Ruth and Vivien's story

Meningioma tumors

Ruth has six small meningioma tumors on the lining of her brain. Her daughter Vivien has three. But neither woman seems very concerned. "Neither one of us considers the tumors to be a big deal," says Vivien, "especially now that they can be treated with the Gamma Knife™."

Ruth and Vivien do not currently require treatment for the tumors, according to their doctor, Ronald Warnick, MD, a neurosurgeon at Mayfield Brain & Spine and Co-Director of the Gamma Knife Center at The Jewish Hospital-Mercy Health. But if the tumors grow and treatment is required, the mother-daughter pair knows what lies ahead. Both have already undergone stereotactic radiosurgery for a previous meningioma, and both know how remarkably fast and painless the treatment is.

"The procedures that they do sound scary, but they aren't," Ruth says. "When you go in for Gamma Knife, they put that frame on to stabilize your head. Between the treatment planning stage and the actual treatment, they give you breakfast. It was no big deal."

Says Vivien: "I was back to normal as soon as I left."

Ruth and Vivien's comfort stems partly from the benign nature of their tumors. Meningioma tumors arise from membranes (meninges) that surround the brain and spinal cord. Most meningioma tumors grow slowly, and doctors typically monitor them with annual MRI scans. If the tumors grow too large, they may press on brain tissue and impact nerves and blood vessels, making treatment necessary.

"The doctor says anytime you have a brain tumor, benign or not, it will eventually kill you if it keeps growing," Ruth says.

Ruth, now in her 80s, was 60 years old when her first tumor was removed. The tumor, which had been discovered four years earlier during a test for another medical issue, had grown to the size of a small egg. Ruth underwent traditional surgery at Mayfield, and the tumor was removed through a sizeable opening (a craniotomy) in her skull. She had a second tumor removed five years later, though this time technological advances allowed her surgeon to make a much smaller craniotomy. By the time Ruth required treatment for a third meningioma, Gamma Knife was available.

Vivien at left, with Ruth. The initial diagnosis is scary, they both agree.

By coincidence, Vivien required treatment at the same time, as a meningioma that was once the size of a pea had grown to the size of a grape. The mother-daughter pair had Gamma Knife radiosurgery one month apart, and Dr. Warnick's office affectionately called them "the Gamma Girls."

During treatment, hundreds of low-dose beams of radiation were aimed at their tumors, converging on a single point to kill the tumor cells while sparing healthy cells nearby. Radiation works by damaging DNA inside the cells, making them unable to divide and grow. Over time, the tumor cells die off, and the mass becomes imperceptible on future brain scans.

Vivien says her brain tumor diagnosis has changed her perspective on life. "Things happen, and you just take it in stride," she says. "You deal with whatever is in front of you and don't worry about it."

The initial diagnosis is scary, they both agree. "But after the initial shock, it's not something to worry about, because it's easily treatable," Vivien says. "They can see it if it does grow."

Observes Ruth: "I was fortunate to have this type of tumor, because they can do something about it. Anymore, I don't have to really worry about it. I have regular scans. Everything is OK right now."

The women's shared routine extends to their follow-up appointments, which they schedule back-to-back. Dr. Warnick sees them in the same exam room, starting with Ruth and then segueing to Vivien.

Both women praised their clinical team. "The entire staff is up front and explains everything they know about your condition as well as all treatment options," Vivien says. "It's a team that really cares about what they do. I would like to thank all of them, but especially Dr. Warnick, because I felt very confident that I understood what was going on with me as well as the options available. I know that he's going to tell me everything that he will do, and that he will do a good job."

~ Cindy Starr

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