Neurosurgeon Shares Tips to Help Patients Find Specialized Care
, by Brittany Cordeiro, NCI-CONNECT Program Manager
Dr. Edjah Nduom treats and studies rare brain and spine cancers. He shares his knowledge to help patients find specialized care for their tumor type.
It’s a common story heard by Neurosurgical Oncologist Edjah Nduom, M.D., of the National Institute of Neurological Disorders and Stroke at NIH. A patient presents to their local emergency room after having a seizure. An MRI reveals a brain tumor and the neurosurgeon is called in.
“Most brain tumors don’t require urgent surgery,” Dr. Nduom says. “Patients need to know that there is time to think about their brain tumor diagnosis and find the best doctor for their care.”
Dr. Nduom has provided clinical care to brain and spine tumor patients in the Surgical Neurology Branch at NIH since 2015. He studied biomechanical engineering at Stanford University and received his medical degree from the University of Pennsylvania. He had neurosurgical training at Emory University School of Medicine in Atlanta. During his residency, he also completed a clinical fellowship at NIH. Dr. Nduom completed two years of further fellowship training in neurosurgical oncology and tumor immunology at The University of Texas MD Anderson Cancer Center in Houston.
His patient care is driven by his desire to make progress in a difficult disease. “People are struck with brain cancer out of the blue. The cancer cells are resilient and aggressive. This makes them hard to treat,” Dr. Nduom says.
Surgery to remove as much of the brain or spine tumor as possible is often the first treatment.
Patients have better outcomes when they’re treated by a neurosurgeon who has experience with their tumor type.
Finding a specialized neurosurgeon is especially important for rare brain and spine tumor types. And, a specialized neurosurgeon also often has skilled colleagues to refer patients to for further treatment.
Choosing the Right Neurosurgeon
It is important for patients to feel comfortable talking to their healthcare team to help them understand their diagnosis and treatment options. Patients also need to be able to ask for referrals.
“A confident surgeon is not going to be offended if patients and caregivers have questions and ask for a second opinion,” Dr. Nduom shares. He suggests asking the following questions:
- Do you treat brain or spine disorders?
- Do you treat tumors like mine? Or for rare brain or spine tumors, do you have the most experience treating tumors in this area?
- How many patients with my tumor type do you treat in a year?
- Are there other neurosurgeons I can talk to?
- Who should I see for a second opinion?
Dr. Nduom cautions that if a neurosurgeon can’t provide a referral – or another neurosurgeon for a second opinion— patients should be concerned. “If a doctor has experience, he or she should know others that can provide advice, too,” he says.
It is equally important for patients to know the care team that works with their neurosurgeon. This may include nurses, neuro-oncologists, neuroradiologists and other specialists. “Patients should ask about specialists and if the neurosurgeon has a tumor board at his or her institution,” Dr. Nduom says.
A tumor board is a group of specialists who collectively review a patient’s diagnosis to provide feedback on treatments and clinical trials. “If I take a patient’s case to a tumor board, I let the patient know I am going to get more opinions,” Dr. Nduom says. “It is a fantastic opportunity to collaborate to determine the best plan.”
Approaching Surgery for Rare Tumors
Dr. Nduom treats patients with all types of brain and spine tumors. His approach to surgery depends on the tumor type, especially for certain rare tumor types.
“A patient with gliomatosis cerebri may only need a biopsy because there is not a good way to take out large tissue,” Dr. Nduom explains. Rare tumors like ependymoma and medulloblastoma are also types that can be hard for unexperienced neurosurgeons to remove entirely. Dr. Nduom often sees patients with recurrent disease or disease that remains after treatment.
“We do surgery to diagnose and effectively alter the treatment course,” he says. Dr. Nduom has a specific interest in the safe removal of brain cancers located in eloquent areas of the brain, brainstem and spinal cord. Eloquent areas control functions like language, motor, and sensory.
After surgery, a neuropathologist reviews the tumor tissue to provide an accurate diagnosis. This helps Dr. Nduom and the neuro-oncology team determine the next best treatment for the patient. He also studies the tumor tissue to better understand brain tumors and develop new therapies.
Researching Immunotherapies for Brain Tumors
Dr. Nduom researches immunotherapy and adjusting the immune system to treat brain cancer. His work attempts to harness the power of the immune system to fight brain tumors.
“The immune system is the front line of defense against the abnormal cells of cancer,” Dr. Nduom explains. “Unfortunately, many cancers have found ways to hide themselves from the immune system.”
Dr. Nduom studies the way brain tumors hide themselves. Brain tumors also send signals to prevent the immune system from fighting them. He is investigating this process and drugs called immune checkpoint inhibitors that keep the immune system working to attack cancer cells.
While his work has mostly focused on glioblastoma, Dr. Nduom is seeing more patients with rare brain and spine tumors. He is partnering with NCI-CONNECT to treat and study these patients.
Partnering to Make an Impact
Dr. Nduom reminds patients that NIH is full of free resources and programs to help them. This includes NCI-CONNECT.
“NCI-CONNECT is a focused group of researchers and clinicians studying rare brain and spine tumors, and reaching patients directly,” Dr. Nduom says. “I am excited about the opportunity to interact with patients and expand my efforts and techniques.”
The NCI-CONNECT Clinic is dedicated to treating patients. The program in collaboration with NIH specialists like Dr. Nduom is also generating a tissue bank of rare brain and spine tumors to start to subtype tumors and better understand them.