Thomas Nelson Joins the Neuro-Oncology Team at the UCSF Brain Tumor Center

Thomas Nelson, MD, earned his medical degree from the University of Kansas Medical Center and completed his residency in neurology at Cedars-Sinai Medical Center in Los Angeles, CA. He then pursued a neuro-oncology fellowship at the combined Dana-Farber Cancer Institute/Mass General Brigham Program in Boston, MA, where a K12 Career Development Award supported his research in cancer neuroscience. He is a member of the Institute for Electrical and Electronics Engineers, participating in two working groups that are developing international standards for machine learning enabled medical devices and cancer data repositories.

Choosing Neuro-Oncology

My undergraduate training is actually in electrical engineering, so I was a software engineer in New York City for a while after I graduated. I always enjoyed problem solving – the complex mathematics and the applications of physics and chemistry. But I really wanted to have an opportunity to have a more direct, positive impact on people’s lives, so I went back where I’m from in the Midwest for medical school. There, I found a passion for neurology and oncology. In neurology, I felt like I could bring a problem-solving approach to the concerns that patients were expressing. And in oncology, I felt that sharing these really difficult moments in people’s lives with them was an incredibly unique experience.

The Promise in Cancer Neuroscience 

First and foremost, I'm a clinician, and my goal is to make every patient I meet feel better and do better for as long as we can.

The recent development of some of these specifically targeted IDH inhibitors will really revolutionize how we treat patients with IDH-mutant gliomas. But for some of the more aggressive and more common brain tumors, unfortunately the outcomes remain pretty poor. 

Cancer neuroscience uses fundamental neuroscience techniques to address questions in oncology. We see that gliomas cause changes to the surrounding tissue that drive the growth of the tumor, so neuromodulation techniques in combination with other therapies could potentially quiet the neural activity that’s feeding into the tumor to slow, or perhaps even stop, the progression. 

Existing medications and treatments like responsive nerve stimulation, deep brain stimulation and vagal nerve stimulation are already used to manage epilepsy. But folks with brain tumors have not often been considered for some of these treatments. The fact that we consider these exclusive patient populations is something that I want to change. My hope is that we can capitalize on existing as well as novel treatments to control more aspects of tumor biology.

Frontiers in Artificial Intelligence in Neuro-Oncology

Something I like to emphasize when I talk to people is that these types of machine learning algorithms have existed for a long time. I do think that what we’re seeing right now is the boom of AI, but we will probably come to use these tools in every component of clinical practice.

During my research fellowship, I became interested in using AI to evaluate tumor progression and response to therapy from imaging. It’s a whole field in and of itself but gaining as much information as possible from MRI scans is a very valuable area of research for neuro-oncologists using these images every day. 

Standardizing that clinical decision-making with AI algorithms may also be a smart application. There will always be a role for physician oversight though. And if all you're providing to the algorithm or the model is objective information about the patient, then you're missing how have they been doing and how they been feeling in ways that aren't easily captured by information in the medical record.

The Best Part of Being at UCSF

When I was looking at positions as I was transitioning out of my fellowship, I was looking for a nucleus of really smart people and a center that had an infrastructure conducive to my interests in tech and medicine. The UCSF Brain Tumor Center supports and encourages researchers and clinicians working closely together to advance patient care, and the people here are also very kind.

This is also such a culturally vibrant area with amazing nature around the campus. I do urban hikes around the city, and as a hiker, it’s so incredible to have nine national parks within the state.