The Neuro-oncology Program: multi-disciplinary expertise for children with tumours of the brain and spinal cord

When a child is diagnosed with a brain tumour, the family faces the daunting task of learning about a terrifying diagnosis and then navigating a very complex treatment process. At the Montreal Children’s Hospital, that process is made easier thanks to a team of professionals who work closely together to provide children with leading-edge techniques and treatments. Neuro-oncologist Dr. Adam Fleming is a key member of the Pediatric Neuro-oncology Program, a multidisciplinary team that works with children through every step of their treatment.
Dr. Fleming joined the MCH in 2011 after training in pediatric neuro-oncology at the world renowned Dana-Farber/Children’s Hospital Cancer Centre in Boston, Massachusetts. His arrival signalled an increased focus at the MCH on treating children with brain and spinal tumours. “Brain tumours in children are rare,” says Dr. Fleming, “but children who present with them require highly specialized care. From our Pediatric Neurosurgery team to the specialists in Pediatric Oncology and Radiation Oncology, the MCH is a place where families can receive the highly specialized care they need.”
Whether a child comes to the MCH via the Emergency room or is referred from an outside physician or hospital, the referral process generally starts with the neuro-surgical program. A child is in good hands at the MCH since the hospital’s Pediatric Neurosurgery team is one of the most highly skilled in the country. Dr. José Luis Montes heads the department which also includes Dr. Jean-Pierre Farmer (also Chief of Surgery at the MCH), and Dr. Jeffrey Atkinson. Thanks to the hospital’s 3T intra-operative MRI, and the development of functional neuro-imaging, the neurosurgery team can provide a very high level of accuracy and detail to patients with complex problems.
Dr. Fleming, who trained as a pediatric hematologist-oncologist before specializing in neuro-oncology, divides his time between seeing patients and conducting clinical research. He works in partnership with Dr. Nada Jabado (see main article) to help bring discoveries to the bedside. He is very positive about what the MCH Pediatric Neuro-oncology Program can offer patients and their families. “For example, in addition to our renowned expertise in neurosurgery and research, Dr. Carolyn Freeman (Radiation Oncologist at the MUHC) has developed radiation therapy techniques that can maximize benefit and minimize harm,” says Dr. Fleming. “Overall, the MCH works to provide the very best comprehensive care for children with brain and spinal tumours.”
Dr. Fleming also collaborates with many clinicians and researchers who are conducting early-stage clinical trials in larger North American centres, such as Toronto and Boston. “For patients with rare or relapsed brain tumours, we will help them choose the right clinical trial for them, whether it’s here or elsewhere.”
The comprehensive, multidisciplinary team includes many other professionals such as a dedicated Clinical Nurse Specialist, a neuro-pathologist, neuro-radiologists, oncology nurses, palliative care experts, psychologists, Child Life specialists, social workers, and music therapists. “Pediatric neuro-oncology is a very dynamic field,” says Dr. Fleming. “We are making great strides in our understanding of brain tumour biology, and we’re always striving to better meet the complex needs of families facing this difficult situation.”