[May 2007] By the time patients reach the office of neurosurgeon Joseph M. Piepmeier, MD, their life expectancy is likely to be limited. But even in these terminal cases, with few treatment options available, Piepmeier finds reason for hope.
“Many of the patients I see, I know the first day I see them that they have a fatal problem,” Piepmeier says. “But we’re going to try to prolong their life and sustain a high quality of life for the time they have left.”
Because it’s not always possible to remove a brain tumor without damaging the brain, Piepmeier must weigh the benefits of surgery against possible effects on the quality of life. And that leads to a search for new treatments. Although the bulk of his work takes place in the operating room—he performs 200 surgeries a year—Piepmeier is also involved in clinical research as he seeks new ways to help patients. He works with radiation therapists as well as other specialists. “We have some terrific new technologies, such as the gamma knife, which really extends what we can do for patients,” he says. Piepmeier is also involved in a clinical trial of a new treatment modality known as convection-enhanced delivery, in which a targeted toxin is infused into the brain through catheters over four days. “Instead of giving it by mouth or by vein, we are actually infusing it into the brain,” he says. His clinical research also includes a study with Anthony van den Pol, PhD, on viruses that attack and destroy brain tumors.
His focus, as always, is on his patients.
“These patients have cancer in the brain. You can’t imagine a more immediate recognition of what’s really important in life and what’s not. The immediate focus of their life is right here, right now. It’s a terrific challenge but it’s a wonderful place for a physician to be,” he says. “If you can translate new ideas and novel therapies to these patients who are in very hopeless situations, that’s a big attraction.”
- Originally published in the May 2007 issue of Yale Practice.
Name: Joseph M. Piepmeier, MD
Title: Nixdorff-German Professor of Neurosurgery.
Area of expertise: Neuro-oncology.
Place of birth: Knoxville, Tenn.
College: Duke University.
Med School: University of Tennessee School of Medicine.
Training: Internship and residency in neurosurgery at the Yale School of Medicine.
Family: Married to Patty Pedersen, director of university corporate and foundation relations; son Bion, 22, and daughter Mary, 20.
What is most challenging to you in academic medicine? Most of the patients I deal with have a fatal disease for which there is no good treatment. Cancer in the brain is a big challenge for everyone.
What is most rewarding? When I can make a difference. When I can prolong life and improve function, it is terrific.
What do you like most about your practice? I enjoy the surgery. It’s fun and it’s challenging. I really enjoy teaching residents.
Personal interests or pastimes? Reading history, playing golf and a new passion, sporting clays, a variation of skeet shooting.
Last book read: 1421: The Year China Discovered America, by Gavin Menzies.
What would you do to improve our clinical environment if you had a magic wand? I would encourage more active involvement in clinical trials and more attention towards bringing novel therapies to patients.