miracle of neurosurgery has extended my life and given me the
opportunity to turn potential tragedy into quality time that
has enabled me to help others. The CyberKnife enabled corrective
trimming of my brain tumor beyond the capability of traditional
August of 1999, returning home from a successful camping and
trout fishing trip in the California Sierra Mountains, I was
dogged by a stiff neck, the kind you feel when you sleep without
a good pillow. The next morning I had serious flu symptoms, tried
to sleep in, and scheduled an afternoon appointment with my regular
doctor. On the walk from the front door to the car, I lost equilibrium
and fell into a fortunately soft bush. As I was not able to walk
further on my own, my spouse and a man who was working on our
house extracted me from the bush and assisted me the next few
steps to the car. The plan was significantly changed, as I was
rushed to the local hospital emergency room.
medical assessment, I was assigned to an experienced neurosurgeon.
MRI images showed a large (4cm x 8 cm) benign tumor, called a
meningioma, on the inside of my lower rear skull, which was pressing
on, and had displaced, my brain stem by a visible amount. This
explained the symptoms with my motor skill performance and dizziness.
was placed in ICU and scheduled for emergency surgery, first
to install a plastic shunt to relieve pressure by my brain fluids,
then, after a week of being stabilized, to remove the tumor with
traditional invasive surgery. Three months later, a mesh plate
was surgically installed to replace the missing skull bone.
after the main surgery, I awoke on a ventilator, which was fortunately
removed in a day, but the post-surgical story was that this very
capable surgeon was not able to remove the entire tumor. The
vascular base of the tumor was so integrated with the brain stem
that all attempts to remove this remnant resulted in my heart
stopping, several times. So the surgeon wisely discontinued further
removal at that point, leaving a remnant. A second issue was
that the pathology revealed atypical cells, which can restart
growth as cancerous tissue. Two years later, a longer-term side
effect of the surgery appeared, as I had two hip replacements,
due to necrosis, which apparently progressed because of the heavy
steroids needed to control brain swelling over the several months
of recovery from surgery.
after surgery, it was suggested that I proceed with stereotactic
radiation, which was expected to achieve atrophy of the vascular
remnant while not impacting any healthy nearby brain or brainstem
tissue. The local options were the ‘gammaknife’ at UCSF, which
needed a somewhat invasive locator frame screwed to my head for
a while, or the newer, but still experimental, workstation-controlled
CyberKnife, being developed by Dr John Adler and his associates
at Accuray, Inc.
am very pleased and happy to report that I decided on the CyberKnife
treatment, which was completed in mid-February, 2000. There were
no side effects then or to date. I have returned to my pastime
of stepping from rock to rock in Sierra streams searching for
the illusive trout for a camping breakfast. It is now September
13, 2003, three and one half years later. I just completed my
annual MRI review at Stanford with Dr. Steven Chang, who is following
my case. He reports that I have normal function and that the
remnant is not growing and continues to display shrinkage.
– September 13, 2003