Careers After Neurosurgery: Dr. Kassell Leads a Foundation to Advance Focused Ultrasound

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After departing as co-chair of the Department of Neurosurgery at the University of Virginia (UVA), Neal F. Kassell, MD, FAANS(L), founder and chairman of the Focused Ultrasound Foundation, has now made it his life’s work to accelerate the adoption of focused ultrasound, a noninvasive, game-changing, highly-disruptive therapeutic technology that has the potential to treat hundreds of medical disorders and save millions of lives.

This chapter began much later in his career, and rather unexpectedly. After receiving his medical degree from the University of Pennsylvania in 1972 and completing his residency in 1977 with Charles Drake, MD, in London, Ontario, Canada, he joined the faculty at the University of Iowa. This was followed by a move to the University of Virginia in 1984 where he co-chaired the Department of Neurosurgery with John Jane Sr., MD, FAANS(L), until 2016.

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During his career as a neurosurgeon, Dr. Kassell published hundreds of scientific papers and book chapters and received numerous grants supporting his research. In April 2016, Kassell was also named to the Blue Ribbon Panel of then-vice president Joe Biden’s Cancer Moonshot Initiative – a relationship that began when he was involved in treating Biden’s life-threatening brain aneurysms when he was a senator in 1988.

Dr. Neal Kassell

Around 2002, Dr. Kassell was searching for a noninvasive or minimally invasive approach to treat a large number of his patients who had tumors in surgically-inaccessible locations, or had failed prior surgery, radiation therapy and chemotherapy. He was casting about for a solution and could not find one. A seminal event occurred  in 2004 when Dr. Kassell was operating on a patient with a ruptured aneurysm; his neuro-anesthesiologist, Marcel Durieux, MD, was using an innovative method for measuring blood flow in the heart via bursting microbubbles with ultrasound and measuring the clearance to determine blood flow. Dr. Durieux suggested that Dr. Kassell should try using this in the brain; they conducted laboratory experiments, and the concept worked.

“Then, one day, I was driving home from the hospital – I remember the exact location and time – it was 4:30 in the afternoon,” says Dr. Kassell. “And the light bulb went off in my head. ‘Why couldn’t this same technology be used to somehow treat brain tumors?’ I thought after all my years of research, maybe I finally had a Nobel Prize-winning idea.”

Energized about what he thought was a novel concept, he began researching it. “I went on the internet and found that focused ultrasound treatments were a Nobel-Prize winning idea – they just weren’t mine.”

Dr. Kassell recognized the enormous potential of using focused ultrasound to treat a wide variety of life-threatening or disabling medical disorders, not just in the brain. However, having been deeply involved with the early research, adoption and later commercialization of Gamma Knife, he understood that the evolution of a highly-disruptive, therapeutic technology from laboratory research to widespread utilization as a global standard of care was a monumental process that often took decades.

As an answer to this challenge, he created the Focused Ultrasound Foundation – a unique medical research, education and advocacy organization – in October 2006 as a catalyst to shorten this timeline and speed the process of developing the global use of focused ultrasound treatment as a standard of care. “The idea is that saving time equals saving lives,” says Dr. Kassell. “Every month that we can shave off the process will result in a decrease in unnecessary death, disability and suffering for countless people.”

The foundation examines the critical path from laboratory research to widespread utilization on a frequent basis and identifies bottlenecks, then applies resources to overcome those barriers. The foundation has multiple programs to increase awareness, education and advocacy.

In the first years of the Foundation’s existence, Dr. Kassell continued to practice, but it became apparent that focused ultrasound had so much potential and would be an all-consuming effort. “I loved my job as a neurosurgeon – it is the best job in the world – but there was a moral imperative to dedicate my efforts 100% to focused ultrasound,” he says. “This was an extremely difficult decision. I still literally have dreams about operating once or twice a week. However, in my clinical practice, I would affect several hundred lives per year, and the research I’ve been doing since 1962 affected thousands of patients per year… but focused ultrasound truly has the potential to impact millions of people.”

And so, Dr. Kassell gave up neurosurgery in 2016 to devote his full time to the foundation. “When I started the foundation, I didn’t appreciate how hard this was going to be,” he says. “It turns out to be much harder than neurosurgery because it is information-based, global and rapidly growing, and there is no limit to the amount of effort that can be put into this; 24/7 is not enough.”

Since 2006, the progress and achievements of the foundation have been very successful, and as a result, the field has grown more rapidly than anyone ever imagined. “In the last decade, the number of mechanisms that we understand of how focused ultrasound can treat tissue has grown from three to more than 25. As a result, the number of clinical indications in various stages of research and development and commercialization in the last decade has grown from three to more than 160,”he states.

Dr. Kassell believes that focused ultrasound will be as revolutionary to therapy as MR scanning was to diagnosis, by serving as an alternative or complement to traditional surgery and radiation therapy; providing a new way of delivering drugs more safely and effectively and enhancing cancer immunotherapy . It could result in a new multi-billion-dollar noninvasive therapy industry, just like MR created a new multi-billion-dollar imaging industry.

Although the accomplishments of the Focused Ultrasound Foundation have been significant over the past 16 years, Dr. Kassell reminds us that there is still much work to be done, and he remains steadfastly committed to his post-neurosurgery career and the mission of the foundation he created – helping millions with focused ultrasound.

 

 

 

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