Surgery for Brain Tumors at The Children’s Hospital of Philadelphia


>>FOR A PATIENT WHO HAS
ANY KIND OF A BRAIN TUMOR, COMING TO CHOP HAS A
PARTICULAR ADVANTAGE BECAUSE OF THE EXTENSIVE EXPERIENCE OF
THE NEUROSURGEONS AS WELL AS THE CLOSE INTERACTION THAT
GOES ON ON A TEAMWORK BASIS BETWEEN NEUROSURGERY,
NEURO-ONCOLOGY, RADIATION ONCOLOGY, DIAGNOSTIC RADIOLOGY,
AND ALL THE SERVICES THAT ARE SO IMPORTANT IN
TERMS OF PUTTING TOGETHER A TEAM THAT DEALS WITH
THESE COMPLEX PROBLEMS.>>SURGICAL SPECIALISTS CAN
MAKE A TREMENDOUS DIFFERENCE IN A CHILD’S LIFE
WITH AN OPERATION, BASED ON THEIR
EXPERTISE AND ABILITY. IT’S A LITTLE BIT
LIKE BEING A VIRTUOSO, AND THAT’S WHAT A PEDIATRIC
CANCER OPERATION IS WHEN PROPERLY PERFORMED.>>A GREAT CONCERN IS ALWAYS
TO BE AGGRESSIVE WITHOUT BEING RECKLESS. YOU WANT TO REMOVE AS
MUCH TUMOR AS YOU CAN, LEAVING THEM
NEUROLOGICALLY INTACT, AND THAT’S THE
REAL CHALLENGE.>>PATIENTS WHO HAVE
THEIR SURGERY AT CHOP, WE ALWAYS OFFER THEM
THE FULL RANGE OF ADJUNCT THERAPY. IF THERE’S A TREATMENT
THAT WE OFFER HERE, WHETHER IT BE THROUGH
A RESEARCH PROTOCOL OR THE PROTON BEAM THERAPY,
THEN WE WILL TRY AND KEEP THEM HERE IF WE THINK IT’S IN
THEIR BEST INTEREST. BUT IF IT’S MORE CONVENIENT
FOR THEM TO BE TREATED CLOSER TO HOME AND
THEY’RE ABLE TO GET THE SAME TREATMENT REGIMEN
SOMEWHERE ELSE, THEN THE ONCOLOGY TEAM HERE
WILL WORK VERY CLOSELY IN COORDINATING A TREATMENT
PLAN WITH AN OUTSIDE PHYSICIAN. IT’S IMPORTANT FOR US TO
GET THE FAMILIES BACK HOME.>>REFERRING PHYSICIANS
ARE OBVIOUSLY A CRITICAL COMPONENT OF WHAT WE DO
AND WHAT WE NEED TO DO. OUR GOAL UNDER THOSE
CIRCUMSTANCES IS TO MAKE THEM AN INTEGRAL PART OF
OUR COMMUNICATION SYSTEM, THAT THE NEUROSURGEONS
COMMUNICATE DIRECTLY WITH THE OUTSIDE PHYSICIANS AND
THE OUTSIDE PHYSICIANS HAVE ACCESS BY TELEPHONE
AND E-MAIL TO MOST OF THE NEURO-ONCOLOGY AND
NEUROSURGERY ATTENDINGS.>>EVERY PATIENT THAT COMES
TO THE CHILDREN’S HOSPITAL OF PHILADELPHIA, WE ENROLL
THEM IN A STUDY WHERE WE’RE GOING TO SAVE ANY TUMOR
THAT’S LEFT OVER ONCE THE PATHOLOGISTS HAVE
MADE THEIR DIAGNOSIS. WE THEN SEND IT TO THE TUMOR
BANK THAT WE ARE PIONEERING HERE AT CHOP, THE GOAL
BEING THAT IF WE CAN START PERSONALIZING THESE TUMORS
BY KNOWING WHAT GENETIC ABNORMALITIES THEY
HAVE, WE CAN THEN, AGAIN, IN COMBINATION WITH
OUR ONCOLOGY COLLEAGUES, TREAT THAT PATIENT FOR A
SPECIFIC GENETIC ABNORMALITY. AND WE WORK VERY CLOSELY
WITH THE SCIENTISTS SO, AGAIN, IT’S A LARGE,
COLLABORATIVE RELATIONSHIP.>>WHAT WE DO HERE AT
CHILDREN’S HOSPITAL OF PHILADELPHIA IS TO TAKE THE
BEST OF THE STANDARD CARE THAT CAN BE OBTAINED AND
TO TRY AND ADVANCE THAT TO THE NEXT LEVEL. SO WE HAVE AN OBLIGATION
TO PUSH THE EDGE OF THE ENVELOPE AS QUICKLY
AND AS FAR AS WE CAN.>>ONE OF THE THINGS THAT
DREW ME TO BEING A PEDIATRIC NEUROSURGEON IS BEING
ABLE TO WORK WITH THE KIDS, SEE HOW THEY
HANDLE THE SURGERY, AND SEE THEM GO THROUGH
A PAINFUL AND FRIGHTENING OPERATION, TO THEN UNDERGO
OFTEN ROUNDS OF CHEMOTHERAPY AND RADIATION,
AND THEN SEE THEM BACK WITH AN UNBELIEVABLY
POSITIVE ATTITUDE. IT’S INSPIRING. IT’S THAT KIND OF HOPE
THAT KEEPS YOU GOING, BOTH AS A SURGEON
AND AS A SCIENTIST.

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