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Don’s Brain Tumor

MY CYBERKNIFE STORY

The 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 surgery.

In 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.

After 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.

I 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.

However, 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.

Immediately 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.

I 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.

Don – September 13, 2003