Neuro-Oncology

Blood-Brain Barrier Program

Patient Care

At OHSU, we are committed to treating the whole person. Our team's goal is not only to prolong the length of survival, but also to improve the quality of survival.

Our comprehensive approach to patient care treats our patients' medical needs, and also offers help and guidance in dealing with the many complex challenges that face patients and their families. This approach includes education, behavior modification, case management, social services, medical management, nursing care and end-of-life support.

BBB Team

Patients regularly interact with members of our multidisciplinary team. Dr. Edward Neuwelt directs the team, which consists of physicians (neurosurgeons and a neuroradiologist), as well as nurse practitioners, nurses and support staff. Additional support such as a neuropsychologist and social services is available through OHSU.

Patient treatment often includes expertise from hematology, oncology, psychology, neurology, ophthalmology, pathology, neurosurgery, audiology, radiology, physical therapy, anesthesiology, radiation therapy, oncology nursing and the oncology pharmacy, as well as that of the nutritional staff, ancillary hospital staff and BBB nurse coordinators. Additionally, the BBB team applies expertise offered by the referring and follow-up care physicians.

Patients are admitted to the OHSU Hospital oncology ward where the oncology nurses and staff get to know the patients and their families, and help make their hospital stay welcoming and comfortable. During this stay, patients and their families often gain a network of new supporters through the services offered by OHSU Hospital and the BBB Program.

Annual Meeting 2008 - Oregon group

Oregon group at BBBD Annual Meeting 2008 at Skamania Lodge, Stevenson, WA

Team Member Roles

Dr. Neuwelt:
Dr. Neuwelt is responsible for directing the care of patients and overseeing the BBB pre-clinical research program. He sees new brain tumor patients in the neuro-oncology clinic and also makes hospital rounds.

BBBD physicians:
The physicians that work with Dr. Neuwelt also see patients and families in the neuro-oncology clinic, assist with directing patient care, and assist with the BBBD procedures. In addition, the physicians are directly involved in preclinical and clinical research, as well as in the analysis of clinical outcomes data.

Nurse practitioners:
The nurse practitioners play a vital role in coordinating patients' day-to-day care, and are instrumental in coordinating hospital admission. Between monthly treatments, nurse practitioners phone patients weekly to check on their condition and to assess their need for additional support or in-home care.

The nurse practitioners also maintain contact with patients after they have completed the program, to assist them with their transition to home and ensure that they return for their scheduled clinic visits. The services provided by our nurse practitioners are fundamental to the overall well-being of patients.

Other support staff:
A licensed neuropsychologist performs an evaluation and can help address the cognitive and psychological needs of patients and their families. The neuropsychology evaluation is repeated at the end of BBBD therapy.

These evaluations assist both the BBB treating team and the patient. A neuropsychological exam takes approximately one hour and assesses the following aspects of cognitive function: memory and learning; information processing; attention and concentration; verbal reasoning skills; language and speech; visual spatial and visual motor skills; motor skills; and emotional function. Counseling and therapy is an option for those having difficulty adjusting or who may be experiencing increased depressive or anxiety symptoms.

Because the quality of life for BBBD patients is very important, the psychological needs of all patients and their families are addressed as part of the multidisciplinary approach at all BBBD Consortium sites.

Case managers are also available to help patients transition from hospital to home. They can assist with insurance and financial concerns and home health-care options. Social workers are available to assist with psychological and social support for patients' families.

Hematology-oncology, anesthesiology, pharmacy, ophthalmology and audiology all participate as part of the team as well, and provide specialized medical care and support. Additional consultants are called, depending on individual patient needs.

Because some of our patients are children, the BBB team also works closely with pediatricians and with pediatric oncologists to decide treatment plans.

The primary role of our BBB office team is to schedule monthly hospital admissions and tests, answer general patient questions, and work with insurance companies to obtain authorizations for each admission.