This first-of-its kind clinical model brings together both the latest therapies to improve brain tumor survival and the comprehensive portfolio of rehabilitation services that patients need to help them maximize the quality of their lives.
An estimated 90 percent of brain tumor patients must cope with one or more significant functional, cognitive, motor or language impairments as a result of their tumors. The Functional Wellness Initiative identifies and treats both adult and pediatric patients with malignant and benign brain tumors that affect language, motor, psychological and neurocognitive outcomes.
“Many patients face a complex mix of challenges as a result of their tumors,” Hervey-Jumper says. “In the past, separate evaluations were needed from each discipline before arriving at a treatment strategy. That meant burdening patients with multiple appointments and making it more challenging for providers to coordinate their efforts. Here at Michigan, we bring the experts together for the patient right from the start.” Hervey- Jumper’s clinical and research focus is on brain mapping and functional reorganization.
During a patient’s first clinic visit, he or she will see a multidisciplinary team of clinicians from neuro-oncology, physical medicine, clinical neuropsychology, speech pathology and neurosurgery. And they will collaborate on an all-inclusive, individualized care plan.
Every aspect of the care plan is based on the unique needs, values and preferences of patients and their families.
“This approach allows us to provide a more individualized care experience,” says Aaron Mammoser, M.D., a neuro-oncologist who specializes in novel therapeutics to improve survival. “Patients discuss their needs and concerns with all of their care providers at one time. By reducing the number of visits needed, we’re saving patients and families time and travel while enhancing their care experience.”
The timing and frequency of subsequent visits, treatment, rehabilitation and assessments will depend upon the patient’s individual care plan. These follow-up appointments allow for continued monitoring and support throughout the care process. As needs change, so will the treatment plan, focusing on both length of survival as well as achieving the best possible quality of life.
In addition to Hervey-Jumper and Mammoser, the team includes:
- Sean Smith, M.D., a physical medicine and rehabilitation physician specializing in improving the quality of life for patients with cancer
- Nicolette Gabel, M.D., a clinical neuro-psychologist who specializes in neurocognitive remediation
- Karen Kluin, S., C.C.C., BC-ANCDS, a speech pathologist who specializes in perioperative language testing.
- Thomas Ferguson, N.P., clinical coordinator for the program
- Other faculty of the University of Michigan Brain Tumor Program include Larry Junck, M.D., Oren Sagher, M.D., Jason Heth, M.D. and Daniel Orringer, M.D.
MEET Donell Hall
Donell Hall was driving to work when he experienced another one of the massive headaches that would leave him temporarily unable to speak clearly. he managed to park, get out of his car, and lay on the ground to wait for help. Just able to function enough to call 911 and say a few words that would lead the operator to determine his location, hall remembers police arriving on the scene and then waking up in the hospital.
After a series of tests, doctors told hall he had a massive brain tumor that needed immediate treatment. Hall had been experiencing these headaches since the age of 14, and he had always thought the speech loss was a side effect of a bad migraine headache. As he approached his late 20’s, the head- aches became more frequent, occurring 2-3 times per year.
Hall first met Dr. Hervey-Jumper and some of the other Functional wellness team members as he was being prepared for surgery to remove the tumor. As a TV/video/broadcast producer and business owner, the ability to speak is critical to Hall’s work and his livelihood.
The team understood this and spent much time discussing how Hall could retain his language skills after surgery. They also anticipated the added complexity of radiation and chemotherapy to shrink the remaining tumor that would not be able to be removed without risking long-term speech loss.
“The team was fantastic. They spent a lot of time prepping me for post-surgery to make sure I would be able to talk like I did before the surgery,” says Hall, who is now 30 years old. “If I can’t speak quickly and have people understand me, my job is over.”
After his surgery in November 2014 to remove the tumor, hall continued working regularly with a speech pathologist to improve his language skills and his memory. Although less frequently now, he still visits the Functional Wellness Program about once a month and was able to return to work last month. “My language is coming back – I still forget a lot. But I’ve got most of it back. I feel good,” says Hall with a smile.