If your child has had a new diagnosis and a brain tumor, the immediate reaction is shock and disbelief and fear. So I do think asking questions is very important. When evaluating a surgeon or a center for treatment for specific brain tumors, really, it's understanding what the surgeon and what the center feels comfortable managing. Here at the Mayo Clinic, we felt comfortable managing anything complex to anything simple for brain tumors. And I think that there are certain brain tumors, however, that would probably only be treated at very high level tertiary centers that see type of rare brain tumors enough. So the most important thing is establishing what that tumor is. A diagnosis for a brain tumor is very, very important. That starts at the time of the MRI and getting good MRI and imaging of the tumor, as well as any area that's at risk. If families are told their child has an inoperable brain tumor, I think really getting a second opinion at another institution makes sense. And I'm happy when we see them here upfront to recommend other institutions as well. A lot of times I would also offer the family just the consult with colleagues across the country just electronically, just to see what were their thoughts too. The types of questions that families and guardian should be asking the doctors are, what needs to be done? How dangerous is it? What are the risks of the therapies that they're talking about? Is this what is required? What else is being done? It's important to try and think of all of the different things. If it's surgery or chemotherapy or radiotherapy, there are different approaches. It's always hard to know exactly how to evaluate your local treatment center. But because we know that the volume of of experience of practice does impact outcomes, I do think you should ask the hard questions. You know, how many of these have you treated, how many similar patients are treated? How often do you do this treatment? That does give you an indication of how familiar and comfortable they may be with the types of treatment they're recommending. Making decision to stay close to home travel for decisions care is very individualized. Every family's going to have to make these tough decisions themselves. If you at least make a decision to have a second opinion with the other centers and other professionals that you've talked to. Oftentimes you can come to a decision based on the pros and cons of what's important to be done close to home, What's important to be done elsewhere? To figure out how much can be done close to home, where maybe it's more convenient and how much maybe should be done at a specialized center. I think it's really important for patients to try to seek to a center where they have a collaborative group of doctors that are really are looking for their best interests of the patient. That's part of the reason why we get a lot of patients coming to Mayo Clinic. They really want to get that comprehensive answer in terms of what is the best treatment for them. And that's what we tried to provide in a very efficient manner. We work very closely with our colleagues. We try to get patients in very quickly in order to be able to provide them the answers that they're really looking for because it's a very anxious and very difficult time for them. Having a pathologist who is used to seeing brain tumors, used to seeing pediatric brain tumors, knowing that the molecular diagnosis is very important these days. And doing it efficiently so that we can work with that diagnosis is extremely important. Once we've established the pathologic diagnosis and understand where that tumor is, then having a comprehensive evaluation with the full team is extremely important. So the tissue diagnosis and understanding what the surgeon saw and what has been removed, very foundational pieces of information. As a radiation oncologist, I think that the questions that parents, just their doctors, if their child is being considered for radiation is, is proton therapy at indication for this type of tumor. What we've learned now is that the pediatric brain is the most sensitive to the effects of radiation. And so for the vast majority of pediatric brain tumors, we do recommend proton radiotherapy if possible. It is a way that we can treat these tumor safely, have the highest cure rates and the least amount of complications, especially in the developing brain. That's very important to try to minimize the effects of radiation on thinking and memory and concentration. At Mayo Clinic, we really have all of the options available to us. If proton therapy is the best option, that is what we will do. If radiosurgery for that child, though it's less commonly used, we have that available. And ultimately the decision we have made at Mayo Clinic in general is that the patients' needs come first and other things are left aside. And there's certain decisions we've made fundamentally that allow us to do that.