Seeking Solutions for Brain Tumors

 HealthLeaders media Live from Barrow Neurological Institute at the St. Joseph’s Hospital and Medical Center, Phoenix

So says Phil Pomeroy, vice president of neurosciences at Barrow Neurological Institute, located at the St. Joseph’s Hospital and Medical Center in Phoenix. Pomeroy is responsible for business development and strategic planning for Barrow.

Healthcare is “not exactly moving closer to a cure,” Pomeroy says. “Ultimately, brain tumors are devastating.” But Pomeroy says Barrow is working to make an “impact and a difference.”

Against that backdrop, the BNI has taken steps toward improving such brain tumor research programs especially through varied clinical approaches that can lead hospital officials to improve brain tumor care, Pomeroy said at a HealthLeaders Media Rounds event, “Neurological Service Line Growth: Telestroke & Brain Tumor Innovations,” held in May at Barrow.

Building a brain tumor program is defined by lengthy pathways and initiating a strict clinical plan, says Pomeroy. The hospital is exploring new treatment options including molecular targeting, stem cell research, and neuro-oncology planning.

“We are finding folks who are looking for potential solutions through clinical trials and basic research, and with some degree of hope with experimental therapies,” Pomeroy says. Patients are attracted to new protocols and “will travel long distances” if necessary, he says.

The Barrow Brain Tumor Research Center concept includes neurosurgical intervention, neuro-oncology consultation, and radiation-based therapy. Barrow developed its program with the backdrop of a brain tumor cancer center “vacuum” in the Southwest and brain tumor research shifting from the national to the local level. The hospital includes 64 licensed and staffed neuro-intensive care beds, 80 licensed and staffed neuro acute-care beds, and 11 neuro operating rooms.

Key areas of development include “homegrown therapeutic solutions,” a complete clinical trials program, and providing experimental therapy options for every patient, according to Pomeroy.

“It is really built on a foundation of research,” Pomeroy says.

A “successful clinical program requires clinical focus, market differentiation, educated resources, and visionary leadership,” he says, as well as a “well-conceived plan.”

Pomeroy says the brain tumor research program has yielded benefits in terms of clinical research as well as patient outcomes.

Pomeroy says the program has resulted in at least a 50% increase in clinical research projects, including a doubling of peer-review populations, as well as additional professional education seminars and patient and caregiver conferences.

Michele M. Grigaitis, DNP, FNP-BC, CNRN, a nurse practitioner in the division of adult neuroscience at Barrow, says the hospital has used advanced practice nursing that has resulted in improved efficiencies, such as contributing to reduced length of stay for patients. The nursing staff works cohesively with the hospital’s 20 neurosurgeons for standardization of care.

For the nurses, evaluating length of stay is important, Grigaitis says. They can help enable a patient to be discharged directly from the intensive care unit “instead of taking them to the floor where they will be spending extra days.”

The development of clinical programs is significant because of the lack of progress in the brain tumor research field, according to Pomeroy.

An estimated 63,000 Americans were diagnosed with brain tumors in 2010, and 612,000 patients currently live with a primary brain tumor.

“Progress to date has been limited, even with cost being no object,” Pomeroy says. The late Sen. Edward M. Kennedy survived 14 months after diagnosis, and journalist Robert Novak survived 13 months.

“Our survival rates in 1980, compared to 2010—we have gained only four months, so we’re not exactly moving closer to a cure,” Pomeroy says.

Barrow is working to make inroads in evaluation of brain tumors, he says. “Our concept is built on a foundation of research, lab work, and clinical trials, and [is] tied into a high volume of patients that feed the clinical trials,” Pomeroy adds. He describes Barrow’s approach as “home grown; it’s really taking innovative approaches to therapeutic solutions that will open some new doors, and we already have.”

 “We’re not in the top ranking among [hospitals conducting] clinical trials, but when you look at enrollment we are at the top of the list,” he says. “We are offering a high volume of cases, and the more you do, the
better you are; like in many disciplines, it relates to better outcomes and
therapy approaches.”

Researching a prospective “tumor vaccine is something we are pursuing,” he says. In developing programs, whether telestroke or brain tumor research, “having clinical focus is absolutely critical,” Pomeroy says.

Funding sources for the Barrow programs include the National Institutes of Health, focusing on areas ranging from basic science research, advanced diagnostics, or therapeutic innovations. “I think increasing our clinical volume will be a substantial indicator of our success,” Pomeroy says.

This article appears in the September 2011 issue of HealthLeaders magazine.