Throughout ten years of working to reinvigorate the Neurosurgical Service, it has been Dr. Black's passion to nurture and sustain vital links between basic science research in the laboratory and the care of patients at the bedside. This can be a difficult connection to maintain. It takes unique talent and inexhaustible determination to combine the painstaking attention to detail that is required in the laboratory with the compassion and urgency required in patient care. Dr. Black has demonstrated a unique gift as one of the few surgeons in the world who is as respected for his achievements in basic science research as he is for his clinical care.
Probing the Causes of Brain Tumor Growth
In the study of brain tumor biology, Dr. Black and his colleagues in the laboratory are searching to uncover the events that cause brain tumor growth and discover ways to stop their development. A wide variety of scientific approaches are utilized, from examining the abnormalities in chromosomes and human genes, to identifying the factors in a cell that encourages growth. Studies such as these are often inspired by clinical experience.
For example, physicians in the clinical setting were the first to notice that tumors called meningiomas were more common in women than in men. Researchers in Dr. Black’s laboratory have shown that increased levels of female hormones likely contribute to the increased incidence of these tumors in women compared to men. This kind of information provides critical clues needed to develop drugs which prevent the growth of these and other tumors.
Brain Tumor Research & Imaging Technology
Dr. Black's most notable accomplishments as a clinician-scientist focus on his research in brain tumor biology and the imaging of the brain. In the basic science laboratory, Dr. Black probes the mysteries of tumor cells, searching for ways to control their growth. In the imaging laboratory, he collaborates with radiologists from the Brigham, to develop new methods for surgeons to see inside the brain - before, during, and after surgery. Thanks to increasingly precise visualization technologies which reveal the details of what's going on within the brain, surgeons can be far more effective at removing tumors safely, as well as performing other technologically demanding neurosurgical procedures.
The basic science and clinical research efforts in tumor biology, neuroscience, and imaging technology have rapidly built an international reputation for the service in innovation and scientific excellence and the physician training program has become one of the best and most sought-after in the world for residents, students, and fellows.
Arresting Tumor Growth
Another laboratory research project that holds promise for the development of new treatments for brain tumors involves limiting the blood supply to the tumor to control its growth. A colleague of Dr. Black's at Children's Hospital, Dr. Judah Folkman, first investigated the idea that one may be able to control tumor growth by preventing the development of new blood vessels, a process known as angiogenesis. Tumors require tremendous amounts of nutrition and oxygen in order to grow. As a tumor gets larger, new blood vessels must form around and through it in order to meet these ever-increasing needs. The result is an intense concentration of new blood vessels at the site of the tumor. It is thought that if one can either arrest or altogether prevent the proliferation of the cells that form the new blood vessels, the tumor may be starved of the nutrients it needs to grow.
Dr. Folkman has identified a substance that can effectively prevent the formation of new blood vessels and thus stop the growth of several tumor types such as colon and breast tumors. Researchers in Dr. Black's lab have now shown that this compound inhibits the growth of brain tumors in animal models and they are developing methods for delivering this drug to the site of a brain tumor using gene therapy. Once this work is completed, this method will be ready for testing on human patients.
Programmed Cell Death Research
Neurobiologists are finding the answers to how and why cells grow and die during the development of the brain. Members of Dr. Black's research team are currently applying these discoveries and insights to tumor cells. They have identified substances found naturally in the brain that instruct normal cells to grow, or signal them to die. Researchers in the lab have shown that if you introduce a high concentration of one of these naturally occurring substances to the site of a brain tumor, it will quickly die, leaving the surrounding normal cell around it intact. This approach is now being brought to clinical trials where it will be tested on patients with incurable, aggressive brain tumors.
