May 13th, 2011
02:00 PM ET
Gupta: Waiting out a meningioma
All 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.
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.
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.
About this blog
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.
An impressive share! I've just forwarded this onto a co-worker who was conducting a little homework on this. And he in fact ordered me lunch because I discovered it for him... lol. So let me reword this.... Thanks for the meal!! But yeah, thanx for spending the time to talk about this matter here on your internet site.
Pretty! This has been a really wonderful post. Many thanks for supplying this information.
Good post. I certainly love this website. Stick with it!
Oh my goodness! Incredible article dude! Many thanks, However I am going through issues with your RSS. I donít know why I am unable to join it. Is there anybody having identical RSS problems? Anyone who knows the answer can you kindly respond? Thanks!!
Greetings! Very helpful advice in this particular article! It is the little changes that will make the most important changes. Thanks for sharing!
This page truly has all of the information and facts I needed concerning this subject and didnít know who to ask.
There is definately a great deal to learn about this issue. I like all the points you have made.
You ought to be a part of a contest for one of the most useful sites on the web. I'm going to recommend this website!
Your style is really unique in comparison to other folks I have read stuff from. Thanks for posting when you've got the opportunity, Guess I will just book mark this web site.
I could not refrain from commenting. Well written!
An intriguing discussion is definitely worth comment. I do believe that you need to publish more on this issue, it may not be a taboo subject but generally people don't speak about these topics. To the next! All the best!!
Very good blog post. I definitely love this website. Continue the good work!
I needed to thank you for this fantastic read!! I definitely loved every bit of it. I've got you bookmarked to check out new things you postÖ
Oh my goodness! Awesome article dude! Thank you, However I am having difficulties with your RSS. I donít know the reason why I can't subscribe to it. Is there anybody having the same RSS issues? Anyone who knows the solution will you kindly respond? Thanx!!
Having read this I believed it was rather enlightening. I appreciate you taking the time and effort to put this content together. I once again find myself personally spending a significant amount of time both reading and commenting. But so what, it was still worthwhile!
Very good blog post. I definitely appreciate this site. Continue the good work!
Oh my goodness! Incredible article dude! Thanks, However I am encountering issues with your RSS. I donít understand why I can't subscribe to it. Is there anyone else getting similar RSS problems? Anyone who knows the solution will you kindly respond? Thanx!!
I was able to find good info from your articles.
Hi, I do believe this is an excellent blog. I stumbledupon it 😉 I am going to return yet again since I bookmarked it. Money and freedom is the best way to change, may you be rich and continue to help other people.
Right here is the perfect site for everyone who hopes to find out about this topic. You know a whole lot its almost hard to argue with you (not that I actually will need toÖHaHa). You certainly put a brand new spin on a topic that's been written about for a long time. Great stuff, just great!
I would like to thank you for the efforts you have put in penning this blog. I really hope to see the same high-grade blog posts by you later on as well. In truth, your creative writing abilities has motivated me to get my own, personal blog now 😉
Can I just say what a comfort to discover someone that truly understands what they're talking about on the net. You actually understand how to bring an issue to light and make it important. More and more people must look at this and understand this side of your story. I can't believe you aren't more popular because you certainly have the gift.
Excellent post! We are linking to this great content on our site. Keep up the good writing.
You have made some really good points there. I checked on the net to find out more about the issue and found most people will go along with your views on this website.
An outstanding share! I have just forwarded this onto a co-worker who has been doing a little research on this. And he in fact bought me dinner simply because I found it for him... lol. So let me reword this.... Thanks for the meal!! But yeah, thanx for spending some time to talk about this issue here on your internet site.
After going over a few of the blog articles on your site, I seriously appreciate your technique of writing a blog. I added it to my bookmark site list and will be checking back in the near future. Take a look at my web site too and let me know your opinion.
I blog quite often and I really appreciate your content. The article has truly peaked my interest. I will take a note of your blog and keep checking for new information about once per week. I subscribed to your Feed as well.
After I initially commented I appear to have clicked the -Notify me when new comments are added- checkbox and now each time a comment is added I get four emails with the exact same comment. Is there a means you are able to remove me from that service? Many thanks!
Hello there! This post could not be written much better! Going through this post reminds me of my previous roommate! He always kept preaching about this. I will forward this post to him. Fairly certain he will have a very good read. I appreciate you for sharing!
I couldnít resist commenting. Perfectly written!
I must thank you for the efforts you've put in penning this blog. I am hoping to see the same high-grade content by you later on as well. In fact, your creative writing abilities has inspired me to get my own, personal blog now 😉