At Stanford, in addition to joint consultations between physicians, an interdisciplinary brain tumor board meets weekly to review and discuss patient treatment plans. More than 20 specialist physicians and nurses in neuropathology, neuroradiology, neurosurgery, neurology and neuro-oncologiy usually attend.
Within the Stanford Brain Tumor Center, Recht said, "We have a very strong group identity. We get along and we meet a lot. We really work well together; we respect each other's expertise and we usually make our decisions by consensus."
Another element in the Center's care will be a group of nurses with special certification in neurological care and social workers experienced in the needs particular to tumor patients and their families, with access to resources in neuropsychology, rehabilitation and counseling.
Seeing the whole picture
"We are very hands-on with our patients," said neurosurgeon Gordon Li, MD, who recently joined the team. "Patients might not be used to doctors actively calling them, making sure everything is going smoothly and wanting to know what's going on. We think it's our job to take care of not just the medical issues, but the person and their family, too."
"We have a heavy focus on counseling for patients. We really want to hear what they feel and we take the time to do that thoroughly," said Seema Nagpal, MD, another new member of the Brain Tumor Center team. "We know a brain tumor is a tough diagnosis to deal with. A first visit to us includes time with a doctor, time with our nurses and sometimes with social work and other support services."
The Center will also connect patients directly with clinical trials and research at Stanford, where investigations include brain cancer's cellular biology, cell markers for early tumor detection and genomic structure.
Harsh, also director of Adult Surgical Neuro-oncology at Stanford, believes that medical research and clinical care at Stanford is endowed with a "tremendous and continuous drive for excellence." He has practiced neurosurgery for more than 25 years and seen many advances in care. Like his colleagues at the Brain Tumor Center, Harsh has learned and applied innovations in minimally invasive brain tumor surgery and imaging technology. "As a team," he said, "we build on each other's expertise to improve what we can do for our patients. We are mutually enhancing in our ways of approach and thought."
That new image technology he can now employ is as much about combining the available in new ways as about inventing new devices. Stanford's Josef Parvizi, MD, PhD, another member of the Brain Tumor Center group, is a neurologist focused on human brain mapping. He has been part of Paulsen's care team.