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| Hospital Affiliations -- Newspaper
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Advances Changing Surgeries on Brain
By Laura Ingram
James Oxgord faced losing his life last week, after living
more than a year longer than expected. Tilly Morris faced
losing her memory and speech three weeks ago. Modern brain
surgery techniques for removing tumors saved them both.
Dr. Don Penney used new nickel-sized wafers of tumor-killing
drugs on Oxford to stop new tumors from sprouting. While
she was awake, he mapped points on Morris' brain which
he needed to avoid during surgery in order to save her
ability to speak and remember.
"One form of science is looking at things in new ways,"
Penney said.
The chemotherapy drug Penney used in Oxford's surgery
had been around for decades, but not in a wafer that could
be applied directly to the brain in order to release the
drug slowly over a month.
Oxford, 35, had his first malignant brain tumor in June
1995. Penney removed it that month and treated him with
radiation and chemotherapy to stop any more tumors from
growing.
Oxford expected to live only nine more months so he exercised,
took vitamins and even quit his teaching job to enjoy
time with his wife and two sons.
"He wanted to do as much as possible," his wife, Aleisa,
said.
Penney checked his brain every three months for tumors,
but none grew as nine months turned into two and a half
years.
"He had already defied all the odds," Penney said.
But two weeks ago, Oxford's vision blurred just as it
did before his 1995 brain tumor, and he knew he had another.
Since Oxford's 1995 surgery, the Gliadel wafers became
available. It was the first new treatment for recurring
brain tumors in 20 years. Before the Gliadel Wafers in
1996, doctors relied on the bloodstream to carry cancer-killing
drugs to the brain.
"You reduce the effects of putting them in your body,
"Penney said. "They do have damaging effects on organs
outside of your brain. It also makes more sense to put
a higher concentration in the tumor bed."
Penney operated on Oxford again, popping in six wafers.
The wafers slowly will release tumor-killing drugs over
the next four weeks to prevent more tumors from growing.
"It should increase his lifespan and minimize the chances
of local reoccurrence," Penney said.
The family is hoping with these wafers, and prayer, Oxford
will live longer.
"There is no cure right now," Aleisa Oxford said. "But
there is a lot of hope that these can prolong his life.
Time is a factor. The next time, maybe they can do something
better."
Brain mapping, as was used with Morris, also is not a
recent development in neurosurgery, though it is being
used in different ways. Done first in 1939, interacting
with conscious patients during surgery had been applied
routinely to epilepsy patients.
Removing the tumor inside Morris' head without brain mapping
would have been a high risk to her because it was just
centimeters away from brain portions affecting speech
and memory.
The tumor, diagnosed as benign, had a low risk of spreading
or reoccurring, but Morris wanted it out because she blacked
out at least twice a day and had little energy.
But, because every brain is different, some risk still
existed, even using brain mapping.
"Removing ran the risk of losing her speech and worsening
her memory deficit," Penney said.
With damage to those portions of the brain, Morris, 41,
of Stone Mountain would not be talking to her 18-year-old
daughter about attending Georgia Southern University or
her 12-year-old about girl Scouts. She would not be able
to discuss her husband's duties as a deacon. Morris would
not remember having her babies. She also would not remember
the surgery.
With Morris awake but drugged enough to not feel anything,
Penney opened her skull with drill and saw. Then, he prodded
certain areas, noting which ones had an affect on her
ability to read and recognize flash cards imprinted with
pictures of a beagle dog and a green frog. Those areas
were marked to be avoided during surgery.
"When I was done, I had a map. Then I was able to plan
my tumor removal avoiding these areas of important function,"
Penney said.
Morris ended up with about seven little flags covering
the exposed brain tissue in surgery. Morris could not
feel the touching, but she knew it was happening.
"I was at peace with the surgery," Morris said. "It didn't
bother me."
Right after surgery, Morris recognized and talked to her
seven brothers and sisters in the recovery room.
"Dr. Penney saved my speech," Morris said.
"I have my memories and my life."
Gwinnet Daily
Post, March 28, 1998
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