Meningioma

MENINGIOMA

Mayoclinic.com gave this definition of “meningioma”: “a tumor that arises from the meninges—the membranes that surround your brain and spinal cord. The majority of meningioma cases are noncancerous (benign), though rarely a meningioma can be cancerous (malignant).”

It was a scary and yet strangely positive description. No one ever wants to read the word “malignant” unless you’re reading a Charles Dickens novel about an evil landlord, but “benign” and “majority” are two words that go well together.

From the University of Washington Medical School Web site I learned that meningioma tumors “are usually benign, slow growing and do not spread into normal brain tissue. Typically, a meningioma grows inward causing pressure on the brain or spinal cord. It may grow outward toward the skull, causing it to thicken.”

So, wait, what the fuck? A meningioma can cause pressure on the brain, and spinal fluid? Oh, you mean just like fucking hydrocephalus? Just like the water demon that once tried to crush my brain and kill me? Armed with this new information—with these new questions—I called my doctor.

“Hey, you’re O.K.,” he said. “We’re going to closely monitor you. And your meningioma is very small.”

“O.K., but I just read—”

“Did you go on the Internet?”

“Yes.”

“Which sites?”

“Mayo Clinic and the University of Washington.”

“O.K., those are pretty good sites. Let me look at them.”

I listened to my doctor type.

“O.K., those are accurate,” he said.

“What do you mean by accurate?” I asked. “I mean, the whole pressure-on-the-brain thing—that sounds like hydrocephalus.”

“Well, there were some irregularities in your MRI that were the burr holes from your surgery, and there seems to be some scarring and perhaps you had an old concussion. But other than that it all looks fine.”

“But what about me going deaf? Can’t these tumors make you lose hearing?”

“Yes, but only if they’re located near an auditory nerve. And your tumor is not.”

“Can this tumor cause pressure on my brain?”

“It could, but yours is too small for that.”

“So I’m supposed to trust you on the tumor thing when you can’t figure out the hearing thing?”

“There is no physical correlation between your deafness and the tumor. Do the twenty-day treatment of prednisone, and the audiologist and I will examine your ear and your hearing then. If there’s no improvement, we’ll figure out other ways of treating you.”

“But you won’t be treating the tumor?”

“Like I said, we’ll scan you again in six to nine months—”

“You said six before.”

“O.K., in six months we’ll take another MRI, and if it has grown significantly—or has changed shape or location or anything dramatic—then we’ll talk about treatment options. But if you look on the Internet—and I know you’re going to spend a lot of time obsessing about this, so I’ll tell you what you’ll find. About two per cent of the population live their whole lives with undetected meningiomas. The tumors can become quite large, without any side effects, and are found only at autopsies conducted for other reasons of death. Even when these kinds of tumors become invasive or dangerous, they are still rarely fatal. And your tumor, even if it grows fairly quickly, will not likely become an issue for many years, decades. So that’s what I can tell you right now. How are you feeling?”

“Freaked and fucked.”

I wanted to feel reassured, but I had a brain tumor. How can one feel any optimism about being diagnosed with a brain tumor? Even if that brain tumor is neither cancerous nor interested in crushing one’s brain?


Sherman Alexie

from his new book WAR DANCES
Posted over on The New Yorker