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Setting Out to See the World After Brain Surgery

February 8, 2024

Nancy M. in Porto, Portugal

Nancy M., a devoted teacher in Elizabeth, New Jersey for the past 39 years, doesn’t have any tattoos. If she were to get one, it would say, “sempre em frente,” a saying honoring her Portuguese roots that means “keep moving forward.” This is a mantra she has learned to live by, especially after suddenly discovering she had a large skull base tumor and needed to undergo highly complex brain surgery to have it removed.

“I was living my normal, happy life and went to my regular eye doctor appointment without any concerns,” says Nancy. “I didn’t realize anything was wrong until I had to cover my left eye and read the letters on the screen with my right eye. I couldn’t make anything out. The ophthalmologist kept making the letters bigger and bigger until there was just one large letter on the screen. I still couldn’t tell what it was, which was really surprising because my day-to-day vision seemed normal.”

The eye exam that followed didn’t reveal anything out of the ordinary. Nancy was then referred to a neuro-ophthalmologist who ordered an MRI scan. The scan showed Nancy had what appeared to be a skull base meningioma – typically a benign, slow-growing tumor – seated at the bottom of her skull, under the brain and just above her nose. The tumor, which was invading her eye socket and stretching her optic nerve, was causing vision loss and needed to be surgically removed.

Nancy scheduled an appointment with neurosurgeon Yaron A. Moshel, MD, PhD, Co-Director of Atlantic Health System’s Gerald J. Glasser Brain Tumor Center. Dr. Moshel is well-known for his expertise in treating skull base tumors, which are some of the most complicated and difficult to treat due to their location.

“After meeting with Dr. Moshel, I knew I wanted him to do my surgery,” recalls Nancy. “I came in to see him with four legal-sized papers filled with every question imaginable. He sat with me patiently and answered every single one thoughtfully and thoroughly, assuring me that each was important. The unknown is very scary, but from the start, Dr. Moshel was genuine, kind and understanding. He knows exactly how to care for patients on a human level.”

Given the complexity of Nancy’s tumor, which was not only difficult to access but also growing around what Dr. Moshel calls critical real estate, it was important she be treated at a multi-disciplinary brain tumor center. At the Glasser Center, Nancy had access to every possible treatment option through a comprehensive and well-coordinated medical team.

Potential treatment options included minimally invasive approaches that would allow the tumor to be removed endoscopically through the nose or an incision in the eyelid with the help of a small camera. An open microsurgical skull base approach was another option, designed for the most complex tumors like Nancy’s.

Nancy M. at the Eiffel Tower in Paris, France

“The biggest challenge with Nancy’s case was determining the best way to get to the bottom of the skull without causing any damage to highly sensitive brain tissue,” explains Dr. Moshel. “While it might seem more aggressive, removing the bones of the skull and face is actually less invasive to the brain. We can always reconstruct bones. We can’t reconstruct a damaged brain. We were confident this would be the most promising approach for Nancy.”

During the open surgery, Dr. Moshel and the team removed Nancy’s orbital bones to get underneath her brain and remove the tumor without needing to significantly manipulate brain tissue. This approach enabled the team to remove the tumor in its entirety, eliminating the need for post-operative radiation. If that wasn’t the case, Nancy would have been able to have state-of-the-art radiosurgery, such as CyberKnife®, done right at the Glasser Center.

“Knowing our team can treat any residual tumor cells with pinpoint accuracy is extremely important,” adds Dr. Moshel. “As a neurosurgeon, having this minimally invasive treatment option at our fingertips post-surgery allows us to use the safest techniques for removing complex brain tumors without compromising outcomes for our patients.”

“The entire team involved with my surgery and recovery was like a well-oiled machine,” says Nancy. “The neurosurgeons, neurologists, anesthesiologists, nurses, physical therapists, they all just take such great care of you. I’m also grateful to have two incredible sons and so many amazing family members, friends and co-workers who helped me get back to my wonderful life with a renewed sense of gratitude and appreciation. Now, I get to go out and continue seeing the world.”

Nancy has happily returned to teaching, one of her many passions, and is looking forward to the future. A travel lover at heart, she celebrated her first post-surgery birthday in Paris, is planning to go ocean kayaking in the fjords of Norway and has a long list of future travel destinations.

“No one’s life is perfect, but life is meant to be lived. Live life forward. Surround yourself with people you love, turn on your best soundtrack, venture out … and take Dr. Moshel’s phone number with you.”

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