Twenty years ago, Dr. Alfredo Quinones-Hinojosa hopped a border fence from Mexico into the United States and became a migrant farm worker, living in the fields in a broken-down camper he bought for $300. When told he would probably be a farm worker for the rest of his life, he signed up for English classes at a community college, where one of his teachers encouraged him to apply to UC-Berkeley. There, he developed a passion for science, and showed remarkable aptitude. He went on to Harvard Medical School and graduated with honors, followed by a residency in neurosurgery at UC-San Francisco, where he completed a postdoctoral fellowship in developmental and stem cell biology. He later received the American Association of Neurological Surgeons Ronald Bittner Award. Dr. Alfredo Quinones-Hinojosa is now an Associate Professor of Neurosurgery and Oncology at Johns Hopkins and serves as the Director of the brain tumor program at the The Johns Hopkins Bayview campus. There, his focus is on the surgical treatment of primary and metastatic brain tumors, with an emphasis on motor and speech mapping during surgery.
Question: What is the most exciting part of brain science for you?
Alfredo Quinones-Hinojosa: I think the most exciting part of what I do right now is exactly the fact that what we are doing is giving patients new hope; that we're looking at a disease, which is brain cancer, that people have looked at for hundreds of years and we have not been able to understand, and we're finally perhaps beginning to scratch the surface, we're beginning to look at an old disease with new eyes.
And what new eyes are those is the fact that within brain cancer there may be a small population of cells that have the ability to recreate the same type of cancer, which means that despite the fact that we can actually do a perfect surgical resection and we can take a lot of these tumors out, these patients eventually continue to progress, perhaps because we're leaving those small little cells back there that are able to recreate the whole tumor. So our role now is to understand those small cells. We're not looking at the whole tissue that we're leaving behind, but we're looking at a special subset of population of cells that we can potentially affect; that we can potentially damage their ability to recreate that cancer. And I think, to me, that's absolute dynamite, because it may actually change the paradigm and the way that we treat brain cancer currently.
Question: How will brain cancer be treated differently in the future?
Alfredo Quinones-Hinojosa: In the future the way that I vision-- my vision is that every patient will be treated slightly different, depending on their ability, depending on their markers, depending on the kind of cells they have in their brain. Right now the way that we are categorizing brain cancer is in different categories, and we lump all patients together in different categories, when in reality we are beginning to understand that every patient is different. Just like we're all human but we have different characteristics, different personality, tumors are probably the same way, and no one single treatment can be tailored for many patients.
You're probably going to individualize treatment, and that excites me. The other thing that excites me about what we do in the operating room, and in the laboratory, is the fact that we'll probably open doors for other fields to conceive the way to unleash the potential of the brain. If brain cancer is a disease that continuously has the ability to grow-- there are many other diseases in the human brain where we need that growth, like in multiple sclerosis, Huntington's disease, Parkinson's disease. So our role is to try to learn from that of normal growth so we can apply that knowledge to people who need growth in parts of the brain that are thirsty for new cells.
Recorded on: July 2, 2008
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