Patient Story - Pituitary Tumor
Mother, writer, singer — and brain tumor survivor
If overachiever awards were presented to moms, Dawne Kirkwood would retire the trophy. She is the single mother of five remarkably talented children. She writes and gives talks on achieving goals and making dreams come true. She loves to sing and dance with her kids. And she is the survivor of two benign brain tumors.
A 20-hour surgery, 20 years ago
Twenty-some years ago, while living in the San Francisco Bay area before marriage and children, Dawne was alarmed to discover milk in her breast. She knew she couldn’t be pregnant, so she rushed to her doctor’s office to determine the cause.
Dawne was eventually diagnosed with a pituitary adenoma, a benign tumor located at the base of her brain. In 1986, the surgery to remove this type of tumor was anything but minimally invasive. The young patient was in the operating room for no less than 20 hours, and her nose had to be broken so doctors could gain access to her nasal cavity.
Although the surgery was successful, Dawne’s recovery was particularly long and painful, and she remained in the hospital for more than two months. But with her undaunted spirit as her ally, she gradually returned to her daily routine with no lingering symptoms.
A startling discovery: the tumor returns
For the next two decades, Dawne’s growing family left her with little time or energy to think back on that somber chapter in her young life. She had happily settled outside of Tacoma, and her children and career made certain her days were as hectic as they were rewarding. She was healthy and full of life, and the thought that the brain tumor of long ago might someday return never crossed her mind.
In the spring of 2006, Dawne’s life took a sudden and unexpected detour, beginning with a car accident. Although she wasn’t seriously injured, the paramedics took Dawne to the local hospital, where she underwent a routine brain scan. It was hardly more than a blip on the image, but its presence was undeniable: Dawne’s pituitary tumor had returned.
Seeking advice from someone who knows
Dawne was devastated at the news. She loathed the prospect of another 20-hour surgery and two-months-plus recovery at the hospital. What’s more, her life was different now. She had children, a home and a career — and they all demanded her constant time and attention.
The doctor who discovered the tumor recommended that Dawne find a neurosurgeon. Oddly enough, this suggestion turned her world right-side up once again. Several years before, because one of her daughters had become fascinated with the study of brain surgery, Dawne had befriended Charlotte Foster, the clinical director of the Swedish Neuroscience Specialist Clinic. If ever there was a time to turn to a friend for advice, this was it.
Dr. Marc Mayberg describes an amazing technology
As expected, Charlotte knew exactly what to do. She recommended that Dawne make an appointment with Dr. Marc Mayberg, a neurosurgeon who specializes in benign brain tumors.
Dawne went to see Dr. Mayberg the following week, and immediately knew she was in the best possible hands. “All at once, Dr. Mayberg was reassuring, kind-hearted and confident,” recalls Dawne. “He pointed out my tumor — about the size of a kidney bean — on the MRI. He was very honest in explaining that the tumor was next to my optic nerve, and the surgery might affect my vision.
“Then he told me about an amazing new technology. At first I wasn’t sure I heard him correctly, but he thought he could remove the tumor — through my nose.”
The team recommends surgery — the one-hour version
“Although Dawne’s tumor was not yet causing her any problems,” explains Dr. Mayberg, “when we compared her current MRI with older scans, we could see that it was growing. If left untreated, it would begin to damage her pituitary gland and put pressure on her optic nerve, which could ultimately lead to blindness.
“We met with our entire team of specialists and determined that the best option for Dawne would be a transsphenoidal adenomectomy — removing the tumor through her nose. The good news is this newer approach is far less invasive than the surgery she had before.”
You call this brain surgery?
“In a transnasal procedure,” continues Dr. Mayberg, “we look through the nostril with either a high-powered microscope or an endoscope, so there are no incisions. This approach allows access to the pituitary region and much of the bottom part of the brain.
“Immediately behind the nostril is an air-filled pocket — a sinus cavity — that gives us a surprising amount of room to work. With extremely precise GPS-like navigation, we can thread miniaturized instruments through the nostril and remove a tumor. Best of all, the patient is usually in the hospital for only one night, then goes home to enjoy a very rapid recovery.”
24 hours later, Dawne heads for home
Photo courtesy of The Kitsap Sun
“In the hospital for a day rather than two and a half months? A one-hour surgery as opposed to 20 hours? We take one hour to eat lunch!” exclaims Dawne. She needed no convincing and scheduled her surgery for a date two weeks away.
On surgery day, all went as Dr. Mayberg had predicted, and he successfully removed the entire tumor. After the procedure, the moment she was allowed to get up, Dawne walked into the bathroom and looked in the mirror. Her perfect vision was an enormous relief, as was her own reflection: her nose was intact, she had no scars or bandages, and her abundant hair still framed her face. “I looked just like me,” she recalls.
Dawne went home the following day and in no time at all, she was singing and dancing with her daughters once again. “I couldn’t blow my nose for a month,” she reports. “That was all!”
Perfect eyesight — and even greater new vision
During the two weeks between her appointment with Dr. Mayberg and her surgery, Dawne did something that might surprise some people: she went to the Grand Canyon. “I had always dreamed of seeing the Grand Canyon,” she recalls. “Knowing there was a slight chance that my vision might be impaired after surgery, I decided the time was now.
“Once you learn that you have a brain tumor,” reflects Dawne, “you begin to look at everything differently. You no longer put everything off until someday. People too often forget that your minutes, your hours, your days all add up to your life. You start to realize that someday is today.”
That’s one effect of her brain tumor for which Dawne will be forever grateful.