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Nurse practitioner cares for brain tumor patients

It wasn’t always easy for Kathleen Mogensen to pursue a degree as a nurse practitioner 30 years ago while working as a nurse. Some of her fellow nurses were frustrated that she got to work split shifts while attending the then-fledgling NP program at the University at Buffalo, and many doctors weren’t enamored with the idea of a “midlevel” health professional who could do much of what they could.

It hasn’t always been easy during the last 20 years working at Roswell Park Cancer Institute as a neuro-oncology nurse practitioner, either.

“There can be somebody sitting next to me today with a full life, three kids, working at a high-level job who walks out to their car and has a seizure,” she said. “Tomorrow, they’re in the operating room. The day after, they’re told, ‘You’ve got less than two years to live.’ ”

Mogensen, 56, a North Tonawanda native who lives in the Town of Tonawanda, helps people with brain tumors in one of the smaller departments at Roswell. She can take extensive patient health histories, design treatment plans and write prescriptions. She focuses on quality of life and symptom management.

She worked in recent years to get medical care for a mom who wanted to go on a cruise with her three adult daughters. She helped treat a young man who spent a college semester in Singapore. And she has held the hands of patients as they have died within the walls of Roswell.

“Skiing is my outlet, my balance,” Mogensen said. She and her husband, Mike, are downhill instructors at Kissing Bridge.

Despite the challenges, Mogensen is grateful for the good doctors and thoughtful health leaders who helped pave her way as one of the region’s first nurse practitioners. And she still marvels at the nurturing, determined world she walks into four days a week at the region’s comprehensive cancer center.

She and Dr. Laszlo Mechtler, chief of neuro-oncology at Roswell, have a similar approach to their patients.

“Whatever it takes,” she said.

Q. You’ve worn many hats as a nurse practitioner. Can you talk about your jobs?

I did five years in internal medicine but I missed the hospital. Then I went to the VA oncology program. That’s been my love from the very beginning. It just pulls me in. I think I can make a difference with oncology patients. I like the continuing research in this continually evolving field. I did five years at the VA and through word of mouth was recruited by Dr. Mechtler. He was setting up the neuro-oncology program here at Roswell. He’s also vice president of the DENT Neurologic Institute. The neuro-oncology program is a combined entity between DENT and Roswell, so I’ve worked in both places for 20 years with him as my attending physician. As of February 2014, I’m just here. It was too tough to go back and forth.

What are some of the more common conditions of the patients you treat?

We see tumors that start in the brain and stay in the brain. That is our major focus. It’s very much multidisciplinary here at Roswell. We work closely with neurosurgery and radiation. Each of those departments has an attending physician and midlevel (nurse practitioner). Glioblastoma is the most common brain tumor. It’s probably 50 percent of what we see. It’s very aggressive. We also see other tumors that are much less aggressive, that are more treatable. We do see long-term survivors. One of the things I presented during a national physicians meeting was a vignette of three of our patients who were treated for a brain tumor and went on to have children after undergoing chemo. We’re telling patients we’re going to throw everything at their cancer that we can. At the same time, we’re telling them, “You’re getting six weeks of chemo and radiation, then four weeks of no treatment. You should plan a vacation then.” We tell them that the first day we meet them.

Q. Over 20 years, what are some of the advances you’ve seen in the treatment of brain cancers?

In 1995, Temodar was approved for use for newly diagnosed brain tumors and it was a game changer. It improved life expectancy a bit but it’s an oral chemotherapy drug that’s incredibly well tolerated. People can take that chemo and teach kindergarten. Take that chemo and work for a bank. Take that chemo and work as a sheriff. It improves quality of life. Things aren’t moving as fast as we would like, but there are some new improvements. Vaccines have the potential to be a big breakthrough. One of the breakthroughs was the human genome project and the ability to do brain sequencing. Now we know what specific pathways are leading to tumor growth. That’s step one. Step two is designing something to interrupt those pathways. (Roswell Neurosurgery Director) Dr. Robert Fenstermaker’s vaccine is specifically designed to interrupt one of those pathways and keep the tumor from growing.

email: refresh@buffnews.com

On the Web: Learn more about a Roswell clinical trial for a brain tumor treatment vaccine and the Roswell neuro-oncology unit at refresh.buffalonews.com.