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My life as a brain surgeon

I like being a brain surgeon. I like my work. The operating room is my office, and I get to say things like “STAT” and “scalpel.” Although, I have never once said “STAT” except to imitate some character on M.A.S.H., and I have always called a “scalpel” a “knife” for reasons I don’t really remember. I know I can under-impress people after they find out what I do. I rarely have swashbuckling stories to tell, and I’m not sure I look the part—that guy on Gray’s Anatomy often makes real neurosurgeons feel inadequate. Thanks guy. That said, I also enjoy teaching, and I like the technical aspects of...

“It ain’t brain surgery”

Now I’d like to focus on brain surgery. You’ve likely heard the phrase “it ain’t brain surgery” used in a casual conversation, but it’s not to me—it IS brain surgery. Every once in a while there is a situation where surgical removal of a tumour isn’t safe. In truth, I can operate on any tumour in any part of the brain—it is never a technical limitation—but in some situations, I would do more harm than good. Surgery is never curative of a primary cancerous brain tumour—never. These nasty tumours penetrate the brain with microscopic invasion. These rogue cells are always well beyond the...

Shedding light on treatment options

There is a lot of information available about current treatment strategies for brain cancers, but I’d like to touch on just a few points here. First of all, until about five years ago, the outcomes for brain cancer were stagnant for decades and there was very little progress. At that time a new drug, called Temozolamide, was used in combination with surgery and radiation which resulted in an improvement in two-year survival. Without the drug, the chances of survival were one in 10 and now with the drug, the chances are one in four—a pretty good improvement, I would say. Secondly, there is the...

Our dedicated effort at the BC Cancer Agency

We have expanded our brain tumour team (in the Neuro-Oncology Group) with the addition of patient and family counsellors, nurses, and occupational therapists. These professionals ensure that all facets of care are attended to, including blood tests, X-ray results, wound healing and beyond. We have decreased the wait times for consultation, treatment, testing, imaging, and even surgery. Less waiting means less apprehension and less time lost. We have consolidated the brain tumour care team into one visible team that is gathered together physically as well as strategically—providing a much more...

Information, knowledge, and understanding

In the Neuro-Oncology Group at the BC Cancer Agency, we are driven to use our experience to improve the flow and breadth of care for patients. It is not sufficient to simply watch hundreds, actually thousands, of reactions to those awful words, “you have brain cancer.” We have used these observations to answer the question: How can we make this situation better? Cancer is a diagnosis that robs one of control—the apparent control—we have over life and dreams such as where are we going on vacation, when are we going to witness our child’s graduation, what are we going to do in retirement, and...

The pathology report says, “You have brain cancer.”

Though I have spoken those words literally hundreds of times, I don’t really know what it feels like to receive those words. I have, however, seen a stunning emotional range of reactions. One of my first duties, in the protection and maintenance of humanity (from my last post), is to anticipate how the person in front of me is going to want to hear those words. That anticipation starts from the very first time I meet and engage with someone—their verbiage, body language, questions or lack of questions, social support, ethnicity, etc. All of these considerations, and more, are calculated in...

Defining “brain tumour”

By itself, the term brain tumour is monstrous. And to receive it as a diagnosis is paralyzing. Our humanity is defined by our brains—a brain tumour is therefore a direct attack on it. All those who have endured a brain tumour, and all those who have witnessed a loved one endure a brain tumour, know this too well. Many brain tumours are very slow growing, which we term benign , and modern medicine can take pride in curing many of these. However, many brain tumours grow rapidly. They multiply and invade the entire expanse of the brain—taking hostage of the brain, one territory at a time: speech...

Dr. Brian Toyota: Who is this guy?

Hello, my name is Brian Toyota. I am very pleased to be the BC Cancer Foundation’s December guest blogger. I was invited to guest blog because I am the Provincial Chair of Neuro-Oncology at the BC Cancer Agency (the Agency). This also means I am responsible for maintaining the highest possible level of care for all people diagnosed with a brain tumour in the province of B.C. and to build and enhance the future of brain tumour care and research. In other words, I am simply the captain of a broad team of people at the Agency devoted to caring for people who face the diagnosis of a brain tumour...

Introducing Dr. Brian Toyota

Thank you Dr. Aly Karsan for guest blogging with us last month about the Personalized Medicine Project (PMP) – it is an excellent example of the leading-edge research taking place at the BC Cancer Agency. I am now pleased to introduce our final guest blogger for 2011: Dr. Brian Toyota. Dr. Toyota is the Provincial Chair of Neuro-Oncology at the BC Cancer Agency and he is going to blog about BrainCare BC, as well his experience at the BC Cancer Agency. Please welcome Dr. Brian Toyota and follow his posts this month. Festive regards, Douglas

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