From Waffle House to Winship  

Just before Christmas 2025, Joe Bowers was waiting in the vestibule of a Waffle House near his Gainesville home to be seated with his family when, suddenly, he fainted.

“My left arm just started shaking back and forth,” says Bowers, 25. “I realized something was wrong, and I called out for my dad, who was right there. I later learned they thought I was pulling a prank on them. Then the world slowly went black.”

Bowers was transported to a local emergency room, where, based on brain imaging, he was initially diagnosed with multiple sclerosis (MS). But then an MS specialist examined the pattern of masses in his brain. As Bowers remembers it, he was told: “Nah, it’s probably cancer. You should go to Emory.” 

When Bowers got to Winship Cancer Institute of Emory University, his neurosurgeon, Edjah K. Nduom, used the same set of imaging to diagnose Bowers with grade 4 IDH-mutant astrocytoma. This type of astrocytoma is an aggressive, fast-growing brain cancer that begins in astrocytes — the cells that help support and structure the central nervous system. Instead of forming one clearly defined tumor, it spreads into surrounding brain tissue, creating multiple poorly defined tumor areas rather than a single, distinct mass.

Nduom is “very smart and very experienced,” Bowers says. Nduom, who is also the director of the Winship Brain Tumor Center and a professor in the Department of Neurosurgery at Emory University School of Medicine, performed a craniotomy, a common brain cancer surgery that involves making a small hole in the skull to remove tissue to confirm the diagnosis. 

After waiting a month to heal, Bowers returned to Winship to meet with all the doctors who would be part of his treatment team going forward — in one convenient appointment. In addition to Nduom, he saw a neuro-oncologist and a radiation oncologist focused on brain tumors, one after another. Neuroradiologists, pathologists and clinical trial coordinators were also available for consultation.

Bowers’ need for specialized diagnostic and medical care arose the same month that Winship opened the Winship Brain Tumor Center (BTC), its new multidisciplinary clinic for the treatment of brain tumors. The center was born out of a concerted effort to bolster Winship’s brain tumor offerings across the board — from diagnosis to treatment to research.

The clinic, located on the plaza level in Winship’s Building C on Emory University Hospital’s Clifton campus, was launched in December 2025. It’s a space where patients with brain tumors can meet with their entire treatment team — whose members are actively consulting one another on the case before and during the appointment. 

“It has transformed care for our patients,” Nduom says. “Patients love it. Providers love it. I leave energized from BTC more than I do on any other normal clinical day.”  

The time in clinic allows for efficient, collaborative care, a distinct departure from the medical norm, in which there is a lag between every related appointment as patients navigate different provider schedules and providers set aside time in their own calendars to study imaging and schedule consults.

In addition to optimizing efficiency, the Winship BTC elevated its diagnostic capabilities when Emory recently became the only institution in the region to offer DNA methylation testing, a diagnostic method that can pinpoint brain tumor characteristics more precisely than standard pathology.

“What I called a glioblastoma in 2016 was probably six to eight distinct diseases that we all treated the same,” Nduom says. With the methylation profiling technology in-house, he says they have actionable diagnostic information within two weeks — rather than the six- to eight-week wait when samples are sent to an outside lab.

Brain tumors are complex diseases with many permutations. When time is of the essence, cutting down on care team appointments and diagnosis time doesn’t just save time — it can save lives.

“Patients living with brain tumors require a lot of care from multiple different specialists,” says Laura Donovan, co-director of Winship’s Neuro-Oncology Program and medical director of the Winship Brain Tumor Center. “It’s such a great opportunity to see patients and then have a meeting in real time with all the subspecialists involved in their care to come up with a multidisciplinary plan.”

Nduom recently recruited Donovan from Columbia University to build up the clinical side of the Winship BTC. She spoke about plans to extend the center’s reach through more patient offerings — like palliative care and rehabilitation services — as well as to serve patients with brain metastases and a tumor-causing genetic condition, neurofibromatosis, rather than solely treating primary brain tumors.

Donovan — along with recently hired neuro-oncologist Byram Ozer, co-director of the Neuro-Oncology Program and director of Translational Research in Neuro-Oncology at Winship — also plans ultimately to leverage the BTC Center’s increased presence and infrastructure to help keep patients in-house as they transition from pediatric to adult brain cancer care. Previously, patients who have had pediatric brain tumors that require ongoing care beyond childhood were referred out to other practices in the community, since their cancers are considered distinct from adult-onset diagnoses.

“What I look forward to is a situation where Dr. Ozer and I will work together to see patients across the lifespan,” says pediatric neurologist Timothy R. Gershon, a member of Winship’s Cell and Molecular Biology Research Program, director of the Children's Center for Neurosciences Research and a professor in the Department of Pediatrics at Emory University School of Medicine. “We need to focus on transitioning patients’ care from childhood through adulthood. ”

Continuity of care for former pediatric patients is just one of a variety of  treatment innovations the brain tumor team is working toward incorporating into their standard care practices.

Through the Emory Proton Therapy Center, Winship is the only cancer center in Georgia with access to this form of radiation treatment that allows for more precisely targeted dosing. This is helpful in treating many different cancers, but it’s especially important for mitigating side effects when dealing with the brain and central nervous system, where an off-target hit of radiation could cause major side effects.

Winship is also the only cancer center in the state to offer laser interstitial thermal therapy, thanks to the expertise of Kimberly Hoang, assistant professor in the Department of Neurosurgery at Emory University School of Medicine. She uses an MRI-guided laser to avoid more invasive surgeries when tissue in question is nestled in complicated locations. “It’s a minimally invasive procedure to burn away the bad tissue, a much smaller treatment area than other brain surgeries that we do,” Hoang says.

Of course, Winship’s neurosurgeons continue to perform standard operating room surgeries. But even then, the subsequent tissue samples in some cases help further research in addition to offering pathology results for individual patients. It’s difficult to draw a hard line between treatment and research, another integral part of the brain tumor team’s focus.

“It’s kind of like this feed-forward mechanism where everything is just going to get better,” says radiation oncologist Lisa Sudmeier, assistant professor in the Department of Radiation Oncology at the Emory University School of Medicine who participates as a clinician in the BTC and runs a research lab looking at harnessing the immune system to treat brain cancer. “The patient care is going to help the research become stronger, and the research is going to help us learn more and develop better care for the patients.”

Neurobiologist and research pharmacologist Renee Read, for example, partners with neurosurgeons to enroll brain tumor patients in studies where they receive promising new drugs before surgery, then analyzes removed tumor tissues to gauge how well these treatments may work. 

“The surgeons hand the tissue to us, and we’re able to ask: Does the drug even reach the brain? Does it reach the tumor?” says Read, co-leader of Winship’s Cell and Molecular Biology Research Program and an associate professor in the Department of Pharmacology and Chemical Biology at Emory University School of Medicine.

Read and Nduom are currently collaborating on some of this research. A past collaboration identified a potential drug, originally approved to treat rogue blood vessels, that could be repurposed as a new treatment for glioblastomas, aggressive brain cancers diagnosed in both adults and children, with a median survival of just 12–18 months.

“Connecting amazingly cool basic science questions about how the nervous system works along with the unmet needs of patients and families is exciting from a research standpoint and motivating from a more human standpoint,” Read says.

Read is also collaborating with Gershon on finding strategies to improve immune responses to T-cell therapy in children with malignant brain tumors. They are looking at responses in both mouse models and organoid models, 3D systems where scientists try to replicate human biological tissues as closely as possible.

“By coming at it from two perspectives at the same time you get a better view of the real situation,” Gershon says. “The reality of cancer research,” he adds, “particularly if you’re trying to do something translational, is that cancer is really hard to cure. If it were easy, it would’ve been fixed by now.”

Tobey MacDonald, director of the Pediatric Neuro-Oncology Program in the Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta and professor of pediatrics at Emory University School of Medicine, is a pediatric hematologist-oncologist and a member of the Cell and Molecular Biology Research Program at Winship. He also uses patient samples — with parent consent — in his work with Georgia Tech nanoengineer A. Fatih Sarioglu. Together they have developed a one-of-a-kind blood test that can pull out exceedingly rare cancer cells in the blood to track brain tumor growth over time and tell whether they are responding to treatment. They are currently focusing on medulloblastoma, a pediatric malignant brain tumor that develops in the cerebellum, the brain’s motor control center. He describes the test, using a 3D-printed nanoscale chip, as a filter that works akin to panning for gold.

“My hope is this really translates into a clinical benefit for our patients,” says MacDonald, who was inspired to enter medicine after growing up with two older sisters struggling to live with Type 1 diabetes. “This is the most excited I've been in my career that we might be able to really make a difference.”

In addition to innovative research, Winship BTC faculty  are focused on increasing patient access to clinical trials.

“We’re really looking to grow our trial portfolio,” Donovan says. Around the same time Nduom hired her to build out the MDC’s clinical offerings, he also recruited fellow neuro-oncologist Ozer from the National Cancer Institute to bolster the department’s research offerings. 

In less than a year, Ozer has helped shepherd a local site for at least three national studies as well as multiple Winship-generated ones, exploring  everything from implanting radiation devices during initial neurosurgery to cutting-edge immunotherapy techniques.

“I keep thinking, ‘I’m in the honeymoon period — it’s going to end,’ but so far it still feels honeymoonish,” Ozer says. “It’s been really fun and exciting and stimulating work.”

Many of the clinical trials are led by laser interstitial thermal therapy expert Hoang.

“Clinical trials generally give you access to things that you would not normally have access to in standard-of-care therapy. You’re on the cutting edge,” she explains to patients potentially interested in participating in a trial arm. Additionally, “people who are in clinical trials are followed, for better or worse, more closely than those who are not in clinical trials,” she notes. “Most people would appreciate that their physicians and the clinical trial staff are watching so closely.”

Hoang is especially interested in device-based therapeutics but, as a principal investigator, she works
on everything from decreasing steroid-induced psychosis in patients with brain cancer to technological advances in finding tumor margin lines.

“We know not all brain tumors are a terrible diagnosis, but a lot of them still have a not-great prognosis,” Hoang says. “I think that challenge — to be able to take something from the bench to the bedside — is actually quite complicated in the United States.” She adds, “It keeps my job as a surgeon interesting.”

In the midst of all the growth of Winship’s brain tumor team, Joe Bowers’ treatment plan is on track. He temporarily moved to Atlanta to begin proton therapy in March, which he is doing in conjunction with a year-long oral chemotherapy regimen, a standard-of-care treatment he selected from options the brain tumor team presented to him.

“When you have something as big as cancer, you need to hit it as hard as you can as fast as you can,” he says.

After a recovery period post-craniotomy that included relearning how to move his left arm, Bowers is “more or less back to normal.” He was focused, prior to starting his course of radiation, on planting blueberry and raspberry bushes in his yard so his toddler son can harvest them in summers yet to come.

He is also focusing on his faith, his young family and the moments of levity available — which brings him back to the place his saga started.

“Waffle House was the most iconic place for that to happen,” Bowers says of his initial cancer symptoms appearing at the quintessential Atlanta-based diner chain. “You always hear about crazy stories happening in a Waffle House, and it’s referenced in all my medical notes, which I just find hilarious.”

Kira Goldenberg is a writer and psychotherapist in San Francisco.

Designed by Linda Dobson
Illustration by Rocco Baviera
Photography by Jenni Girtman
Videography by Jim Gagne