Brains behind operation

Christopher Duma’s goal is to modernize the treatment of neurological diseases.

Duma, a neurosurgeon, is the medical director of the brain tumor and GammaKnife programs at Hoag Memorial Hospital Presbyterian in Newport Beach.

He has developed a novel treatment using GammaKnife technology to “head off tumors at the pass,” he said. He patented the treatment, which he calls Leading Edge.

“I treat the most brain tumors south of Los Angeles,” Duma said.

His scalpel’s reach extends south to the Mexican border and east to Tucson.

GammaKnife technology allows surgeons to use pin-pointed radiation to target brain tumors and treat other neurological diseases like Parkinson’s. The method is noninvasive, meaning the surgeons don’t need to use a real knife.

The Leading Edge treatment, using GammaKnife technology, is almost like setting backfires to stave off a spreading wildfire. It allows Duma and his team to develop highly specific treatments that stop tumors from continuing along migratory pathways of white matter, tissue through which the gray matter of the brain communicates with itself. Tumors can travel and grow through the white matter.

A tumor can be treated in as little as 10 minutes; the most complicated procedures take an hour.

“Then they can go home and go dancing that night,” Duma said.

The treatment has helped patients with malignant gliomas live beyond the median survival rate of 17 months. As many as one in five patients survive for three years, which Duma called an “astonishing number.” Sen. Ted Kennedy, who was stricken with this type of brain tumor, lived 14 months.

Innovative approaches

One of Duma’s patients, Veronica, was described by her best friend Richard Parrot as a poster child for Duma’s dedication to modern, aggressive treatment techniques. Parrot declined to give Veronica’s last name.

“She’s been getting her care here since 2004,” Parrot said. “She’s been my best friend for 25 years.”

Veronica, a former deputy district attorney in Los Angeles, was diagnosed with breast cancer in 1996. It metastasized to her lungs, and later to her brain and spine.

Veronica has received countless procedures at Hoag. She was at the hospital Monday for her 11th GammaKnife procedure, Parrot said.

“The journey is fraught with ups and downs,” he said.

Duma and his team have performed many aggressive treatments on Veronica, who also has visited a grotto in Lourdes, France, for its reputed healing waters.

“Dr. Duma likes to say she’s on her ninth life, but in her case, it’s probably her 27th,” Parrot said. “She’s the kind of patient that wants to fight the good fight.”

He lauded the doctor for his innovative decisions on his friend’s treatment.

“Dr. Duma would be one out of maybe 100 neurosurgeons to take that path,” he said. “Of the many highly negative and dour doctors that I’ve seen with Veronica on her journey, he is one of the most enthusiastic, ebullient and highly optimistic.”

Sharing the news

Duma presented the Leading Edge method recently in New Orleans, at a meeting of the Society for Neuro-Oncology. He also has presented his data at meetings in Belgium and Korea.

“It was very well-received,” he said.

His goal is to get multi-institutional interest in his method. He also hopes to develop the stem-cell program at Hoag, and develop methods of treating Parkinson’s and cancer with them.

“We have the scientists, we just need the support from the community,” he said.

Duma also implants brain stimulators that are similar to heart pacemakers into patients. He was the first surgeon in Orange County to implant one in 2000, and since then has performed about 500 of the procedures.

“Since day one, I’ve been interested in the brain,” Duma said. “It dates way back to when I was in elementary school.”

He purchased a copy of the classic textbook “Gray’s Anatomy of the Human Body” when he was 9 years old.

“I had a great role model as a family doctor,” he said. “It was kind of a no-brainer for me to go to medical school.”

He gravitated toward being a surgeon, and developed an interest in computer-aided treatments, learning to navigate through the brain using digital imagery. Duma said 10% of his work is performed for those without insurance. He also treats Medi-Cal patients.

“We can always get it done,” he said.

The neurosurgeon said he needs only six hours of sleep each night.

In his spare time, Duma is an accomplished musician with a band that performs for charity, including to raise funds for some of his own patients. He also is a patron of the Orange County Performing Arts Center and the Philharmonic Society of Orange County.

In addition to his work in the brain tumor program, Duma is on call 24 hours a day for seven days a month at Hoag’s emergency room.

He has three children, is a soccer coach, and endeavors to be home every night for dinner.

“Family is No. 1; patients are No. 2,” he said. “And you have to work your life that way. But it’s a balance.”

Under the GammaKnife

Through GammaKnife technology, which is noninvasive and doesn’t involve the use of a real knife, surgeons can treat brain tumors and other neurological diseases like Parkinson’s by attacking malignant cells with pinpointed radiation. Christopher Duma’s Leading Edge technique, which uses GammaKnife, allows the Hoag neurosurgeon and his team to develop highly precise treatments that stop tumors from continuing to migrate along pathways of white matter inside the brain.