: Dr. Brem's recent coverage in The Tampa Tribune

[Guest guest]

Just fyi in case anyone in the area is looking for a doc. Marie

----->; 13, 2003 3:51 PM

Subject: Fw: Dr. Brem's recent coverage in The Tampa Tribune

> Hi, all,

>

> I hope the following newspaper articles are of interest to you....Dr. Brem

> was a medical advisory board member of the Acoustic Neuroma Association of

> Canada (ANAC) and Shirley Entis, a neuroscience nurse working closely with

> him at H. Lee Moffitt Cancer & Research Center sent the following to me.

I

> am very proud to know them both. Gray

>

> --------------------

>

> Subject: FW: Dr. Brem's recent coverage in The Tampa Tribune

>

> Saturday was " Dr. Brem day " in The Tampa Tribune. Below is the

link

> to Judy Gray's story headlined 'Moffitt Names Tireless Neurosurgeon

> Physician Of The Year.' It didn't run in all editions but still was

printed

> widely. This link should work through tomorrow (Tuesday). Also on

Saturday,

> Dr. Brem's opinion piece on the more optimistic outlook for brain tumor

> patients ran on the Saturday Forum (oped) page, 17-A. See text below.

> Brunais

>

> Media Relations x1478

> http://tampatrib.com/News/MGAWJSKR8AD.html

>

> Moffitt Names Tireless Neurosurgeon Physician Of The Year

> By JUDY SILVERSTEIN GRAY Tribune correspondent

> Published: Dec 28, 2002

>

> USF CAMPUS - A solemn, steady beep monitors the patient's breathing.

While

> large hands skillfully guide a scalpel deep into the center of the

patient's

> brain, Brem remains microfocused.

>

> A neurosurgeon, Brem says he enjoys the discovery of new techniques,

> procedures and treatments. ``When I was a resident, patients with brain

> tumors were considered hopeless. Now these cases are highly hopeful,'' he

> said. Already the recipient of national acclaim, Brem recently was

awarded

> Physician of the Year by the H. Lee Moffitt Cancer & Research Center.

It's

> a distinguished honor he says humbles him. ``There are so many

outstanding

> clinicians here,'' he said.

>

> Brem, 55, spends his days immersed in cutting-edge technology that has

> helped revolutionize his field. ``My dream,'' he said, ``is to break the

> code for brain tumor formation. Hopefully, in my lifetime, we'll see a

cure

> for brain tumors and we'll close the doors here.''

>

> Brem said he's most proud of the way teams at Moffitt combine humanity

> with technology. ``We focus on the patient; we give them the best

> technology we can offer, and we match that with the best care. Staff and

> clinicians do an extraordinary job blending humanity, values and progress

> here. We bond with our patients,'' the Harvard Medical School graduate

said.

> ``We get to know all about the patients before we operate on them. I'm

like

> those guys on the ads for football or baseball: I love coming to work; I

> love my job.''

>

> Brem keeps a grueling pace, with workdays that begin at 5 a.m. If he's

> lucky, he's home by 7 p.m. to share dinner with his daughter, , 16,

> son, , 7, and wife, Hanna. But more often than not, his protracted

days

> stretch more toward 9 or 10 p.m.

>

> His children aspire to follow in his footsteps and pursue careers in

> medicine. recently was selected one of the National Youth

Leadership

> in Medicine appointees.

>

> Brem was raised by parents who were Holocaust survivors. He has two

> brothers who work in surgery, his younger brother as chairman of

> neurosurgery at s Hopkins Medical Center in Baltimore. A sister works

> as an oral surgeon. Brem credits his parents' focus on education,

> describing his father as a success story in the style of Horatio Alger -

an

> author whose books typically were rags-to-riches tales. ``They gave us our

> work ethic. They were my inspiration,'' he said.

>

> Clinical research remains an integral part of Brem's routine.

Collaborating

> with two scientists at the University of South Florida, Brem is looking at

> proteins that block blood vessel growth, peptides that might inhibit tumor

> growth and the role copper plays in tumors of the brain. He also admits to

a

> longtime fascination with angiogenesis. He looks at ways to starve tumors

of

> blood supply.

>

> ``Surgery is safer and more effective now; radiation is more focused and

> less toxic, and chemotherapy more targeted with fewer side effects.

> Biologic breakthroughs are promising. This is a revolutionary time in

brain

> tumor treatment,'' said the program leader of neuro-oncology at Moffitt.

>

> Brem says there's something else that keeps him motivated: ``From my

> perspective, you can't help but learn that life is extremely precious and

we

> need to maximize every opportunity.''

>

> -----------------------

>

> Saturday Tampa Tribune, Dec. 28, Page 17-A

> Reasons For Hope In Battle Against Brain Tumors

> By Brem

>

> Years ago, when I was a resident, a patient with a brain tumor had a very

> bleak prognosis. Many times, physicians decided it was not worth even

> pursuing more than a biopsy and patients were left to die. Things have

> changed radically. Many new technologies exist that help people live

> longer.

>

> Brain tumors are a serious problem in all age groups. This year more than

> 185,000 Americans will be diagnosed with a brain tumor. There are over 100

> different types of brain tumors, some are benign - curable by surgery

> alone - and others are malignant - requiring combinations of surgery,

> radiation therapy and chemotherapy. The incidence of certain brain tumors,

> for example glioblastoma and metastatic cancer, are increasing, especially

> in the elderly. Children with tumors such as ependymoma, medulloblastoma,

> and astrocytoma are living longer due to advances in therapy.

>

> Nevertheless, more advances are needed as brain tumors are now the leading

> cause of cancer death in children under age 20 (surpassing acute

> lymphocytic leukemia). They are also the third-leading cause of cancer

> death in young adults aged 20 to 39.

>

> At H. Lee Moffitt Cancer Center & Research Institute, we have developed

> surgical techniques, adopted state-of-the-art technologies and employed

> unusual delivery methods of chemotherapy. Through this combined approach,

> we have achieved positive outcomes in patients whose brain tumors are

> sometimes called " inoperable " by other doctors.

>

> You can watch a video of an actual operation on our patient, Russ

> Augustine, by going to the Web site

> http://www.moffittcancernetwork.org/eventdetails.asp?EventID=368

> (Another way to get there is from site www.moffittcancernetwork.org

> http://www.moffittcancernetwork.org> click on " Presentations, " then find

> the title " Tumor Surgery - Brain Mapping and Neuronavigation. " )

>

> Augustine's first indication of something wrong came when he had a

seizure

> while running on a treadmill. Augustine, 26, did lots of research on the

> brain tumor treatments before deciding on coming to Moffitt. Patients are

> very Internet-savvy in this day and age. Our Neuro-Oncology Program at

> Moffitt is part of the NABTT national consortium, or " New Approaches to

> Brain Tumor Therapy. " The government funds this consortium, which

consists

> of some of the best Neuro-Oncology centers in the country (Moffitt, s

> Hopkins, Massachusetts General and others). The centers meet at least

twice

> a year to discuss and develop new clinical trials for brain tumors.

>

> A typical brain surgery will involve three kinds of mapping: anatomical

> (motor), metabolic (SPEC MRI) and functional (fMRI) brain mapping. In

> addition, we can do intraoperative language and motor mapping on an awake

> patient, depending on the location of the tumor.

>

> As you can see during Russ Augustine's surgery, we do computer

> image-guided surgery using the Voyager neuronavigation system. The patient

> gets non-invasive (painless) fiducials (markers) applied to the scalp and

> then is imaged with MRI. The information is then fed into the computer,

> and a 3-D image of the brain and the tumor are created. Using a " wand " or

> the light beam of the microscope, we can navigate in the patient's brain

> and see exactly where the margins of the tumor are, and avoid injury to

> neighboring vessels or brain tissue. This way we can remove the entire

> tumor without harming any of the normal brain tissue.

>

> I tell patients we like to do " tumor " surgery - not " brain " surgery!

>

> Using motor-evoked potential (motor mapping), we can see exactly where

the

> motor and speech areas are so I we can avoid disturbing them. This results

> in a truly physiological surgery using today's modern techniques.

>

> The last few minutes of surgery are usually critical. We are going through

> " no-man's land, " making sure there is no tumor left behind and no

bleeding

> is occurring. The surgical objective is always a " maximal safe

resection. "

> Many of our patients, like Russ Augustine, are ready to go home 24 hours

> after their craniotomy.

>

> This year we presented to the American Association of Neurological

Surgeons

> a study of 30 patients who had motor mapping done during their

> craniotomies. Many patients had motor symptoms like Russ Augustine's

> before their surgery. (One of his legs had begun to drag.) This study

> showed that three to six months after their craniotomies, 70 percent of

> patients had the same or better motor function. By contrast, the natural

> history of a patient with a tumor in the motor strip would be a gradual

and

> steady decline of motor function.

>

> There still is not a " cure " for a malignant brain tumor. But with all the

> ongoing research, many exciting things are on the horizon. A brain tumor

is

> no longer the equivalent of an automatic death sentence.

>

> Brem, M.D., is Program Leader of the Neuro-Oncology Program. In

> December 2002, he was named Moffitt's Physician of the Year.

>

>

>

>