When Dr. Erin Dunbar, a graduate from the College of Medicine’s class of 2001, helped assemble a new interdisciplinary brain-tumor center at the University of Florida, she didn’t just include oncologists, neurosurgeons and other specialists. She also called on medical librarians, social workers, physical therapists and counselors to create a team that reflects her guiding principle: Treat the whole patient, not just the tumor.“If those specialists are not intimately working together, there’s no way the ideal plan can come together. A patient just can’t get to five different specialists in five different places in a day,” said Dunbar, 36. “I wanted the center to have an infrastructure where we unified around the patient.”
What Dunbar and her colleagues created — under the guidance and direction of UF neurosurgery chairman, Dr. William A. Friedman — was the Preston A. Wells Jr. Center for Brain Tumor Therapy. The center, co-directed by Friedman and Dunbar, was established in 2006 after a $10 million gift from the Lillian S. Wells Foundation, a Fort Lauderdale group that supports medical research.
Building on its strengths in neurosurgery and radiosurgery, the department set out to establish one of the nation’s leading comprehensive brain tumor centers, and Dunbar has been a leading architect, designing programs and treatments that optimize a patient’s well-being at every stage of his or her care.
“I want patients, caregivers, and providers to understand that, while there are scary and difficult diagnoses, there are promising choices in therapy, and there is hope for a quality-filled life,” she said. “It’s an unbelievable privilege that patients and their families give me their trust and invite me into their lives the way they do.”
Erin Dunbar, M.D., ’01
Each patient is treated by a health care team that includes neurosurgeons, radiation oncologists, neurologists, psychologists, social workers and therapists working together to determine an individualized treatment strategy. That could mean combining conventional therapy with one of the center’s many clinical trials, which range from novel drugs to drugs used in novel ways, combinations of medicines for symptom management, or combinations of rehabilitation, education and support services.
The center’s model of uniting health care professionals and closely linking elements of patient care with research is what the chairs of the four neuromedicine departments could look to as they recently began to develop more collaborative approaches for treating and investigating all diseases of the brain.
“This is all about improved outcomes for patients,” Friedman said. “And it’s about involving basic scientists who can help us develop novel approaches to the treatment of brain diseases that affect millions of people.”
The right person for the job
After graduating from medical school at UF, Dunbar remained in Gainesville to complete an internal medicine residency and medical oncology fellowship. She then completed a neuro-oncology fellowship at Johns Hopkins, where she gleaned ideas on how to structure the new brain tumor center at UF.
“I felt it (Johns Hopkins Comprehensive Brain Tumor Center) was the best model that could be translated back to UF,” she said.
Dunbar and her colleagues oversee a number of investigational treatment protocols, including UF’s first Phase I medical brain-tumor trial, which uses an oral medicine that patients take at home, rather than a hospital-administered IV therapy. The convenience of the experimental treatment not only improves the patient’s (and caregiver’s) quality of life but enables the center to recruit participants from a wider geographical area.
Dunbar has also created trials to test how exercise can reduce fatigue in patients with brain tumors, as well as how education can empower patients, their families and their caregivers. The trials, recently accepted for presentation at the American Academy of Neurology’s 2011 annual meeting, give patients and caregivers concrete ways to positively impact their future.It’s that spirit of understanding and compassion that Dunbar has for her patients and their treatment journey that sets the physician apart. In fact, the walls in her McKnight Brain Institute office have space for her many awards and honors, including a cum laude degree from Florida State University, election to Phi Beta Kappa and Alpha Omega Alpha academic honor societies, induction into the Chapman Society, UF’s chapter of the Gold Humanism Honor Society and recognition as one of the Outstanding Young Alumni from the UF Alumni Association in 2009.
But rather than awards, Dunbar chooses to use the space in her office for graphics and charts that explain brain and spinal cord tumor care to patients and students. She also fills her exam rooms with information about sources of financial, logistical and emotional support.
“I want patients, caregivers, and providers to understand that, while there are scary and difficult diagnoses, there are promising choices in therapy, and there is hope for a quality-filled life,” she said. “It’s an unbelievable privilege that patients and their families give me their trust and invite me into their lives the way they do.”