You never get a second chance to make a first impression, but your first chance with a second opinion may be the best decision you ever make. Just ask Mark L.
In the last days of 2019, Mark started bumping into walls. In the first weeks of 2020, he began experiencing dizziness and fell out of bed. Then, just as COVID-19 was creeping into New Jersey and monopolizing our thoughts, the 63-year-old from Hunterdon County wound up in the emergency department at Morristown Medical Center.
It was there that an MRI revealed a brain tumor – specifically, a vestibular schwannoma at the base of his skull, pressing on his cranial nerves. Though the tumor was benign, it was not without consequence.
“Within a few weeks, I went from being perfectly healthy to dizzy to not being able to walk,” Mark says.
Mark and his husband, Jeff Turner, took the diagnosis in stride. They nicknamed the mass Schwannoma Ryder (“You can cry, or you can make jokes,” says Mark. “We chose to make jokes.”) and set about finding a plan to deal with it.
Upon Mark’s release from the hospital, he followed up with a neurosurgeon who wanted to wait six months and then do another MRI to check for any signs of the tumor’s growth.
This wait-and-watch approach did not sit well with them; Mark’s quality of life was suffering. Also, Mark kept coming back to the fact that person after person had recommended the same doctor, Yaron Moshel, MD, PhD, co-director of the Gerald J. Glasser Brain Tumor Center at Overlook Medical Center’s Atlantic Neuroscience Institute.
“I was never one to seek a second opinion. I went to Catholic school growing up so if someone told me to do something, I just did it!” Mark explains. “This was the first time I ever got a second opinion. It was based on gut instinct, and also, everyone kept saying, ‘Go see Dr. Moshel.’ ”
The appointment with Dr. Moshel changed Mark’s life. Rather than waiting, the neurosurgeon had another idea. He explained that Mark’s tumor was located adjacent to the brain stem, in the small internal auditory canal where nerves that control balance, hearing and face movement branch out toward the cochlea in the inner ear.
“If you have a tumor inside this canal, it doesn’t have to be a large one to give you problems,” he says – exactly what was happening to Mark. “There are multiple nerves in this small space, and the tumor was compressing them. But it gets complicated. How do you treat this? It used to be that the only options were to watch and see if it got bigger, or to do surgery, but that carries risks to hearing and facial paralysis.
“You’re not going to die from this type of benign tumor,” he continues, “so any problem that comes out of surgery is a problem you’re going to have for life.”
Still, he thought it was best to treat Mark’s tumor. The dizziness and loss of balance were already impinging on his day-to-day functions and if the tumor grew much larger, surgery would be a necessity.
Dr. Moshel’s solution: CyberKnife®, a noninvasive radiosurgery device that uses pinpoint accuracy to deliver high doses of radiation to treat tumors, without damaging surrounding healthy tissue.
“The key to delivering radiation safely – especially to the brain – is to target the one spot that is the tumor, and not touch the rest,” he says. “We use CyberKnife to treat tumors around delicate nerves and the otherwise inaccessible extensions of larger tumors that we would otherwise not feel comfortable treating with surgery alone. It totally changes how we are able to treat brain tumors.”
“At Overlook, CyberKnife is so much a part of our culture, we use it as a verb: ‘We’ll CyberKnife it,’” says Joana Emmolo, MD, director of radiation oncology for the Gerald J. Glasser Brain Tumor Center. “When you have people driving 90 minutes and passing three other hospitals along the way to get here, that says a lot.”
There’s a reason for that. Overlook has been a leading provider of CyberKnife technology for more than 15 years and has the most experience in New Jersey in providing CyberKnife technology to patients with various types of cancerous and noncancerous tumors.
“We’re fortunate to have the funding, support and technology to provide patients with this cutting-edge treatment,” says Dr. Emmolo.
Mark agrees. Though he admits he felt anxious about treatment, that feeling quickly subsided.
“My treatment was over before it even began – just 30 minutes a day for five days. I could not have been more pleased. From the support staff to the doctors, it was seamless and I felt well taken care of and in good hands,” he says. “I was in awe of what CyberKnife looked like. It’s like science fiction. The fact that this exists is miraculous. How many lives it has saved!”
Though Mark completed his treatment in less than a week’s time, he comes face-to-face with a reminder every day. He took with him the custom mask that is used to safely and securely position patients’ heads for CyberKnife.
“As an artist,” says the accomplished quilter, “when I was fitted for the mask and it was shaped and molded to my face, I loved it.”
He notes that there is a whole community of people who use these masks for art, and he hopes to do the same; these days, he’s considering needlepointing it with thick yarn. “If you work in the arts, you want to leave a legacy,” he says – and for sure this is part of his.
Months after his CyberKnife experience, Mark continues to feel grateful.
“Maybe I’m luckier than most. I never believed I wasn’t going to get well,” he says. “I have an innate feeling that everything is going to be OK. Every time there is an obstacle, know it is a lesson to be learned. You never get a bad side without a gift. For me, the gift is that I became more empathetic, more mindful, more grateful. You get to go around only one time. You can waste the days or you cannot. That’s why I always have some sort of project going on. It keeps me centered and engaged. As babies, we are born with wonderment. It gets plucked out of us, but you can find it anywhere. You just have to look for it.”
Drs. Moshel and Emmolo are part of the Gerald J. Glass Brain Tumor Center.