Neurosurgeon Values Teamwork for Optimal Care
, by Kendall Morgan, NCI-CONNECT Contributor
Neurosurgeon Dr. John Heiss shares how his ability to provide the best care for rare brain and spinal cord tumors depends heavily on teamwork, both inside and outside of the operating room.
The diagnosis of a rare brain or spinal cord tumor can be overwhelming and finding optimal care can be challenging for patients. At the NCI Neuro-Oncology Clinic and other cancer centers, John D. Heiss, M.D., head of the Clinical Unit of the Surgical Neurology Branch and program director of the Neurological Surgery Residency Training Program in the National Institute for Neurological Disorders and Stroke (NINDS), says that teamwork plays a vital role.
Heiss conducts clinical and translational research to improve the treatment of brain tumors, cancer pain, degenerative brain diseases, and other conditions affecting the central nervous system (CNS). Every other week, Heiss also gets together (either in person or virtually) to share his expertise in neurosurgery with other NIH neurosurgeons and specialists in other medical disciplines, including neuro-oncology and radiation oncology, for what’s known as the tumor board.
“At tumor boards, we evaluate cases and we weigh in on what we think would be most helpful for people with tumors of the central nervous system and, less often, the peripheral nervous system,” Dr. Heiss says. “We try to give every patient the best possible medical treatment we can.”
Dr. Heiss and his team collaborate with NCI’s Center for Cancer Research, Neuro-Oncology Branch health care team to evaluate patients with brain and spinal cord tumors for clinical studies, in addition to consulting on surgical treatment options to help develop a comprehensive care plan. If NIH isn’t a good fit, the neuro-oncology team can help refer patients to another cancer center.
“We are really good at treating some conditions and other places are better for other conditions,” Dr. Heiss says.
Often, patients learn that we have expertise in treating rare brain and spinal cord tumors and contact us.
The Value of Surgical Teamwork
As one notable example, Dr. Heiss says many patients diagnosed with ependymoma find their way to the NCI Neuro-Oncology Clinic based on the team’s experience, expertise, and research in treating and improving the quality of life for people with this rare tumor diagnosis. The NCI neuro-oncology healthcare team also has an international reputation in evaluating and treating patients with glioblastoma and many other rare CNS cancers.
The NIH neurosurgical team is an instrumental part of the NCI neuro-oncology clinical program. “Our neurosurgeons are accomplished at removing rare brain and spinal cord tumors,” Dr. Heiss says.
When surgery is needed to remove a CNS tumor, Heiss says that teamwork is key. Prior to surgery, the neurosurgeons meet with neuro-radiologists to learn and plan for what to anticipate during surgery. They also ensure the health of the patient is adequate to undergo surgery.
During surgery, neurosurgeons work closely with a neuro-monitoring team, which uses electrical tests to keep tabs on patients who are under anesthesia. Surgery is usually in very delicate areas of the brain or spinal cord, so monitoring is important to ensure the patient comes through the surgery well, with cognition and functions, such as speech and motor movements, intact.
After surgery, neurosurgeons consult neuro-oncologists, radiation oncologists, and other specialists about additional treatments. Patients in need of more treatment may be eligible for one of many ongoing clinical trials. Physical therapists and rehabilitation specialists also work with patients to help restore abilities that may have been lost as a result of the cancer, surgical removal of the tumor, or other treatments.
“When patients leave the clinical center, they’re generally better than when they came in,” Dr. Heiss says. “Our goal in neurosurgery is a maximum safe resection. We want to take out the tumor and leave the functioning brain and spinal cord behind.”
The ‘Real Heroes’ of Teamwork
While providing the best care possible today is always the goal, Dr. Heiss and the NCI-CONNECT team, together with their patients, are also actively engaged in the search for new and better treatments to improve the lives of people living with rare CNS cancers.
“The intellectual and collaborative environment at NIH has kept me here for the last 30 years,” Dr. Heiss says. These days, he enjoys encouraging and supporting his younger colleagues and trainees in neurosurgery. While he gives credit to all the colleagues whose teamwork enables him to do his job well, he says the patients are the true heroes.
“Our patients are highly motivated to participate in clinical trials not just to help themselves, but to improve treatments for others," says Dr. Heiss. “Their participation and commitment to our mission is what drives our work.”