Key highlights:

About our guest: 

Dr. Gabriel A. Brooks is an oncologist in Lebanon, New Hampshire and is affiliated with multiple hospitals in the area, including Dartmouth Hitchcock Medical Center and White River Junction Veterans Affairs Medical Center. He received his medical degree from Perelman School of Medicine at the University of Pennsylvania and has been in practice for 11-20 years.

Key Moments:

At 16 mins and 0 seconds: About team-based care in cancer.

“Nothing I do for my patients happens in a vaccum. There are questions about radiation, radiology or pathology…the cases we bring to tumor board are the cases where we have questions. It maybe for a patient with a new diagnosis or a patient I’ve had for years and the situation has changed and there is a new question. I could send the patient to another specialist but it’s not the same as four specialists in one room looking at a single case.”

At 30 mins and 05 seconds: Tumor board vis-a-vis guidelines.

“The NCCN guidelines are very influential documents that say what the evidence is in that cancer type. They are not proscriptive. There are lots of areas that are highly subjective in patient care. It’s also true that they are a US organization and refer to drugs available in the US. Tumor board addresses the issues where guidelines are not detailed enough, or where more subjective discrimination is required.”

At 32 mins and 50 seconds: Guidelines drive most situations.

“95% of the time, or rather 99% of the time…most of the things that I do are consistent with the NCCN guidelines. Once is a while there is situations where the guidelines don’t apply.”

At 39 mins and 12 seconds: Decision making in cancer.

“The idea that you can make this decision today that is going to specify every step along the way for the rest of the year for most of our patients is not realistic.”

At 41 mins and 13 seconds: Honesty in difficult conversations.

“I think it is very important for me to be truthful to my patients and tell them that my goal is to help you live longer and help you, but maybe not to cure you. …It’s not my job to tell my patients what the future holds, because we really don’t know.”

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