>> 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.