Week 3- Aniqua Rahman

This week was very similar to last two weeks. I saw patients with Dr. Pannullo as usual.  From my observations so far, I have realized that most of her patients either have recurrence of brain lesions after resection of the primary tumor or metastasized cancer, which had metastasized to brain from a primary tumor in breast or lung. According to her nurse practitioner, about 65-70% patients have recurrence/primary malignant or benign brain tumor and 30-35% patients have metastasized brain lesions. In addition to seeing patients, I went to an IRB meeting. Honestly, I had a hard time understanding the technical terms and didn’t quite understand the main purpose of the meeting. Like last two weeks, I attended the tumor board meeting (Floor 8A, Starr Pavillion, Tuesday 4:00pm). This week, it was my turn to observe round in Pediatric ICU. I spent my morning with the neuro team in Pediatric care.

One of the highlights of this week was observing Stereotactic radiation surgery in Stitch Radiation Center (located in the basement of Starr Pavillion). The device they have for radiation therapy is called LINAC (Linear accelerator). The term “Stereotactic radiation” surgery refers to the combination of advanced radiation tools and complex three-dimensional (“stereotactic”) surgical planning techniques. Radiosurgery procedures done on the brain are performed by a multidisciplinary team that includes a neurosurgeon (like Dr. Pannullo), a radiation Oncologist (like Dr. Wernieke), a medical Physicist (like Dr. Sabbas) and a nurse (like Kathleen Dempsey), all of whom have undergone special training and certification in stereotactic radiation surgery. The surgery itself is very quick, but the preparation and treatment planning take about one and a half week before the actual surgery can start. The pre-op plan includes outlining the MRI images of parts of brain that need to be exposed to radiation or saved from radiation (Neuro-surgeon’s task), making a facial mask for the patient so that the head stays on the same place throughout the surgery (medical technician’s task), determining the dimensions of radiation exposure (radiation oncologist and medical Physicist’s task).

I also discussed my immersion project with Dr. Pannullo. Dr. Pannullo said that they are installing new software called ExacTrac, which  is a patient positioning system that drives faster treatment times and maximizes throughput while offering flexible treatment protocols and quick planning, setup and delivery. My project will be some sort of analysis using ExacTrac.         

This week, I had a sad experience also. One of Dr. Pannullo’s patients (26 years old male) whom I mentioned in my first blog died last Monday. He had late stage Glioblastoma.