loss if not delivered to the right area. Being off-target by less than a quarter of an inch could render the therapy useless.
Adding to the complexity: Doctors had to give Crosswhite two MRI scans to make sure her brain had not been harmed.
"I think it's worth trying despite the risk," says Alzheimer's expert Dr. Leon Thal of UCSD, "because we stand to gain a tremendous amount of information about whether the approach will work. And then if it does, we're going to find simpler ways of trying to deliver the same type of compounds and get the same effect."
A month after the surgery, Crosswhite was back on the ski slopes.
And although it will be months yet before doctors will be able to tell if the gene therapy is slowing the progression of her Alzheimer's, Crosswhite says those who know her have noticed a difference already.
"People around me seem to feel that my short-term memory is much better than it used to be," she says. "That may be just wishful thinking, but I don't think so."
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University of California, San Diego
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