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May 13th, 2011
02:00 PM ET
Gupta: Waiting out a meningiomaAll the news about one of my favorite actresses, Mary Tyler Moore, reminded me of the first time I saw a patient with a meningioma. It was 1995. I was a junior neurosurgery resident, and my professor introduced me to a 69-year-old, perfectly healthy appearing woman. That surprised me at the time, because moments earlier, I had been reviewing her MRI scan. She had an obvious bright mass in her brain located in the right frontal lobe. I carefully examined the movements of her eyes and face. I checked her motor strength and sensation in her four extremities and completed a full neurological exam. Her long-term memory and instant recall were intact, and she did not complain of headaches. “I wouldn’t even know it is up there,” she said, referring to her brain tumor. This pleasant woman had been showing up at the clinic for several years, with a scan in hand to review with my professor. If the mass looked no different, and more importantly, if the patient didn’t have any neurological changes – they would simply make a date to see each other again in another year, and repeat the process. They had collectively agreed to not operate on the obvious brain tumor, but instead to watch, wait, and bank on the possibility she would never need an operation in her lifetime.
Two years later, we did operate on the then-71-year-old woman. Her most recent scan had shown a sudden growth in the size of the mass. Worried that it might continue growing at an accelerating rate, my professor and the patient collectively agreed an operation was the best course of action. There are other things that may have tipped the scale toward an operation. If the mass had changed in its appearance, and looked more malignant. And, of course, if our patient had started to have any symptoms such as blurriness of vision, seizures, headaches or weakness, to name a few. These are the types of conversations and considerations Mary Tyler Moore has likely been having with her doctors over the past few years, now deciding an operation was prudent for possibly one of these reasons. By the time you read this, Ms. Moore may have already had the brain surgery necessary to remove the tumor, and may even be scheduled for radiation treatment, which is sometimes necessary if all the tumor cannot be removed. Here is wishing her a speedy recovery. soundoff (1,497 Responses)1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Next »Leave a Reply to JebgEncox
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.
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That may sound surprising, given we are talking about brain tumors. Truth is, while there are many types of brain tumors that do require urgent operations, meningiomas are often treated differently. They have such a characteristic appearance on an MRI scan, there is often little doubt when you see one. And, about nine out of 10 times, they are benign. If the tumor is relatively small, the patient is not very young, and there are no symptoms – the neurosurgeon is likely to offer the “watchful waiting” as an option.
Mary is a truly great actress. Best wishes for a speedy and hopefully uneventful recovery.
If she would like to talk to someone who has undergone brain surgery, she can email me.
Great article Dr. Gupta. I hope Mary sails through this operation with flying colors and is on the mend soon.
Good luck, God Bless Mary.
Sounds like god already blessed her... with a brain tumor
Mine was discovered last May....surgery in June...radiation in Sept... another surgery to repair damage to my vocal cords in Mar .....just found out on 5/4 ( a month before my 40th b-day)that I am tumor free..... what a crazy year.... I take solice in the fact, like many others I am sure, that it is not cancer!!! I hope she gets the same type of amazing care that I recieved at UC San Diego!!!
My sister had exactly this type of tumor two years ago and it looked much scarier on the MRI than it actually was. She had surgery as the tumor was causing seizures and is now doing great with no ongoing concerns. Prayers to Mary so she may have the same good outcome.
30 years ago, my 59 year-old mother was diangnozed with a meningioma. The outcome, however, was far different. After years of being diagnosed with everything from early onset dementia to "catatonic" depression, my mother was finally discovered on the floor, looking up at us helplessly, and not knowing who we were or where she was. This time, I demanded that she be checked for something physiologically wrong. My sisters and I were shocked to find out that this benign tumor had been growing within her for years. The surgery was successful, but she needed extensive rehab, during which she developed REAL catatonic depression from which she never recovered. She told us she was going to will herself to die....which she did a few days later.
I am truly glad that medicine has come quite a long way since then. But I do sometimes wonder what our lives would have been like had someone thought to administer a CT scan a lot sooner.
I am so sorry for the suffering your family went through.
I'm so sorry your Mom and family had to suffer like that! So much progress has been made in the last 30 years. Thank you for sharing your Mom's story and all the best to you.
Sending Mary love & laughter. She has always been a favorite of mine as well.
Dr. Gupta, to balance the coverage of meningioma, would you consider at some point sharing experience you may have with the less cheerful sort of meningioma? My routine, uncomplicated resection left me with monocular vision, epilepsy, a mild memory disorder & lasting fatigue.
I know many others who have had mengiomas, that while thankfully not cancerous, have certainly been destructive. One young woman I know just had her third surgery in less than a year, is currently undergoing radiation, and has additional related surgery shortly planned soon after, all due to a benign meningioma. It gives the average reader a skewed perception to hear repeatedly that meningiomas are common and usually benign, and that most patients are "back to normal" in a few weeks.
I'm also left wondering how any surgery performed on a 74 year old, who has been Type 1 diabetic for 40 years is considered "routine"?
I totally agree Karrie. I too have had 3 supposedly benign meningioma's that had to be operated on within a less than a year and a half. I am working on my 4th one now, and the 3rd pathology came back as malignant so it is no longer considered benign as 5% was considered extremely aggressive tumor. They take a lot out of you.
Just wanted to clarify that my remark about meningioma being "routine", is not directed at this article. I've read today that Moore's surgery is "routine", "elective", that meningioma "are not really a brain tumor" and that "patients resume normal activity I'm a few weeks."
That sort of coverage creates a difficult challenge for those of us who while thrilled not to have received a malignant path report, still have lasting deficits and need family, friends and employers to
understand that there is a wide variety of outcomes.
Was my procedure "routine" for my talented skull base & vascular surgeon? Certainly, and I'm forever grateful it was just another day in the office for him & his team. He rocks! But that said? I wish my happy little meningioma had not taken my right optic nerve hostage. I wish I didn't need Keppra or follow up dates with the MRI tube or neuro opth exams. I REALLY wish the sensation oft forehead being pulled due to the pericranial flap would hurry up and abate. Ditto tinnitus, dizziness, wondering if it's "just a headache" and having the same bedtime as my first grader. 🙂
I might have to have surgery on my M by my right eye/optic nerve. Have been able to avoid it for 5 years now. Did you feel your surgery was needed?
I completely agree Karrie. This should be explained better and for the public to be educated. Almost makes it sound like a mole being removed! No doubt these tumors are on the rise and very dangerous and destructive affecting eloquent structures of the brain. We need high profile people who have been affected like MTM and Elizabeth Taylor to speak out and advocate.
Best wishes and a speedy recovery for Ms. Mary Tyler Moore ! ! ! I too have a Meningioma.
I would also like to thank Dr. Gupta for his very informative report on Meningiomas .
Brain surgery is a very big deal. It's cutting open your skull and cutting into your brain, and carries with it all kinds of possible nasty consequences. It depends a lot on where the tumor is. My meningioma surgery in 2005 meant I lost the hearing and balance nerves on the right side to get to the tumor in the middle of my head. My facial nerves were damaged (droopy on the right), I couldn't swallow, I was dizzy and exhausted, and my memory and ability to just THINK were shot to hell for 2 years. Recovery was long, slow and unbearably difficult. Not to mention the fight of my life with the insurance company to cover the cost of my new hearing device. That is WITH good insurance. My poor kids were virtually motherless for months. All this for a "benign" tumor. My prayers are with Mary.
Ms. Moore, I can only say that you have given me some of the best laughs of my life. I will keep you in my thoughts and prayers, and will leave you with this profound thought "A little song, a little dance, a little seltzer down the pants".
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Mary, I will keep you in my thoughts and prayers. You are a wonderful actress and have brought me many laughs for many years. May the Lord guide the doctors as they operate and may you feel God's love surround you as you recuperate. Know you are loved much.
As with any surgery, there are risks, but we are told that Moore is in good condition for the surgery. According to E-News Now, the actress made the decision to remove the benign brain tumor upon the recommendation of her neurologist and a neurosurgeon. http://bit.ly/kOg3RZ
i have the same tumor with occ. headaches. my nuro. dr. keeps track with a mri one every 18 mos. if need be he would use laser surgery to removed it. what kind of surgery was used on mary? was it lased or cutting? which ever, i wish her a speedy recovery.
My beautiful mother in law recently had this with surgery. It is scary & can cause problems that hopefully go away in time. I have had 11 brain surgeries for ACM (brain fell out back of my skull) IIH & Syringomyelia. I know it takes me at least a year to recover but I will always suffer from intense head pain upon excursion, I am disabled. Must rest after any amount of moving around. Brain surgery is traumatic. It took everything in my power not to rip into my sis in law who left her with 2 teenagers & an 8 year old boy for 3 days right after my mother in law was released from the hospital. Her reasoning, it wasn't the same kind of surgery as mine. So I shouldn't worry. I lost a lot of respect for my sister in law.
Has anyone had surgery experience with a skull base meningioma?
Ajay, I have not had surgery yet or talked about it, but my Meningioma is located along the right planum sphenoidale and is growing slowly each year. I have headaches, migraines, numbess, creepy vibrating sensations, double vision up close, in addition to a generalized seizure disorder that I've had for 30 plus years. When I asked one neurologist about the location of my tumor I was told that it was deep in the brain. From my research on-line and from the written materials that I received from the neurologist I learned that it may be a skull base tumor. I hope your surgery goes well and your recovery is full and uneventful. My heart goes out to you, your family and loved ones. I hear and feel your pain.
I have. Whatcha need to know?
Mine was misdiagnosed as an acoustic neuroma. But was a benign meningioma growing on the brain stem.
Interesting that we are left hanging on why the first one he saw was in 1995. We all know what the cause might be, why not say it?
Not sure I follow. He said he saw his first in residency. Unless he did a neurosurg rotation in med school (not a required rotation), a neurosurgery residency certianly would be an appropriate first place.
My husband has colon cancer which is spreading, because his platelets are too low for the standard chemo therapy. It is not always possible to have a standard treatment. For those whose doctors recommend a treatment, try it. And God bless Mary Tyler Moore; she's been fighting for her health all her life.
This is another example that there is truth in the saying that "life's not fair". I don't know Mary Tyler Moore but I do know that she has used her life experiences that pushes for new advancements for those who suffer from Diabetic illnesses. She's one of those people who look to help others who are suffering, it's a trait that is never in abundance.
My right frontal lobe meningioma surgery was 6 years ago. Neurosurgeons call it an elective surgery many times if there are no obvious "neurological" symptoms
i.e. Seizures,etc. My symptoms were all related to emotion...anxiety, memory, executive function problems such as multi-tasking and prioritizing. I knew something was wrong. My meningioma was an incidental finding that showed up on a CT scan performed when a sinus infection wouldn't go away. I was 44, in good health with great insurance that allowed me this "elective" surgery. Six years later I have never regretted the choice and am in the best emotional health of my life. Meningiomas are most common primary vrain tumor. They are about found in women about 11 times more often than men. When doctors tell women "it's all in your head" they may be exactly right. And since these tumors often appear in women at the age of menopause – when emotions tend to fluctuate anyway – we don't pursue all avenues of diagnoses. It is not my intention to be an alarmist but I am so thankful for my ENT doctor's diagnoses. My suicidal emotional state improved dramatically within 6 months of my surgery.
Konnie,
I too have a meningioma and have the same symtoms that you had. We have been monitoring it for 5+ years, but it does seem like the symptoms have become worse over the last couple years, although very little growth.
I am cuious if your memory, executive function, anxiety and emotional state has improved since you have had the surgery and do you still have some problems with any of these.
My mother has survived two brain tumour operations. Recovery is hard work. Mary you have entertained us for years and always were a soft spot in my heart. I wihs you the a fast recovery and the very, very best.
7 years ago my Mom had some blurry vision and at the very end of a doctor's visit decided to casually mention it. Turned out to be a benign meningioma. Symptoms were presenting enough so that a quick surgery date was scheduled and she's all good now.. It was inching its way toward her internal carotid and I'm grateful for her doctors that helped her from finding out about it the hard way. I'm also glad she opted to say something. Ordinarily she'd be stubborn enough to keep trying new pairs of drugstore glasses until the vision problem 'went away.' It was likely developing and grown from the time she was born.
I had this done 3 years ago. It was a huge success. I had 10 weeks to recover before walking my Daughter down the aisle. I am in great shape and still working at 69 yrs old. Best of Luck to you Mary.
Your Fan,
Bob
P.S. in July , I will be welcoming my first Grandchild. It's a Boy!
Thank God we now have a break from hearing about Gabriel Giffords every 5 minutes.
Good luck Mary. God bless you...He can heal anything!
God bless you Mary!
I am 3 months post operative of a parafalcine right pariental meningioma and brain surgery is anything but routine! Just because a brain tumor is not metastatic does not mean it is not terribly destructive. The difference of metastatic vs. benign: metastatic spreads to the rest of your body. A large brain tumor is still a BRAIN TUMOR. Brain tumors can cause loss of hearing, sight, weakness in you legs, memory loss, seizures, etc. It is very devastating: to a patient's family, job, finances and the patient's quality of life. See how fast you would volunteer to gain 25 lbs (due to steroids) and have your driving privileges taken away for a year (due to seizures)!
May God Bless You ALWAYS, Mary Tyler Moore !! I have always been a big fan from the show in the early 1970's. GREAT Memories:
http://www.youtube.com/watch?v=zCL3B5LgUCo
I am 3 months post operative of a parafalcine right pariental meningioma and brain surgery is anything but routine! Just because a brain tumor is not metastatic does not mean it is not terribly destructive. The difference of metastatic vs. benign: metastatic spreads to the rest of your body. A meningioma is still a BRAIN TUMOR. Brain tumors can cause loss of hearing, sight, weakness in you legs, memory loss, seizures, etc. It is very devastating: to a patient's family, job, finances and the patient's quality of life. See how fast you would volunteer to gain 25 lbs (due to steroids) and have your driving privileges taken away for a year (due to seizures), unable to read or organize you thoughts.
correction of previous post (see post op meningioma brain surgery and still having typing problems)
Thank you for your information on Meningioma brain tumors. My prayers and best to Mary Tyler Moore on her surgery and recovery.
I too have have had this surgery. I have had two tumors and 3 surgeries. To read in the press that it is "elective surgery" and spoken about as if this is a non issue is quite disturbing. After my first crainitomy for a removal of a slow growing "benign" tumor, I had a recurrence less than 2 years later. This caused me to have a 2nd crainiotomy. A recurrence makes you now need to be watched more closely because the chance of another recurrence where a new tumor that is malignant is possible. I then needed a third surgery because my body rejected the hardware in my head causing extreme pain that was unbearable. This then also made me need facial reconstruction. Now 3 years later, I have found when looking for a career, (besides existing migraine headaches), when being tested my math skills and spatial skills are gone...concepts I really had not used as I haven not worked in a number of years. Many of us are left with unfortunate deficits. Benign definately does not mean without severe problems. It is my hope that Dr. Gupta and the other docs can look into these tumors more closely to see from those who have experienced and survived the surgery, just what damage these Meningioma tumors can really cause and devote more time to them in their broadcasts.
Yes, Dianne! "elective surgery" is VERY DISTURBING!!! Take a look at this woman and what Blue Cross Blue Sheild considers an "elective option", Lori Paul"s story ====> http://youtu.be/N2VgrqJ_Mag
I am happy that MTM choose elective surgery for her meningioma. Her outcome and recovery will go much smoother for her. What a true blessing that is!
I, on the other hand, had to have emergent surgery for my meningioma. I was only hours away from either dying or going into a coma. My symptoms and complaints were ignored by well meaning and UNINFORMED doctors for years. This thing in my head was 10cm by the time they found it and had invaded healthy brain tissue.
I am grateful for the gifted surgeon and his team that I had for saving my life and my sanity.
Please do not MINIMIZE benign brain tumors. It does service to noone.
Wishing you the best dear Miss Moore.
Would love to have you at H4GM, Kay!!! If you're on Facebook, please join the Hope for Grey Matters page. Thx, kristi
OK what kind of x-ray was that!!!???? Did anyone notice it had no nose and the jaw was horribly deformed? It doesn't look human.
Its an MRI.
I also have had surgery to remove a peach sized meningioma brain tumor from my frontal lobes and I still have a small one on my straight sinus. I consider myself to be blessed that it was benign but there are still very real consequences to having a brain tumor even if it is benign. My meningioma was so large that it was pushing my lobes apart. I have seizures, fatigue, forgetfulness, trouble trying to solve problems, anxiety, nightmares, and other problems. Yes, I am very grateful to be alive and doing as well as I am but my life is forever changed due to a benigh brain tumor. I also know that I could be faced with another surgery someday if my other meningioma grows any.
@ curious george –> Type of imaging is x-ray, I will explain. noses are made of cartilage that is why it they are so soft, the bridge of the nose is hardened cartilage that can break –> cartilage does not show up on plain x-rays. so if you tear cartilage in knee your doc sends you for an mri or ct scan (sorry caps are not working). i hope that helps you.
Fix...the image above is not an X-ray. It's an MRI. The reason there's no nose is because the image is a "slice" taken not down the center (saggital) of the skull, but rather down one side (parasaggital.) You're correct that X-rays don't show soft tissue well (such as cartilage), but they also don't image brain or brain tumors well.
In 2005, one month before high school graduation, I began experiencing severe headaches at night. They became so bad that they induced vomiting. My trip to a local hospital didn't help; they told me I was experiencing migraines.
After they continued, I went to a neurologist. He shared the opinion of migraines, but ordered a scan to be sure. The MRI revealed a meningioma the size of a man's fist. It was located between my skull and my brain's outer membrane. It had been growing 7-10 years, until it finally grew large enough to cause pain.
It was removed at Vanderbilt by Dr. Thompson on June 15, 2005 (Dr. Thompson is one of the best, if not the best, doctors out there). The surgery was successful, and the tumor was benign thank God.
A check-up scan in March 2008 revealed another tumor, although this one was only pea-sized. Dr. Thompson said it was benign as well, and he decided that the "wait and see" approach was the best. As of my last check-up earlier this month, the tumor has not grown, thank God. My prayers are with all other individuals with brain tumors – God bless!
Cody, if you're on Facebook, please join our page. Would love your input! -kristi
Best wishes and a speedy recovery.
I started two years ago having headaches, but usually they would go away. My doctor had me do therapy then the pain injections and when that didn't work she sent me to a neurosurgeon. Well now I'm going to have surgery in early June for mine. Mine is in the back of my skull and close to the spinal cord. Glad Mary Tyler Moore is doing well and has a speedy recovery. Lets keep everyone who has any problems in our prayers.
I hope Dr. Gupta does a follow up to this article on meningiomas, and talks about how seriously meningiomas can affect someone's health. That sometimes they grow abnormally fast, and several studies are underway to examine why the rate of meningiomas are rising in younger persons, especially females. I know, because I'm one of them. Two years after the fact, I still have "rewiring" issues. I'm just grateful I found a neurosurgeon who took my diagnosis seriously and was able to save my vision, not to mention remove the tumor before it engulfed my carotid artery.
Wonderfully put. MagnoliaNC!
MTM lives down the road from me. Very nice lady; hope she beats this.
AN interesting sideline to this story would be the cost of treatment for such a condition ailment , before and after the operation ( as well as the operation itself) and what kind of coverage different insurance companies/plans would offer for it, and those costs as well.
One can imagine that MTM will have first rate care due to her ultra successful career and that her husband is a cardiologist and is "in-the know" about medical conditions and who the best surgeons might be .... all of which I applaud and am happy about for her and for other in her situation .
How do those who are less well-connected and comfortable deal with such a diagnosis?
How are treatment options different/better/worse in other countries, say in Sweden, Canada or Switzerland where socialized medicine is practiced/offered?
GREAT questions!!!! Even in a major city, neurosurgery isn't a guarantee. MANY, MANY travel and that's IF their insurance grants it as an out of network. VERY costly WITH insurance. I was about the best case scenario you can imagine 3 years ago and STILL paying. NTM, the continual cost of MRIs the rest of your life! Please spread word on this lady I know: Lori Paul"s story ====> http://youtu.be/N2VgrqJ_Mag -kristi
over 60 years ago I had a brain tumor,The doctor told my mom that I was spoiled and didn't want to go to school,i received my last rites and another doctor,( Hadley ) then told my mom that something was defienately wrong,put in childrens hospital in pittsburgh pa,they took it out after an air test,they said another 30 days and I would be gone,I wish Mary as many years as I have had.
Awesome!
What I think is a more interesting story is Ms. Moore's success in living with diabetes. When I first saw the headlines, I was sure her medical problem would be related to the disease. I'm glad to see that it doesn't seem to be, but is instead something that apparently anyone might get.
Yes. Anyone at ANY age. However, more women to men... 3:1. Little is known due to little research.
There are over 18 million people in the United States diagnosed with diabetes, whereas only 200 thousand people in the U.S. diagnosed with a meningioma. There is a MUCH higher likelihood of getting diabetes.
We need MUCH research in Meningioma and force insurance companies to embrace less invasive procedures... Case in point, Lori Paul"s story ====> http://youtu.be/N2VgrqJ_Mag -kristi
Ajay,
I am a 62 year old. I had a scull base Meningioma removed endoscopically last August. It was larger than 3 cm and caused total blindness in my left eye. The surgery was 14 1/2 hours. It was done through my nose. No crainitomy The day after the surgery my eye sight was back. Also, there were no scars. I was out of the hospital in 4 days. Back to work in 7 weeks. The only problems I am currently having are that I have not yet gotten my sense oof smell back and I do have some pain in my extremities. I am so glad that i did went through with the surgery.
Where was your M? Mine is in the sphenoid. They want to operate because my vision is starting to go. I've been on watch & wait for 5 years and now things are changing. They never suggest endoscopic for mine, that would be great.
I have had 5 brain tumers of this type over a period of 6 years then had proton radiation at Loma Linda UMC. I was good for 14 years and now I have another tumor.Hang in there Mary, you can do this.
Dear CNN,
I would like to kindly challenge YOU to do your own investigative research about Meningiomas. Please do not seek information from a physicians stand point for you will only receive generic clinical statistics. Why not go directly to the individuals who are living with the deficits of a Meningioma,..those who have walked the walk and KNOW the talk! It is only then will you get the REAL story about Meningiomas. Did you know that people with Meningiomas do not always feel as thought their doctor takes them or their brain tumor seriously? Did you know that due to this frank disreguard, peope with Menigniomas experience avoidable symptoms of depression? Did you know that there is LITTLE research for the MOST COMMON primary brain tumor? Meningiomas and their treatments are not so cut and dry as the media has recently portrayed. The ONLY thing ROUTINE about a Meningioma is the enormous amount ignorance, lack of interest and general disreguard for those who suffer from a Meningioma. Be bold!..Be better than the rest!..Be the FIRST to tell the REAL story about Meningioma Brain Tumors!!! Are you up for the challenge???
Sincerely,
Cheri O'Neal
Meningioma Patient
Here is a blog that I wrote last year on my personal battle with Meningiomas not being taken seriously. I hope you will read it and take it to heart.
http://brendasbrainstorm.blogspot.com/2010/05/my-person-battlewith-mad-about.html
Sincerely,
Brenda Kleinsasser
Meningioma Brain Tumor Survivor Warrior
I lost my dad two years ago to meningioma, he was diagnosed in 2004 after having a seizure. He had surgery four times, his first was in 2004 but his came back in 2007 and 2008. The first surgery evaluated the tumor as benign, but the second one was classified as atypical and after that they were said to be anaplastic. His last two surgeries were at MD Anderson in Houston. I should have taken him there first. I failed him by not getting him better treatment right from the start. I know most of these tumors are classified benign, but I really don't know if there's any such thing as a benign tumor. Don't let anyone tell you these tumors are easy to treat or not dangerous. The consequences can be the difference between life and death.
I had my Meningioma removed in 2007, it was Golf ball sized on the right side behind my eye wrapped around my optic nerve. I went into a Gran Mal seizure that is how they found it, and I now have to stay on meds for seizures. I have a small spot they has come back and hoping that is not growing into another one, I get my MRI every year. I am wish the Beat for Mary Tyler Moore......