After Fatal Diagnosis, Awake Brain Surgery Gives London Mom a Second Chance

Northwestern Medicine
Neurosciences October 02, 2014
 
Laura Fischer-Beards could deal with having a brain tumor. She learned to live with the chemotherapy and the uncertainty. But when Laura was told her tumor was inoperable and that she had mere months to live, it was unacceptable to Laura, her husband and most of all to her three young boys ages 8, 7 and 4 years old.

“We were distraught,” said Laura’s husband, Mark. “However, shock turned into reality and we remained positive and moved forward with purpose to tackle and overcome the diagnosis.” 

When Mark heard the option was an awake brain surgery, he admits he had some reservations. 

Laura, on the other hand, did not.

It all began about two years ago, when, at 37 years old, Laura experienced severe neck pains. A biopsy revealed she had a low grade glioma brain tumor, which carries an average survival of about 15 years with aggressive treatment. In November 2013, Laura’s MRI showed changes which were concerning for progression to a high grade glioma, which has a much poorer prognosis, where survival is a few years at best. Laura was told surgery wasn’t an option and instead underwent nine months of chemotherapy, which failed to slow the tumor’s growth.


In hopes he could help, a friend of Laura and Mark’s passed them the email address of Jeffrey Raizer, MD, co-director of Northwestern Brain Tumor Institute and director of Northwestern Medicine medical neuro-oncology. 

After reviewing the case, Raizer consulted with Matthew Tate, MD, a Northwestern Medicine neurosurgeon who specializes in awake brain mapping. Together they decided surgery was a relatively safe and viable option for Laura despite what the doctors in London told her. 

“It was important to know whether we were dealing with a more aggressive tumor or radiation damage,” Raizer said.  “If this was a tumor, we could then provide treatment options. If this was not a tumor, we would avoid treating her with chemotherapy and associated side effects that often come with chemotherapy.  Laura’s case illustrates the importance of seeking out a second opinion."

When Mark heard the option was an awake brain surgery, he admits he had some reservations. 

Laura, on the other hand, did not.

“Laura was convinced that this was the right thing to do,” Mark said. “We have three young boys who need their mum.”

So Laura flew to Chicago to meet with drs. Raizer and Tate, and Dr. Tate explained how he removes hard-to-get tumors that are near critical functional areas of the brain. A few days later Laura underwent her awake brain surgery at Northwestern Memorial Hospital on Sept. 10, 2014.

“Laura’s tumor is traditionally considered difficult to approach surgically,” said Tate, also an assistant professor in Neurological Surgery and Neurology at the Northwestern Feinberg School of Medicine. “But I didn’t agree that it was inoperable. We do surgeries in this area of the brain safely with awake mapping and I was pretty confident we could help her.  The goals of the surgery were two-fold: first, to obtain a diagnosis, because we can never be certain that a tumor has changed or upgraded without actually obtaining tissue surgically. And second, to specifically target and remove the area that was rapidly changing and thus most concerning for progression to a high grade glioma.”

During an awake mapping surgery, after asking a few basic questions such as the date, the patient’s name and the names of the patient’s children. Dr. Tate has the patient complete one or more tasks depending on the location of the tumor. In Laura’s case, the surgical target was near areas of the brain devoted to movement, sensation, and attention, and thus she was asked to perform specific tasks to locate the regions of the brain important for those functions, so that Dr. Tate knows what area of the brain to protect. 

After the surgery, Laura and her family received great news. The tumor abnormality was an effect of her radiation and chemotherapy treatments. There was no evidence of a higher grade tumor.  So instead of a few months to live, Laura is looking at 15 or more years. 

“Laura missed her youngest son’s first day of school to be here for surgery,” Tate said. “I expect that she will soon be back to her normal routine.” 

Today, a couple weeks after surgery, Laura is back home with her husband and three boys and enjoying the support of her community. Almost 1,000 people have liked her Facebook page and the Daily Mail* wrote about her story. She works hard at speech and occupational therapy every day but enjoys rest and walks around her neighborhood as well.

“In a way, the surgery, coming to Chicago was like a dream,” Mark said. “I’m proud of how brave Laura has been and we are lucky to have found Northwestern Memorial Hospital.”

Read more information on neurosurgery at Northwestern Memorial Hospital.



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