For patients with aggressive, high-grade gliomas, clinical trials offer access to new experimental therapies studied for their effectiveness. Traditionally, clinical trials have been broken into three phases. Phase 1 clinical trials assess the safety of a new treatment. Phase 2 studies involve more patients and evaluate the efficacy of the treatment. Phase 3 studies are designed to compare the novel treatment to a proven treatment to validate its effectiveness further. Read More
Neurosurgery supports and welcomes transparent physician-industry interactions to foster healthy relations and spur innovative device development to benefit patients. Within the specialty of neurosurgery, there are numerous examples of just such benefits, including increased access to stereotactic radiosurgery (SRS). SRS is a treatment that delivers radiation to precise targets in the brain, such as tumors, while minimizing injury to adjacent areas. Read More
For many neurosurgeons, years of training and technical refinement culminate in safely removing a patient’s brain tumor. We dedicate our careers to shepherding people past this inflection point, but the patient journey does not end there. For those with malignant tumors, our surgical heroics are quickly unraveled by tumor recurrence. Theoretically, adjuvant medical therapy should firewall patients against this reality; however, as we all know, no drug today provides much security to brain tumor patients. Our specialty is uniquely positioned to do something about this. Drug development is no longer the sole domain of oncologists, and some of the most impactful drug studies live in our operating rooms.
The role of neurosurgical oncologists in the laboratory is more important than ever. The emergence of targeted therapies and immunotherapies has shown us that we are at an inflection point for cancer care. We are on the verge of gaining new insights into the causes of cancer and identifying novel pathways and potential new targets. The next-generation research tools available to us now yield unprecedented amounts of data and afford a granularity far beyond what our predecessors could have imagined. While we have historically made substantial contributions to neuro-oncology, our continued participation in the laboratory at this pivotal moment remains crucial. Read More
Working with patient advocates is important for neurosurgeons and neurosurgeons in training. While neurosurgeons help patients through clinical work and conduct innovative research to advance treatment options, advocacy can have an outsized impact on patients across the U.S. Neurosurgeons who participate in patient advocacy gain a better understanding of the priorities of patients, their families and those who care about them. Read More
From time to time on Neurosurgery Blog, you will see us cross-posting pieces from other publications that are worthy of sharing with our readers. Since we are in the middle of our focus series on tumors, we wanted to bring attention to an article published in The New England Journal of Medicine (NEJM) on May 19. Alan R. Cohen, MD, FACS, FAAP, FAANS, discusses recent changes to the classification and management of brain tumors in children. In 2021, the World Health Organization introduced changes in brain tumor taxonomy, emphasizing molecular diagnostic features. These changes reflect the trend of assigning diagnostic categories based on genetic features that, in many cases, drive prognosis and offer potential targets for treatment. Read More
Neurosurgery has a long history of mentorship through a trainee’s dedicated time under a more experienced surgeon’s tutelage. Surgical training has long been considered a more advanced form of apprenticeship, mastering a skill under a more experienced practitioner’s guidance. In this tradition, the Sylvester Comprehensive Cancer Center — part of the University of Miami Miller School of Medicine — has launched an International Neuro-oncology Scholars Program (INOSP) that allows neurosurgery trainees to join internationally renowned brain tumor experts in other countries to increase their experience. Read More
The recent COVID-19 pandemic highlighted socioeconomic differences in health care access detrimental to the outcome, including a per capita excess mortality highest among the Black and Latino population. The prognostic role of socioeconomic factors for patients diagnosed with glioblastoma multiforme (GBM) has been hotly debated. GBM is the most common malignant primary brain tumor in adults and affects 3.3 percent of pediatric brain tumor patients. The disease has made headlines in recent years with the diagnosis of high-profile political figures such as President Biden’s son Beau Biden and the late Sens. Ted Kennedy and John McCain. Significant advances in surgical and adjuvant treatments for this disease have had a positive impact on short-term survival. Yet, there is a still-very-low five-year survival rate in adults, around 5.5 percent. As new therapeutic approaches develop, prolonging short-term survival coupled with high quality of life remains a priority when caring for patients with GBM.
Recent events of systemic discrimination have led to national introspection on the importance of tolerance and diversity. The tragic killing of George Floyd in May 2020 was a sentinel event that raised awareness of the pervasive nature of systemic discrimination and served as a significant impetus for positive change. This was a clear reminder that we still face substantial challenges to tolerance and equal treatment for all as a society. It is also a unique opportunity to reflect on our common purpose as humanity.
Neurosurgery has historically been a uniquely wide-ranging and varied specialty. Unlike other specialties that focus on a particular organ system or body region, neurosurgery is quite literally a “head-to-toe” specialty dealing with the brain, spinal cord, peripheral nerves and the other organs intimately related to the nervous system. Neurosurgeons classically had to be experts in a wide variety of surgical procedures and disease processes. As medical knowledge and technology have advanced, neurosurgeons have evolved with medicine to become experts in particular disease processes, leading to a reorganization of neurosurgery into sub-specialty disciplines.