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Dr. Joseffer explains recent brain tumor diagnosis of Sen. John McCain
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Dale: So we know Cheryl Crow has a brain tumor and so does Mary Tyler Moore. So can you tell us a little bit about what it means to have a benign brain tumor and what are the risks involved with that?
Doctor Shah: It’s always a very scary feeling when you get diagnosed with something as serious as a brain tumor. Whenever you think of that you always think of the worst-case scenario because often times, brain tumors can be quite dangerous and can be quite malignant. However, almost five thousand people a year are diagnosed with some kind of tumor.
Particularly what they have is called a meningioma. A vast majority of this type of tumor is non-cancerous.
Dale: So does that mean she's going to have any sort of procedure done to remove the tumor or is it something she can just let lay? What's her process for this moving forward?
Doctor Shah: Well often times we find meningiomas incidentally on an MRI. You get an MRI for headaches, or dizziness or something like that and we often see something like this. It’s simply a growth of the lining of the brain and it's a kind of overgrowth.
The reason it becomes a problem, or can become a problem, is it can press on adjacent tissue of the brain and can cause neurological compromise. This is a very rare process. In most part the vast majority of these tumors are benign and don't require surgery of any type, just observation.
Dale: From what we hear, Cheryl Crow probably isn't going to need the actual surgery to remove the tumor. Mary Tyler Moore, actually will have the tumor removed. So is that at all chalked up to the fact that there's a huge age difference? Does age play a factor in these types of tumors?
Doctor Shah: Age plays a factor in many things but it doesn't have a factor in this particular issue. Typically for a meningioma surgery would be necessary if a patient develops a neurological compromise. For example, they develop weakness, or seizures, or sensory loss, or they're just not acting themselves.
If the tumor itself is quite large and it’s causing enough pressure on the brain, then surgery might be necessary. The thing is with meningiomas is that they grow at such a low rate that more often than not, people who have meningiomas outlive any risk of requiring surgery down the line.
Dale: And as far as the actual surgery goes, from what I understand it's actually a pretty routine procedure. Could you tell us a little bit about what exactly the procedure entails?
Doctor Shah: Well there's nothing really routine about brain surgery. Each case presents its own trials and tribulations. That's why we are very conservative in our approach to meningiomas, typically because often times they won't require surgery.
But when they do require surgery, we have to remove the entire tumor itself because any remnants that remain can actually regrow again, much like a seed planted in the ground. So we not only have to remove the solid part of the tumor but any areas of the brain in which the tumor touches, such as the lining of the brain or the skull of the brain, too. We may have to remove part of the skull that this may have grown into. So our goal whenever we do surgery of this type is to have a total removed section of the tumor. If there's any residual then there's risk for it to come back.
Dale: And one last question regarding this. Are there any sort of symptoms that people can look for to know that they may be possibly be coming down with a tumor like this or is this just something you can only find out by getting a check-up at the doctor's office?
Doctor Shah: A great majority of these patients have no symptoms at all. And so we find them just based on incidental findings as I had previously stated. The symptoms that really come to light that allow us to diagnose it would be more profound symptoms. Instead of a dull or vague headache, it would be the worst headache of your life. Instead of some intermittent tiredness you would be having persistent lethargy. Instead of having a feeling of weakness you would actually have weakness of one extremity or body part. Instead of having some intermittent disorientation you would be having persistent and unusual personality changes and things like that.
So usually, a meningioma will cause symptoms if it grows large enough in which it's pressing on the brain and the brain is being shifted or molded in such a way that it's being irritated. The other way a meningioma can cause symptoms is swelling; it can develop swelling around itself. Much like when a rock is thrown and causes a ripple effect, a tumor in the brain can also have that ripple effect on adjacent tissue. So a meningioma will become symptomatic if it becomes large enough to cause symptoms.
Update 2013: See also Dr. Joseffer's article about Leptomeningeal Carcinomatosis, as diagnosed in actress Valerie Harper.
LastUpdate: 2016-05-11 16:52:29