Jacob Young, MD, Builds on Glioma Expertise at UCSF Brain Tumor Center

Jacob Young, MD, earned his medical degree from the University of Chicago, where he became interested in translational neuro-oncology working in the lab of Matt Lesniak, MD. He completed neurosurgical residency at UCSF, where he built on his interest in brain tumors and was trained in brain mapping techniques and tumor resection in eloquent cortex by Mitchel Berger, MD, and Shawn Hervey-Jumper, MD.  

A Map for Success

In residency, I participated in nearly 100 awake craniotomies and saw the benefit of maximal resections and pushing the limits, but also never compromising safety and patients’ function. That’s really the model that I inspire to in my own practice, where every patient is treated like family, and we are constantly striving to be aggressive but appropriate in the care that we deliver. 

Training at UCSF, I gained tremendous experience in unique mapping cases such as bilingual cases that require mapping in English and a second language, as well as mapping for patients with singular needs such as patients who are pregnant or who are deaf. These experiences prepared me to integrate advanced cognitive tests, language tests, and motor tests, tailoring what is most critical for each individual patient.

Impact Outside the Operating Room

My care philosophy as a surgeon is compassionate, excellent care must begin before and extend long after leaving the confines of the operating room. Patients often arrive with a limited understanding of their condition and what might happen, and they are understandably frightened. There can be palpable anxiety when I walk in the room, but after an hour of me introducing myself, getting to know them, going through the scans, examining them, answering their questions, I can appreciate this change that's taken place well before providing safe, technically sound surgical care.

Developing a strong relationship with the patient and their family, affirming your commitment to them as a provider, is critical before you can even think about the impact that you get to make in the operating room. Neurosurgical care really spans everywhere that healthcare may need to be delivered – a clinic, an intensive care unit, an emergency room, and, of course, an operating room. So even though my practice is very focused in the type of patients and specific pathologies I see, I enjoy the significant diversity in the care we provide.

Favorite Procedure

Insular glioma resections, particularly in the dominant hemisphere, are a standout because they're so challenging, and it’s very rewarding when you can tackle a tumor that's located in this complex and deep region of the brain while retaining a patient’s quality of life.

Community-based Care

I believe my patients are best served when they have more opportunities to connect with their entire healthcare team, and that doesn’t usually happen in a silo at our institution. I value having bi-directional communication with both primary providers and specialists in the surrounding community because we are all working together to get patients the care that they need. Sometimes that requires coming to an institution like UCSF, but often care can be managed more locally, whether it's adjuvant treatments, imaging follow-up, or medical management with local primary care physicians.

Overcoming the Hostile Tumor Environment to Identify Better Treatments

My laboratory focuses on the glioblastoma microenvironment and how it responds to either targeted therapies or immunotherapies. Interestingly, the majority of cells within a brain tumor are not the cancer cells themselves but immune cells recruited by the tumor, and these cells create this really hostile environment for any therapy to work in. I'm interested in how we can better understand how the immune environment evolves as we treat patients so we can ultimately overcome resistance or understand biomarkers of treatment response.

The Next Big Thing

I think major advancements over the next decade in neurosurgical oncology will involve using the operating room as an opportunity to not only remove the tumor, but also deliver a therapeutic agent or augment the delivery of a drug. For example, using focused ultrasound to disrupt the blood-brain barrier is exciting technology to increase the amount of drug that can reach the tumor – but of course better treatment agents are needed too!