"You can have different combinations for different patients and get a more personalized type of treatment," said Dr. Linda Liau, director of the Comprehensive Brain Tumor Program and Neurosurgical Oncology at the University of California at Los Angeles Medical Center.
Immunotherapies and vaccines for brain cancer cells are newer forms of therapy, but experts hope that these will be even more customizable and effective against recurring tumors. These therapies utilize the body's immune response to specifically attack cancer cells.
"The beauty of the vaccine is if you can get the immune system to recognize the tumor, it travels the body and finds infiltrators," said Dr. Andrew Sloan, associate professor of neurological surgery at University Hospitals Case Medical Center. "They basically go on a search and destroy mission. … There is very little toxicity."
Important, since toxicity can often be the limiting factor when deciding how to treat a patient, particularly an older one.
"Sometimes, elderly patients don't receive as aggressive treatments as younger patients," said Dr. Gene Barnett, director of the Brain, Tumor and Neuro-Oncology Center at the Cleveland Clinic. "They have more severe consequences from toxic chemotherapies. … My guess is that Sen. Kennedy is going to get the most aggressive treatment that he can tolerate."
But in most cases, older patients can handle these aggressive therapies. And they tend to do better when they receive them.
"Unless a patient has a specific medical problem that is a contraindication, age is not a factor," Fine said, adding that given the senator's recent level of job performance, "his status is pretty damn good."
"Most of the therapies we use, both standard and investigative, are very well tolerated," he said.
Also working in Kennedy's favor is the fact that he appears to be free from many of the medical conditions that could cause complications and might bar someone from receiving experimental treatments. These conditions include heart disease, liver problems, Alzheimer's and difficulty speaking or walking.
And newer, targeted treatments mean fewer side effects. In one class of treatment, known as genetic therapies, viruses are used to modify the genetic material in cancerous cells so that they cannot function.
While such therapies represent only a small percentage of new treatments, there are other new strategies as well. Embarking upon them is often a choice the patient must make.
"In general, there are two different types of people," some who are more comfortable with standard care and others who are willing to try new treatments, Fine said. "Both of those patients do the right thing for themselves."