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Neuro-oncology Fellowship Background

Neuro-oncology is being recognized as an increasingly important area of oncology. It deals with the diagnosis and treatment of patients who have primary neoplasms of the nervous system, neurologic complications from systemic cancer, and pain related to cancer. These are relatively common clinical problems. Approximately 17,000 primary brain tumors are diagnosed annually in the United States and currently more patients die of brain tumors than of Hodgkin's disease. Neurologic complications of systemic cancer are estimated to occur in more than 15% of all patients with cancer at some time during the course of their illness. Most of these are due to metastatic lesions, however, some are secondary to remote effects of cancer or to the toxicities of therapy. Pain secondary to cancer is also common and is usually related to either tumor invasion or to compression of pain sensitive structures.

Patients with neuro-oncologic problems are evaluated and treated by a diverse group of physicians. Medical and pediatric oncologists, radiation therapists, neurosurgeons, neurologists, and neuroradiologists are the specialists most likely to provide input into the management of these patients. These physicians must work together to provide optimal patient care and to effectively pursue clinical and basic science research in neuro-oncology. The Neuro-Oncology Study Group serves as a forum for these multidisciplinary interactions at The Johns Hopkins Medical Institutions and as a focal point for the training of students, physicians, and scientists in this field which continues to grow in importance. The Neuro-Oncology Branch is the first Trans-Institutional program between the National Cancer Institute (NCI) and the National Institute of Neurological Disorders and Stroke (NINDS). Participating members include a multidisciplinary team of pediatric and adult neuro-oncologists, radiation oncologists, neuro-surgeons, and neurologists experienced in the care and clinical investigation of patients with CNS malignancies. This team is further enhanced by a close clinical collaboration and coordination of clinical research activity with the multidisciplinary neuro-oncology/Neurosurgical team from the National Children's Medical Center in Washington DC. This clinical research expertise is complimented by the commitment to, and the vast resource invested toward basic cancer biology and neuroscience research within the NCI and NINDS, respectively.

The activities of The Johns Hopkins Neuro-Oncology Study Group formally began in July, 1981. The group has now grown into a research team which is deeply involved in basic science and clinical research in neuro-oncology. Collaborating members include faculty from Medical and Pediatric Oncology, Neurology, Neuroradiology, Neurosurgery, Nuclear Medicine, Nursing, Oncologic Pharmacology, Pharmacy, Radiation Oncology, and Radiology Research. This multi-disciplinary group and the institutional commitment to its goals continue to grow. In 2000, Dr. Howard Fine moved from the Dana Farber Cancer Center to the NIH to chair the newly established Neuro-Oncology Branch of the National Cancer Institute and NINCDS. The aim of the new Neuro-Oncology Branch is to develop an integrated clinical, translational, and basic research program, that will engage the strengths and resources of both the NCI and NINDS, for the purpose of developing novel experimental therapeutics for children and adults with tumors of the central nervous system.