Neuro-oncology in Arizona:
Collaboration and Continuity of Care

Collaboration and continuity of care are 2 aspects of the neuro-oncology practice at Mayo Clinic in Scottsdale, Ariz., that Alyx B. Porter, M.D., particularly appreciates. Her work is supported by a team of neurosurgeons, neuroradiologists, radiation oncologists, medical oncologists, neuropathologists, and rehabilitation specialists. Together, they manage the spectrum of confirmed and suspected brain cancers — from glioblastomas to undiagnosed abnormalities found on MRI.

Their collaboration extends beyond neurologic specialties. Dr. Porter and the team work closely with endocrinologists in treating pituitary adenomas and with otolaryngologists in treating acoustic neuromas. They also work with the division of medical oncology in managing neurologic symptoms (eg, seizures, numbness, weakness, cognitive impairment) that result from systemic cancers or their treatment. Dr. Porter explains, "If the community oncologist has a patient who develops neurologic symptoms apart from pain, we can manage the neurologic diagnosis and provide treatment options."

Supporting these efforts are rehabilitation specialists. Occupational and physical therapy, speech-language pathologic treatment, and neuropsychological therapy are offered in Mayo's inpatient and outpatient rehabilitation facilities.

Continuity of care within and across Mayo's sites

Many patients come to Arizona in the winter months. For patients seen at either of Mayo's other 2 campuses, in Rochester, Minn., and Jacksonville, Fla., the unified medical record and close relationship among Mayo's neuro-oncology division members translate into uninterrupted care.

Neuro-oncology patients can be seen in an expedited time line. At all 3 Mayo Clinic locations, neurosurgery, neuro-oncology, and radiation therapy are housed in the same building, which facilitates face-to-face consultation among team members.

National clinical cancer trials at Mayo Clinic in Arizona

Mayo Clinic in Arizona is part of the National Cancer Institute (NCI)-funded Mayo Clinic Cancer Center and the Mayo-led North Central Cancer Treatment Group, a cooperative clinical research group that helps develop and expedite high-priority NCI-funded trials. Cancer treatment trials generated through these sources are conducted at all 3 Mayo Clinic sites.

Many new chemotherapy drugs, including the immune-based therapies for glioblastomas, are combined with radiation therapy. Radiation oncology researchers at Mayo are continuously developing new protocols to complement advances in chemotherapy.

Currently, 4 clinical trials for glioblastoma are being conducted at Mayo Clinic, each testing novel drug combinations developed at Mayo (see NeurosciencesUpdate, Volume 6, No. 3, for information on development, targets, and mechanisms). Two trials are for patients with newly diagnosed glioblastoma and 2 are for patients with recurrent glioblastoma. In addition, a phase 3 trial is testing the effects of memantine hydrochloride (Namenda; Forest Pharmaceuticals Inc, New York, N.Y.) in counteracting cognitive dysfunction after whole-brain radiation therapy.

Joon H. Uhm, M.D., a neuro-oncologist at Mayo Clinic in Rochester, says, "The dictum 'one cancer center, three front doors' is a very apt description of Mayo's cancer treatment and research integration."

Dr. Porter adds that neuro-oncology on Mayo's Arizona campus provides patients with an interdisciplinary team approach that takes full advantage of all clinical and research resources provided throughout Mayo. No effort is spared to translate those considerable resources into focused, patient-centered care.