Chapter 03: Developing a Brain Tumor Clinic at MD Anderson

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Chapter 03: Developing a Brain Tumor Clinic at MD Anderson

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In this chapter, Dr. Yung talks about his first impressions of MD Anderson and his early efforts to develop the neurology offerings at the institution. He begins by explaining his decision to come to MD Anderson (in 1981) after his fellowship at Memorial Sloan-Kettering. MD Anderson contacted him because the institution needed a neurologist to handle neuro consults. Dr. Yung describes the neurological complications that he would see normally see during consults and explains why he wanted to start the first designated brain tumor clinic at MD Anderson to treat complications and offer but care for primary tumors. Dr. Yung notes that he wanted to continue his research at MD Anderson. He established his laboratory at the Medical School, but relocated to MD Anderson in 1983.

Identifier

Chapter 03: Developing a Brain Tumor Clinic at MD Anderson

Publication Date

3-20-2014

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - Building the Institution; The Researcher; The Clinician; Joining MD Anderson; Contributions to MD Anderson; MD Anderson History; MD Anderson Impact; MD Anderson History; Building/Transforming the Institution; Multi-disciplinary Approaches

Transcript

Tacey Ann Rosolowski, PhD:

Tacey Ann Rosolowski, PhD:

Hmm. So you finished your Fellowship period in 1981 and at that point you made the move to MD Anderson. Is that correct?

Wai-Kwan Alfred Yung, MD:

Uh-hmm.

Tacey Ann Rosolowski, PhD:

So tell me how that came about.

Wai-Kwan Alfred Yung, MD:

S --- So as I finishing the Fellowship and I already have a pretty well developed research, you know, interest in --- in the --- in laboratory and so I was looking for, you know, the next step. I could stay in Memorial but living in New York is very tough. Try to raise a family in New York is very tough so

Tacey Ann Rosolowski, PhD:

And it’s cold.

Wai-Kwan Alfred Yung, MD:

And it’s co --- well cold is not that bad actually sin --- I mean, both my wife and my big city. You know, we came c ---

Tacey Ann Rosolowski, PhD:

Okay. Yeah.

Wai-Kwan Alfred Yung, MD:

And actually why I never really into even though I by --- and I came to Minnesota is really not a rural area in Minnes --- Minneapolis. And St. Paul is a pretty big city.

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

And then from Minnesot --- I mean from Minneapolis and then moved to Chicago. Big City. From Chicago I went to San Diego. It’s not a very big city but, you know, it’s still very much a city. Not ru --- Not --- Not countryside.

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

And then back up to New York. So we always in big city.

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

You know we --- So and we r --- we alrea --- by --- the time I finish fellowship we already have two children, you know. Both of my daughters were --- one --- my oldest --- our oldest daughter was born in San Diego and the second daughter was born in New York. So we already have two children. Then we have to decide, you know, where to settle.

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

You know, in the next move and also if --- a place that I can continue my academic career.

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

So I could stay in New York and Dr. Posner was going to, you know, keep me. But, you know, it’s --- it’s tough. So I look for other places I, you know --- and I was pretty well known to some of the Neuro-Oncology programs

Tacey Ann Rosolowski, PhD:

Hmm.

Wai-Kwan Alfred Yung, MD:

You know, like Duke, you know, Dr. Bigner want me to go to Duke and I look at, you know, do we want to go west or --- again

Tacey Ann Rosolowski, PhD:

Uh-hmm.

Wai-Kwan Alfred Yung, MD:

I would look at other places though. When I was looking besides checking up to Duke, Dr. LaMaistre and --- and --- and at that time the --- the Neurology group --- the --- the --- the --- the Neurology in --- at Anderson was covered by the medical school.

Tacey Ann Rosolowski, PhD:

Hmm

Wai-Kwan Alfred Yung, MD:

I think. So they --- the --- actually Dr. LaMaistre came to New York. You know, somehow --- Let’s see how did I h --- hook up with Dr. --- with --- with San Diego

Tacey Ann Rosolowski, PhD:

Hmm.

Wai-Kwan Alfred Yung, MD:

I mean --- mean MD Anderson. Oh, I know. I now remember. I remember. When MD Anderson was looking for a neurologist to do Neurology consultation

Tacey Ann Rosolowski, PhD:

Hmm

Wai-Kwan Alfred Yung, MD:

to d --- you know --- to --- to handle the --- the --- the, you know, the --- the Neurology need of Anderson they looked to the Medical School and Bill Fields --- William Fields was a Chair of Neurology at --- at UT Houston. And Bill hire a fellow of --- Dr. Posner’s fellow that finished before me --- a year before me a --- a person called Dr. Peter Glass. Peter Glass spent one year at Memorial, came to Mem --- came to MD Anderson as a neurologist to do Neurology consultation

Tacey Ann Rosolowski, PhD:

Hmm.

Wai-Kwan Alfred Yung, MD:

When I was looking for a fellows --- when I was looking for a staff job ready to finish my fellowship and --- and I get a call from --- from Memorial --- from MD Anderson that said for Dr. Fields, that well, we’re looking --- we need more help down here.

Tacey Ann Rosolowski, PhD:

Hmm.

Wai-Kwan Alfred Yung, MD:

And, you know, would you be interested to --- to come to MD Anderson, you know. And so I said, sure, why not? I’ll t --- I’ll take a look at MD Anderson.

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

And, in fact they said well we need actually two --- two more person at MD Anderson. We also were looking for someone that can do pain.

Tacey Ann Rosolowski, PhD:

Oh.

Wai-Kwan Alfred Yung, MD:

And one of the fellow with me at Memorial, you know, is a neurologist --- a woman neurologist who is interest in --- to doing pain. You know, so it’s a --- you know, we --- we want to actually che --- you know, try to tract tumors. If --- If you want to come look fine, all --- you know, Dr. Obben, Eugenia Obben, who’s the other fellow finishing, you know, her training in pain, you know, was also looking. So in fact --- you know, so both of us agreed to --- to come to Anderson --- to look at Anderson to see what down here. I can first --- Actually, I came first to meet Dr. Fields. And the before I came --- actually before I came to look or maybe --- no af --- yeah I came down to look back in 1979 or end of the ‘70s --- or early ‘80s.

Tacey Ann Rosolowski, PhD:

Oh wow, so this was ---

Wai-Kwan Alfred Yung, MD:

My first trip down here

Tacey Ann Rosolowski, PhD:

a year in advance.

Wai-Kwan Alfred Yung, MD:

--- My first trip down here I think is either end of ’79 or early ’80, you know --- yeah ’80 --- kind of --- in 1980 the f --- the year before I finish

Tacey Ann Rosolowski, PhD:

Yeah.

Wai-Kwan Alfred Yung, MD:

fellowship.

Tacey Ann Rosolowski, PhD:

So what were you impressions? Did you immedia ----

Wai-Kwan Alfred Yung, MD:

That was, I mean --- well MD Anderson is only the original building.

Tacey Ann Rosolowski, PhD:

Uh-hmm.

Wai-Kwan Alfred Yung, MD:

The --- The --- The pin

Tacey Ann Rosolowski, PhD:

The Pink Palace.

Wai-Kwan Alfred Yung, MD:

--- The Pink Palace. The pink marble building. The --- The --- you know --- you know, that little T-shaped building.

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

You know. So its --- it --- it --- my impression at --- at that time, gee --- this is --- it’s interesting place. A free standing cancer center. It’s similar to Memorial because that’s --- that wa --- there was a time --- one --- one thing about --- probably because I get a call from --- from LaMaistre because there is only two cancer center. Memorial Sloan-Kettering and MD Anderson. And An --- Memorial certainly is more established. Better reputation back then.

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

You know, then --- then MD Anderson. But I was attracted, you know, by the fact that this is a free standing cancer center.

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

Yeah.

Tacey Ann Rosolowski, PhD:

We --- I just want to get some clarification.

Wai-Kwan Alfred Yung, MD:

Yeah.

Tacey Ann Rosolowski, PhD:

Now when you got the call about these --- this position or two positions opening, up it was pretty clear that they wanted a person at MD Anderson not attached to the medical school or was that not clear?

Wai-Kwan Alfred Yung, MD:

Th --- No, it was --- they want --- they want a person at Anderson

Tacey Ann Rosolowski, PhD:

At Anderson.

Wai-Kwan Alfred Yung, MD:

Yeah.

Tacey Ann Rosolowski, PhD:

Did you get a sense of why that was?

Wai-Kwan Alfred Yung, MD:

But when I came to look

Tacey Ann Rosolowski, PhD:

Ah, okay. Uh-huh.

Wai-Kwan Alfred Yung, MD:

--- when I came to lo --- well because there is --- there is a big need

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

at Anderson for, you know, Peter Glass () was overwhelmed.

Tacey Ann Rosolowski, PhD:

Now tell me about th ---

Wai-Kwan Alfred Yung, MD:

at that time.

Tacey Ann Rosolowski, PhD:

What --- What did y --- What would you --- What did you do? What does a person who’s on staff for Neuro-Oncology consult to do?

Wai-Kwan Alfred Yung, MD:

Well, I think back then, you know, --- the --- the ne --- the neurologists --- the primary s ---, you know, the primary need of service is dealing with the neurological complication.

Tacey Ann Rosolowski, PhD:

Hmm.

Wai-Kwan Alfred Yung, MD:

You know, patient --- patient with --- with, you know, cancer undergo treatment develop problem with --- with, you know, drug toxicity.

Tacey Ann Rosolowski, PhD:

Hmm.

Wai-Kwan Alfred Yung, MD:

And they also develop problem with metaste --- with the --- with the cancer metastasize to the brain

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

to the spinal cord and --- and, you know --- the --- the --- the neuro-oncologist was trained to really deal with these --- make diagnosis during this issue with the --- with the brain toxicity from metastasis to the brain,

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

to the meningis, to the spine as well as drug toxicity. You know, many drugs that was used at that time caused encephalopathy also

Tacey Ann Rosolowski, PhD:

I’m sorry ence --- ence

Wai-Kwan Alfred Yung, MD:

caused --- encephalopathy.

Tacey Ann Rosolowski, PhD:

Encephalopa ---

Wai-Kwan Alfred Yung, MD:

Yeah. And --- Or change in mental status.

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

You know, or cause seizures and cause ne --- neuropathy with numbness and tingling.

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

All these neurological problems that come with the drug that need manag --- diagnosis and management from --- from a expert neurologist that

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

--- that deal with that issue.

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

And Peter was the only one and he was overwhelmed and he --- he’s also very kind of precise, meticulous person. You know, he’s overwhelmed. So they need more help.

Tacey Ann Rosolowski, PhD:

Uh-huh.

Wai-Kwan Alfred Yung, MD:

They were primarily looking for help in that area in terms of neurological complication. But when I came to look at job I said I want to add another element. I don’t want to just deal with neurological complications but I also want to develop, you know, --- I --- I want to see patient with primary tumor in the brain. Meaning these are the gliomas and --- and patient that devel --- and --- and I want to manage those patients to develop chemotherapy for those patients during --- back then the --- those patients are seen by medical oncologist. By Dr. Benjamin and --- and there’s a fellow called Lynn Feun. F-E --- F-E-U-N --- L-Y-N. Lynn Fuen in --- in Medical Oncology. And so I said --- I --- I want to get involved in brain tumor. I d --- I do not want to just deal with neurological problem. I want to start the brain tumor clinic. And so they said fine. Wo --- Work with Dr. Benja --- wo --- then you can work with Dr. Feun and Dr. Leavens. D --- Dr. Leavens was a neurosurgeon. L-E- ---L-E-A-V-E-N-S. Dr. Leavens --- actually Dr. Leavens picture is still in the Neurosurgery Department.

Tacey Ann Rosolowski, PhD:

Oh Okay. Yeah. Umhh. Yeah. Uh-huh.

Wai-Kwan Alfred Yung, MD:

And he just passed way --- Milam passed away how many years now? Not too long ago. You know, he was the only neurosurgeon when I came in 1981. He’s on staff at Baylor as well as here. And --- And so I team up --- so I team up with Milam and Lynn Feun and we s --- we created the first Brain Tumor Clinic. Kind of designated brain tumor clinic for MD Anderson when I came in 1981.

Tacey Ann Rosolowski, PhD:

Wow. Hmm. Hmm.

Wai-Kwan Alfred Yung, MD:

So then we expand. Basically, we expand the Neurology service from just serving as a Neurology doing consultation for compli --- neurological complication to include primary care for patients with, you know, --- with primary brain tumor, you know to rule out.

Tacey Ann Rosolowski, PhD:

Right. Right. Hmm.

Wai-Kwan Alfred Yung, MD:

And I also --- I --- because I was well established in --- in my laboratory, you know, and so Dr. LaMaistre, which you know, --- one --- one of the iss --- one of the reasons why I decided to come to Anderson also Dr. LaMaistre went all the way to New York City to --- to --- to interview me. After I came meeting with Dr. Feun, Dr. Lamaistre was in New York one time and he called me up and say, “Al Yung, I want to meet you.” You know, let’s have a cup of coffee. And --- and I met him, you know, in Waldorf.

Tacey Ann Rosolowski, PhD:

Yeah.

Wai-Kwan Alfred Yung, MD:

I think he stay in Waldorf at that time. And have a very nice chat with ---with Dr. LaMaistre

Tacey Ann Rosolowski, PhD:

Yeah.

Wai-Kwan Alfred Yung, MD:

And --- And that’s also another, you know, convincing reason to co --- another reason that convince me to come --- to come to Anderson.

Tacey Ann Rosolowski, PhD:

Hmm.

Wai-Kwan Alfred Yung, MD:

And so because I want to have a lab. Dr. Feun was Chairman of Neurology over at the med school even though he sort of, you know, has created so-called a section over here at Anderson, but he still sort of have a joint appointment. All of us have a joint appointment in the medical school. And there is no lab space here for me. When I came in 1981, Dr. Feun gave me a lab at the medical school. So I actually o --- established my laboratory at the medical school when I first came. You know, while, you know, --- while my primary --- my primary work is done here, you know, all my clinical work was done at Anderson but my laboratory work was at --- at the medical school. Actually, so I get to know the faculty at the medical school very well because I --- I hang out there for research. My laboratory actually moved back to Anderson in 198 --- ’83 when I moved the laboratory back in the --- when --- there was space opened up for me.

Chapter 03: Developing a Brain Tumor Clinic at MD Anderson

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