Awake Brain Surgery and the latest on brain tumor treatment An interview with neurosurgeon Kevin Yao, MD

Before we get into the medical stuff, I’d like for my audience to learn a little bit about you. What made you decide to do neurosurgery for a living?

KY: I had no idea what specialty I wanted to go into when I started medical school. Early in my first year, several students already were well along the path to their pre-decided specialty. One of them, a friend, had chosen neurosurgery. Somehow I didn’t even know that brain and spine surgery was even an option for medical students. But when I found out, I knew I wanted to learn more. So I figured out how to spend as much time as possible with the neurosurgery doctors and residents, as well as other medical students interested in neurosurgery. Because of this, I was afforded early opportunities to see brain and spine surgery firsthand, and to get an inside look into the work life of a neurosurgeon. Once I saw surgery, and got a taste of the clinical challenges neurosurgeons chose to face on a day-to-day basis, I was hooked. 

One of the many things I admire about you is your ability to maintain a work/life balance. Tell us about your passion for art (or swimming or meditation). 

KY: I’ve been swimming my whole life, or at least since before high school. It’s my main form of exercise, as well as stress decompression. It’s as much a part of me as sleeping or walking. I’m lucky that this happened to be a sport that is easy to do pretty much wherever I live, and that I can hopefully continue into old age as well. 

I also do have a particular interest in contemporary art. It’s a whole other world of ideas that is different from that which I get exposed to in my normal day-to-day professional existence. What I particularly like about art and the people involved with the creation of art, is that ultimately art is a creative vehicle through which a singular voice explains his or her own view of the world: past, present, and future. And for this to be the centerpoint of the conversation, I find it fascinating. I’ve made good friends, and learned a lot through art.  

Yes, I’ve incorporated meditation into my life and habits. I’ve found it to be a fundamental building block to providing clear comprehension in life. And it’s a continual work in progress. Ultimately it’s a key to understanding and not forgetting that life is precious. 

In addition to maintaining a busy private practice, you teach doctors in training at Mount Sinai in New York and keep abreast of all the cutting edge treatments. Please tell my audience about the latest in brain tumor treatment. 

KY:From the surgical side, we use GPS like navigation to pinpoint the location of tumors. This helps to minimize the size and trauma of surgery. We also can use special fluorescent dyes to light up tumors at the time of surgery to help us maximize tumor removal and minimize manipulation of the normal brain. From the medical treatment side, genetic tumor markers are being utilized more and more to determine which treatments to use for certain tumors. And for radiation, pinpoint radiation techniques known as radiosurgery, are being used to treat tumors with high doses of radiation, while minimizing radiation exposure to the normal brain.

Brain surgery is terrifying enough. It always amazes me to think of someone going through it while awake. Tell us a little about your perspective and please link to some of your amazing videos on the subject 

KY:In certain circumstances, doing brain surgery while the patient is awake can improve the outcome of the surgery by providing real-time feedback that vital parts of the brain are not being affected with surgical manipulation. This is particularly true when tumors are in the parts of the brain that control language and movement. While this may seem like a daunting prospect for patients, we take a lot of care during surgery to make sure patients are calm and comfortable throughout the awake part of the surgery. We do all sorts of things like check and double check that they’re positioned in a very comfortable position with all sorts of pillows and cushions. We inject lidocaine type medication into every layer of tissue we manipulate, except for the brain. Ironically the brain itself has no nerve endings or sensation. And we also provide a baseline level of anti anxiety medicine throughout the surgery so that patients can tolerate being awake, and even have an enjoyable experience.

What are the most common problems that you take care of?

KY: I take care of patients with tumors and cancers of the brain and spine. This includes tumors that start in the brain, the linings around the brain spine, pituitary gland, bony spine, or spinal cord. Also included are tumors that start elsewhere in the body and then secondarily go to the nervous system: these are usually metastatic tumors related to cancer. 

I also take care of patients with spine conditions, most commonly degenerative neck and low back problems such as slipped discs, arthritis, or injuries.

What would be the best way for a patient to contact you?

KY: At my office in Englewood, New Jersey or New York: 201-569-7737