It Takes a Village to Treat Brain Tumors

Photograph by Devyn Glista

Cincinnati could become an epicenter for brain tumor treatment now that Mayfield Brain & Spine is collaborating with four area hospital groups and top neurosurgeons worldwide to launch the Brain Tumor Institute. Vince DiNapoli, M.D., and Ronald Warnick, M.D., are leading Mayfield’s efforts, which have already raised more than $1.3 million through philanthropic pledges toward establishing the institute.

DiNapoli’s specialty is surgery on the brain’s intricate architecture at the base of the skull, and he’s been at Mayfield for 10 years. Warnick has practiced at Mayfield for 33 years and focuses on Gamma Knife radiosurgery, which uses hundreds of low-dose beams of radiation to target a single point in a brain tumor. By collaborating with other specialists here and around the world, they hope to create a team that can mix and match as needed.

Locally, Mayfield is working with TriHealth, Bon Secours Mercy Health, The Christ Hospital Health Network, and St. Elizabeth Healthcare to establish the Brain Tumor Institute. The institute won’t be a physical place, but instead a team of experts that can coordinate activity and host outside experts at different hospital sites.

While this isn’t the first time Cincinnati hospitals have been encouraged to work together, DiNapoli says, they tend to feel a sense of ownership over their patients, which can make collaboration difficult, if not impossible. But hiring additional specialists in individual hospitals doesn’t work either, because they don’t see enough of those rare cases to learn and progress in their careers.

With more than 140 different brain tumor diagnoses in existence, it’s not uncommon for patients to have trouble finding the right specialist for their specific case, especially as some cases will require more than one type of treatment. “The pathologies of brain tumors are so rare and so difficult,” says DiNapoli. “You can’t hire a surgeon who wants to be busy and productive and exposed to a lot of cases so they can hone their expertise and then give them just 20 cases a year to manage.”

“I think the timing of the institute is perfect,” Warnick says, “because physicians and hospitals have basically thrown up their hands and said, Are we ever going to accomplish this neuro-oncology recruitment? Who’s going to bring incredible expertise that will help all the hospitals without their need for a major investment?”

DiNapoli and Warnick have worked in tandem on patients at Mayfield, with DiNapoli taking care of the larger part of a tumor and Warnick following up to remove any small pieces that remain. That’s exactly the type of case that can benefit most from an institute staffed by a variety of neurosurgeons.

Complex brain tumor cases can be assessed by a variety of specialists when hospitals cooperate, which can result in more complete and centralized care for patients. “Yes, we certainly work together as a team at Mayfield, and that’s part of the impetus for why I decided to try to create this institute,” says DiNapoli. “We have fantastic partners all through the Cincinnati region with the four health care systems we already collaborate with.”

Mayfield is an independent practice that’s owned by its neurosurgeons. That structure makes it an ideal venue for collaboration among hospitals.

“We want to try to just bring everyone together, whether it be here in Cincinnati, across the country, or around the world,” DiNapoli says. “We’re really excited about the institute and think it can change the paradigm for the way physicians are able to deliver care, especially this highly specialized care for patients with really rare problems.”