The latest in brain tumor treatment: Q&A with Dr. Ian Lee
Dr. Lee received fellowship training in Neurosurgical Oncology at the University of Texas, MD Anderson Cancer Center. He has pioneered innovative technologies for safer, aggressive brain and spinal tumor resection and currently serves in many leadership positions at Henry Ford, including co-director of the Hermelin Brain Tumor Center.
IAN LEE, M.D.
Brain and spine tumor resection
von Hippel Lindau VHL syndrome
Co-director, Hermelin Brain Tumor Center
Director, Spinal Neuro-oncology
Co-director, Intraoperative MRI
Senior Staff Neurosurgeon
2018 Asian Pacific American Chamber of Commerce Salute to Excellence Award
2018 Hour Detroit Innovation of Care Award Winning Team
2016-2019 Hour Detroit Top Docs
Q: WHAT'S CHANGED MOST SINCE THE TIME OF YOUR TRAINING?
We have more minimally invasive treatments available. We have newer methods of visualizing functional anatomy, so we can better work around language, motor function and other important centers of the brain. White matter tractography through diffusion tensor imaging allows us to define safer corridors to access deep tumors. Real-time imaging through intraoperative MRI allows us to maximize resection safely as well as do other types of surgery that rely on real-time imaging, such as laser ablation. With all of these techniques, and now for the spine, as well, we can operate on formerly inoperable tumors, do more complete resections and cut recovery time.
Q: WHAT ABOUT THE PERSONAL TOUCH?
The surgeon’s hands-on experience is still the important element. Knowing where the tumor is located is only part of it. There’s an interplay with what you see in the tumor, and integrating it with anatomic and functional anatomical knowledge.
Q: HOW HAS PRECISION MEDICINE CHANGED TUMOR TREATMENT?
Precision medicine uses specific, individual genetic markers to diagnose patients, before developing treatment options that work on a molecular level. The pace has increased, and now we can sequence an entire genome in days. With this advancement and with the tissue samples in our Tumor Bank, we are learning a lot more about genetics of these tumors, which can help us develop new sets of markers to help with prognosis and treatment. These types of studies as well as trials like 5-ALA will ultimately help to drive better treatments.
Q: WHY IS 5-ALAA A GAME CHANGER?
It’s been the standard of care in Europe for over 10 years, but is new in the United States. 5-ALA is a natural chemical your body produces that fluoresces pink under blue light. Tumor cells take it up preferentially, so it causes the tumor to light up pink, making surgery almost like a paint by numbers to show you where the tumor is. This is important, because to the naked eye, tumors can be hard to differentiate from the surrounding, more normal tissue.
Q: WHAT CHALLENGES REMAIN IN BRAIN TUMOR TREATMENT?
We’re pretty close with how aggressive we can be with surgery, and it’s an integral part, but on its own it’s not curative. There’s more work to be done in finding the balance between precision in tumor resection, while preserving neurological function and quality of life.
Q: WHAT'S NEXT FOR THE CENTER
An even greater focus on precision medicine. Continued advancements in making surgery less invasive, and better integrating surgery with other treatments. Liquid biopsies to diagnose tumors noninvasively through urine, blood and spinal fluid, which is something that we’re researching at Hermelin.
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