Actor Craig Russell on Staying Positive during his Brain Tumor Diagnosis

Episode Transcript

Dr. Correa:
From the American Academy of Neurology, I'm Dr. Daniel Correa.

Dr. Peters:
And I am Dr. Katy Peters, and this is The Brain & Life Podcast. Hello Brain & Life Podcast audience and hello to our co-host, Dr. Daniel Correa. I hope you're digging out from under some of that recent snow.

Dr. Correa:
We didn't get that much snow in the city, but it's just that bite of the cold and the wind that can be a little tough. Today, thankfully, it was one of the first days in a while that I didn't have multiple layers and I wasn't bundled in under a hat covering my ears and wearing either something to cover my face or gloves. Despite all that, I did also get out there and ran and just enjoyed the weather.

Dr. Peters:
Because you're still in training, right? It's a half-marathon or a marathon, correct?

Dr. Correa:
Yeah, yeah. I'm doing training for half-marathon and some other races coming up, but part of just getting out there and remembering each day why I am out there and also fundraising for the Epilepsy Foundation.

Dr. Peters:
That's great. So I want to tell you, today on the podcast, I got to speak with British actor Craig Russell. He was recently on the Netflix series, African Queens. It's about Cleopatra where he is actually cast as Mark Antony. During the filming of the series, he did notice that he had some symptoms and he really shares his story that led ultimately to the diagnosis of his brain tumor, which really came after he went to, I guess, the opening party of this Netflix series, which is fascinating. His particular type of brain tumor is called a meningioma, and he'll discuss his journey with us. We will also hear from a neurosurgeon, Dr. Jonathan Sherman. He specializes in brain tumors and he'll talk about the diagnosis and how he does surgical procedures.

Dr. Correa:
Oh wow. It'll be interesting to hear his perspective of doing the surgery in particular, and I look forward to hearing his unique experience. Because really, that's one thing we've learned that each person's experience with brain tumors and especially meningiomas, can be very unique to their own brain and their own life. I'm reminded of our episode with BMX athlete Josh Perry and his journey with meningioma. In that episode, we got to hear from another neuro-oncology specialist like you. So this will be great to now hear the perspective and the experience of a surgeon in working with patients he cares for. Now, for all of our listeners, make sure you hear both episodes that you also can get that sense of the unique experiences of different people and how they live with and manage their history with a brain tumor.

Dr. Peters:
Hello, Brain & Life Podcast listeners. I want to welcome everyone here today and I'm very excited to say that we're joined today by actor Craig Russell. He's joining us from the United Kingdom and he is worked extensively in film and television as an actor. You can see him most recently on the Netflix series, African Queens about Cleopatra where he is cast as Mark Antony and also the Riches on Amazon Prime. Today he's going to be sharing his really unique experience with a diagnosis of a brain tumor called the meningioma, which is a tumor of the lining of the brain called the meninges and how he really managed this condition while working, writing, acting, and I would say also advocating and we will pick up some tips on living from him and about his active and still working lifestyle. So Craig, welcome to the Brain & Life Podcast.

Craig Russell:
Hi Katie. Thank you for having me.

Dr. Peters:
Absolutely. And can you share your initial reactions and emotions when you first got diagnosed with a brain tumor? What was that like?

Craig Russell:
Yes, of course. As I'm sure we'll go into later, the brain tumor had actually been there... I was later told that they believed it'd been growing there for about 15 years. So for me, the finding out all came very late in that time. My wife eventually convinced me to go and speak to the doctor, which I did in the end of January last year, 2023, following months of me doing weird things. Which again, I guess we'll talk about a bit later. The doctor had a look at me and said, "I suggest you have a CT scan." Which I had a few weeks after that. That CT scan showed up something. I was then told to go for an MRI scan. I went for that and then had a phone call out of the blue from a number I didn't recognize to say, "Hi Craig, I'm PA for Dr. so-and-so and right, we'd like to get your brain tumor out, please." And that was the first I heard about it. Yeah, and I said to the person-

Dr. Peters:
Oh my gosh.

Craig Russell:
Yeah, it took my breath away. I said to the person on the phone, I said, "I haven't got a brain tumor." And she said, "Yes, you have. Yeah, you've got a brain tumor." And I said, "That's the first I've heard of it." To which she was then mortified and she could not apologize enough. But I stopped her and I said, "Please don't apologize. I'm incredibly grateful for the speed at which you are reacting to this. Yeah, okay, let's get it out." Yeah, so you ask my feelings, I didn't really have a lot of time to think about it because when I was told I had a brain tumor, to many people you hear those words and you think, "My god, that's pretty final." I've lost friends and family to cancers for as long as I can remember. But I don't know the words brain tumor. For me personally, they conjured up something incredibly dark and frightening. But I didn't have time to process it.
So we went to then meet the surgeon together a couple of days later who basically said, "You're in safe hands." And I was fully on board with that. I said, "I know I am. I trust you. Thank you." And then on the morning of the sixth... That weekend was a bit strange because I found myself saying goodbye to people because the surgeon said in the meeting on the Friday, "There is a very real chance because of the location of the tumor that you won't make it through the operation." So even though I refused to believe that that would be the case, I've been staunchly positive... I am anyway, I'm that annoying person who sees the good in everything. Quite enjoyable for those around me initially, but after a while you're like, "Oh, shut up, would you please?" And I was positive, I've always been positive about it.
But that weekend I made sure to tell my nearest and dearest how much I loved them and how thankful I was. And then on the Monday when I went in with the surgeon, he said to me, before they knocked me out, he said, "Just to remind you, it's in a very tricky spot. I can't promise I'll be able to get it all." I said, "Don't worry." I said, "I trust you to do the best job you can and that's good enough for me." And he said, "Well, thank you." I said, "No thank you." I said, "All right, go for it." And then he woke me up seven hours later and that was that.

Dr. Peters:
That's amazing. I'm so glad you're doing well. I'm so glad you have that positive attitude and were surrounded by the love and the care of your wife and your family and your friends. Now, you mentioned that your wife really prompted you to go be seen by a doctor and to get a head CT. What were some of those first symptoms that prompted your wife to say, "Hey, we got to go to the doctor?"

Craig Russell:
The very first symptom, which I didn't tell my wife about, but when I look back on it, this is the first thing that I personally remember. I was filming a movie and I had to record a lot of dialogue for it. And I was in a booth just off set and I had to do this real, from the feet guttural scream, if you like, into the microphone. I really put everything into this scream and I felt this weird sensation as if the back of my head had just been plunged into water. I've never felt it before or since. And I heard, it sounds totally odd, this sort of sound of air being pushed through the back of my head. Oh my god. And it shook me a bit and I was sitting down. So I think if I wasn't sitting down, I probably would've lost balance.
And later on I mentioned that to one of the consultants, I think, and they said, "Oh yeah, that's a warning sign. That would've been a warning sign should you have been aware." So that was the first in September. And then the first major one was in the November. I was driving our eldest child home from his friend's birthday party, and on one of the last turnings before our house, a roundabout, I took the wrong turning off it and my son said, "Where are we going?" And I said, "I've got no idea." I genuinely didn't know where we were. And he then had to direct me home. That happened a couple of times. And then the one I think that worried my wife the most was, I went into our spare bedroom to hang something up and I couldn't remember how to get out.
Now, bearing in mind there is one door in and one door out, but it was behind me and I was lost for a moment and I didn't know where I was. And that lasted a very brief moment and I thought, "Oh." And so that was that. Obviously these things kept happening, the getting lost and everything like that. But all the while, every morning I was waking up and at the back of my head, which subsequently was where they found the tumor, I was having these intense painful headaches from where my head had been on the pillow. I'd actually said to my wife for years before this, "Does my head feel weird to you?" She said, "No." I was convinced my head was a different shape to how I remember it being. Again, subsequently they tell me after the operation, "Your skull had been deformed by the size of this tumor."
So all the warning signs were there. And the very last one, which I mentioned today, funny enough, was I went to the launch party of Queen Cleopatra in London. Bearing in mind I lived in London for years, used the tube every day. I went to the tube map to work out how to get, and I couldn't understand it. I couldn't understand how to get from one station to another. I asked these two elderly women who very kindly, they could see the confusion and the worry on my face. And these two women took me on the tube and they took me to my stop, could not understand. It was gobbledygook. After the launch party, I took a taxi back to the hotel instead of the tube because that completely freaked me out. And it was after that I saw the GP, the doctor.
And then after that, that's when it all started to fall into place because the doctor checked my eyesight and realized that most of my left eye had gone.

Dr. Peters:
Oh wow.

Craig Russell:
Yeah. That was obviously a massive flag for her because where the tumor was, it was shutting down that side of my brain.

Dr. Peters:
Craig, I think all those symptoms that you talk about, even the initial one where you talked about that guttural scream, that you had to almost have a pressure... In full disclosure, I'm a brain tumor doctor, and with those symptoms, what was happening to you was that it was increased intercranial pressure. And so when you had that guttural scream, it led to that. Moreover, that feeling, that embossed feeling that something with your head was there and you'd feel it mostly in the morning, that's something we can also see with our brain tumor patients. And particularly for your kind of tumor, it's called a meningioma. Can you just talk about what you know about meningioma and what your doctors have told you?

Craig Russell:
Yeah, so I think the easiest way when people ask me that, I'd hate for this to sound flippant or that I was making light of it in any way. This, of course, is just how I cope with it. And I would say from my point of view, I feel incredibly lucky to have had a meningioma because most meningiomas are completely fine from my understanding, and more often than not, if you have it successfully removed, it will not return. That is my understanding. I know some do and will come back again and again, depending on the grading of that particular tumor, but my particular meningioma was a safe a tumor, if there is such a thing, as you could get really. And they are incredibly common, I think here in the UK, of all the brain tumors, they are one of the more common tumors found.

Dr. Peters:
You're saying all the correct information and educating our listeners, it is the most common primary brain tumor in adults. It happens on the convexity of the brain. I'll say, I got to see some pictures of your tumor because you shared them online. It was quite a large tumor, so I can imagine that your neurosurgeon did talk to you about the risks and the situations associated with it. It sounds like you had pretty positive interactions with the healthcare professionals. What are your doctors doing now? Are they doing any special monitoring for you? Do you get regular MRIs? Do you get regular exams or any kind of rehab?

Craig Russell:
Yeah, so I now have to have two scans a year for the next 12 years. If my next scan in April is also clear, the oncologist said they will then drop the scans, the MRIs to one every 12 months. And as you know yourself, Katy, with a meningioma, it's what I've started to call a luck of the draw tumor. It's not caused by lifestyle or trauma. I don't smoke, I don't do drugs. I'm not a heavy drinker anymore. I always look after myself. I eat healthily, but none of that matter. I've never had a head accident. But none of that matters because it's a luck of the draw tumor. It just decided to grow there. So he said the chances of that happening again, he said are zero in his opinion.

Dr. Peters:
Well, I think it's great that you're being monitored. I think it's great you have a great prognosis and that the surgeon did a great job to really flesh out everything because it's so important to do a big safe surgery. One of the things that I find, you were definitely working and you had this tumor, do you find that you had problems with working or was working more therapeutic and does continue to be part of your recovery?

Craig Russell:
Well, interestingly, because it was growing for so long and so slowly, I think it's half a millimeter a year or something, they grow or whatever. I've literally worked with this thing in my head all over the world. I mean, the play Mark Antony in Queen Cleopatra, sword fighting in the Sahara Desert with a brain tumor in my head. I had loads of things that I've done with this thing. And looking back now, I remember things I couldn't quite hold onto at the time. "Why do I keep forgetting that thing?" And now I think, "Oh well yeah, it's because there was something getting in the way perhaps." But it didn't really become a problem for me until I did what's called a pickup day. Now to those of your listeners who don't know what that is, I'd done a project a few months before. We needed to do a pickup day, film some extra stuff. And that was in the January last year around just before the doctor sent me off for a CT.
I remember the crew came up to me and said, "Hey Craig, how are you? Nice to see you." And I said, "I'm so sorry, I don't think we've met before." And he said, "It's me Jake. I was working with your wife a few weeks ago." "Oh God, of course you were." I pretended. I had no idea who he was. He went, I phoned my wife and she said, "It's Jake. You know Jake." I had no recollection of ever meeting this guy, Jake. Turns out I'd met him lots of times. So I think that was the only... Right towards the very end, that's when it started to become a problem because it really then was affecting my memory in a big way. Then I had the operation in March here, and I'm pretty sure it's the same in the U.S. and most places now around the world, actors now have to do a lot of self tapes, which again, to those of you don't know what that is, you don't have to leave your house anymore to go and do an audition.
You can either go to a studio or record it at home, film yourself doing the audition. And two weeks after they took the tumor out, I did my first self tape and yeah, I say, "Well, it was all right." Because to look at the camera front on, you'd never know what was going on behind. The back of my head looked like Frankenstein's monster, but the front of it, I looked quite normal. Yeah, I didn't get the job. Probably a good thing at the time. I wasn't quite ready. But then I started working in July and I've worked solidly since.

Dr. Peters:
Well, I'm just glad that you're here now and I'm also glad that you continue to work and I think that's a really good message to our patients because I think that having... Just because, I take care of patients and their loved ones that are dealing with this disease is... It can be very isolating and they worry about whether they can go back and do, not only their job, but also the activities that they love and be with their family. So I just want to say thank you for being an example that you really got back to work. You got back to doing the things that you love to do and being with your family. Can you talk a little bit more about the family? And it sounds like your wife is a very important person that helps you, at the beginning of this journey and continues to move forward. How has it been to now interact with your family and friends, knowing that you have a brain tumor diagnosis and that you've been through this brain surgery?

Craig Russell:
And again, I accept that for some of your listeners, they won't be as lucky perhaps as I am in that my diagnosis was as good as I think as it could have been. I accept that I'm lucky there, but I'm also incredibly lucky in that I do have a support network. My wife is, from the very first moment, she has been a complete rock. There for me 100%, doing everything. I'm still not allowed to drive, so my wife still does all of that. She does everything and obviously because my memory was affected, she's in charge of so many things. I do what I can, of course I do. I'm able to do physical things. I'm able to do the housework and the cooking and the cleaning and that sort of stuff. But my wife has definitely to up her workload. Which, obviously, with every passing week that I get better and better, it gets lesser and lesser. And in fact, for months, all she has to do that I can't do, is drive. So there's that.
I also accept that I'm incredibly lucky that both my parents are alive and they were also just a source of strength. I've got a great circle of friends, all of whom show me such terrific love and I know that I'm lucky there as well. But what I would say is, don't underestimate what you have. Don't take for granted any friendship or any relationship you have because one day, and hopefully this will never happen, but one day it may well be tested. And it's when something like this happens that you really learn the value of everything, not just life, but of everything. For those of your listeners who do have a brain tumor, I know where you're at. I am laughing. I am making jokes of it, but don't for one second think I've forgotten how hard it is.
Never underestimate what you're going through. Just because I'm here talking about it in a positive way, it doesn't mean you have to be positive. It's not easy for everyone. As I said near the start, I'm annoyingly positive and that doesn't work for everyone. And if you are someone who is struggling with this, my heart goes out to you and all my love because this can shake, not just the sufferer, but the complete unit. This can shake people to the very core, and life can be hard enough. You throw something like this in the mix and you think, "That's it. It's Over." But trust me, it is not over and it's been proven. There is now enough scientific evidence to back this up. The more positive you're able to be about something, the quicker your recovery will be. That is now a fact. And again, I know it's hard.
And you don't have to listen, I'm just an actor, what do I know? Nothing. We all heal in different ways at different times, but if you can just try and find the love, the positivity, the enjoyment in any given situation, things will happen quicker for you and things will be a little bit easier. I wholeheartedly stand by that and endorse that. And some of the consultants I spoke to at the hospital, they do as well. So for me, it's just a reminder that life is great and you should enjoy every second if you can.

Dr. Peters:
I completely concur. I say, what you're bringing to our listeners is really a message of hope, and I agree with you all. Brain tumors are different. You have a certain experience, but I would say sharing your experience will bring so many people hope and clarity about what they're going through. I just want to thank you so much. I'm sure our listeners will be so excited to hear about your experiences and your positive attitude and your hopefulness. I'm also part of that positive club, so I think we have a lot of positive energy for our brain tumor patients and our listeners. Absolutely.

Craig Russell:
Yeah.

Dr. Peters:
So thank you so much and I just want to thank our listeners and Craig, I wish you the best for 2024 and beyond.

Craig Russell:
Thank you so much. And I send nothing but love your way, Katie, and to all your lovely listeners, thank you for having me on.

Dr. Peters:
Thanks.

Dr. Correa:
We are excited to start taking your questions and feedback and sharing those responses here with you on the podcast. You can also email or record an audio message and send it to blpodcast@brainandlife.org. And of course, you can also reach the Brain & Life team at BrainandLifeMag. That's M-A-G.

Dr. Peters:
Hello Brain & Life Podcast audience, thank you for joining us today. I'm your podcast co-host Dr. Katy Peters, and I'm honored to introduce our medical expert, Dr. Jonathan Sherman, who will be discussing the management of brain tumors, including meningiomas via his expertise as a neurosurgeon. Dr. Sherman is a board certified neurosurgeon specializing in surgical neuro-oncology. He obtained his medical degree from the Medical College of Georgia and completed his neurosurgery residency at the University of Virginia. After completing his residency, he completed a fellowship to further sub-specialized in surgical neuro-oncology at Memorial Sloan Kettering Cancer Center. Following his fellowship, Dr. Sherman joined as the director of Surgical Neuro-Oncology at George Washington University. Later he joined the faculty at West Virginia University as an associate professor of Neurosurgery, as well as being the director of Neurosurgical Oncology Eastern Campus.
In this effort, he currently leads a multidisciplinary team and robust translational research program as well as a clinical trials program. He has several clinical research interests in neuro-oncology and has published greater than 130 manuscripts in peer-reviewed journals. He has also co-authored the textbook Cold Plasma Cancer Therapy as well as 17 book chapters. He is a pioneer in the use of new healthcare innovations such as virtual and augmented reality to improve the outcomes for his patients. He is perhaps my favorite neurosurgeon and one of my close friends and colleagues. So, welcome to the Brain & Life Podcast, Dr. Sherman.

Dr. Sherman:
Thank you Katy. Thank you for that wonderful introduction. I'm excited to be here today.

Dr. Peters:
And I'm overjoyed. Finally, we've got a neurosurgeon on the Brain & Life Podcast. We usually have neurologists, we've had a couple psychiatrists, so you're elevating our level of clinical expertise. So thank you.

Dr. Sherman:
Well, I sense a lot of pressure being the first, but I'll do my best for you.

Dr. Peters:
Okay, so we'll get right into it. We interviewed an actor who has a meningioma. Can you tell us from, really, your perspective, what is a meningioma?

Dr. Sherman:
A meningioma is a tumor that doesn't come from the brain itself. It comes from the covering of the brain called the meninges, and so OMAS tumor, so meningioma. There are certain cells within those coverings that for whatever reason can actually start growing. And a lot of patients actually will have these and they'll never know it unless they... These days, if you cough wrong or sneeze wrong, you get an MRI and we find these things. I'd say the most common tumor that I see that it's benign, are meningiomas that patients show up and then we follow. And there are times where these need to be removed. And so that's what happens. Again, they can grow in various different spots in the brain.

Dr. Peters:
Again, that's those incidental OMAS because we do MRI or CT and will catch these tumors. Are there certain types of people that are more likely to develop a meningioma?

Dr. Sherman:
There's a couple different categories of people that could fall into that group with increased risk. One, patients that have had radiatio.n back in the day, it used to be very common for kids that had ringworm, also called tinea capitis, that would get radiation to the scalp. And those kids are more likely or increased risk later in life to have meningiomas. Women, for whatever reason, are more common to show up than men with meningiomas. It's thought that it could be hormonal, especially with a certain type of hormones like progesterone and estrogen, which are very common to be increased in pregnant women. So actually patients that incidentally, we find meningiomas, there is a risk that those could grow during pregnancy. Those are two categories of people that we see. Oftentimes it's just as we get older, if there's something that's going to be benign, that just grows. Meningiomas are very common where we see them in their benign. So just older patients. It's not uncommon to see small growths that are in fact small meningiomas.

Dr. Peters:
I have seen some of those patients that have had radiation exposure that developed these type of tumors. So thank you for explaining that to our audience. Now, what are the neurologic symptoms of a meningioma?

Dr. Sherman:
As I said, meningiomas can occur in many different parts of the brain. They can also occur in the spinal column as well. Depending on where they are will really dictate what the symptoms are. If they're near the vision area of the brain, you can see patients that have changes in their vision. They might see double with double vision, they might have blurry vision. One of the more common things patients can present with are headaches. Usually they're worse in the morning. It's just how patients present when they're laying flat. Typically the pressure in the brain is just more than when you're sitting upright. So patients can have morning headaches, which are more common in tumors such as meningiomas.
They can also be near the hearing area of the brain, so you can get hearing loss or a condition called tinnitus or ringing in the ears, that can happen. If they're in the frontal area of the brain or in an area of the brain that relates to memory, you can get memory loss for certain patients if they're large enough or causing irritation in the brain. If they're the front base part of the brain, right where the smell center is that's coming out of the nose, you can get loss of smell. If there's irritation in certain parts of the brain from the meningioma, they can result in seizures. They can also grow near the motor area or sensory area in the brain, so you could get some weakness in the arms or legs, also if they grow in the spinal column. And another area is language. If they grow near a language center, then you can see patients that present with some speech problems. As I said, depending on where they are really dictates what the symptoms are and how patients present.

Dr. Peters:
I always say that things in the brain such as tumors, it's all about the real estate. What is it next to? And it sounds like you have to be ready for really anything because it can occur in multiple different parts of the brain. I believe for our celebrity that we interviewed, he had some issues with his vision and some confusion and that led to his diagnosis. But it was lucky that he got caught by a provider and was sent to a great neurosurgeon for surgery. You are a neurosurgeon, so can you tell us about your role? We know that you're doing the surgery, but describe the ins and outs of your day job.

Dr. Sherman:
Yeah, so I liken myself, which is the coin phrase that you brought up as a neurosurgical oncologist where we're really working with our medical oncologists, our neuro oncologists, our radiation oncologists to help manage patients. So it's kind of a team effort. On my day-to-day, the average, we spend more time in the clinic seeing these patients and then finding that additional time to be in the operating room and moving these tumors. I kind of split it more, probably sixty-forty where I'm 60% in the clinic, 40% in the operating room where we see these patients. We spend a long time explaining to the patients and their family about the condition, really breaking it down in layman's terms. And then we spend additional extensive amount of time preparing for surgery. Kind of that old, in your mind's eye, visualizing and prepping for surgery.
Now I do it in a virtual environment where I don't have to do it in my mind's eye anymore. But I'll plan out that surgery, pre-drill virtually, the surgeon. How I'm going to remove part of the brain, the skull that overlies the brain, how I can get there. Minimize any injury to the normal brain tissue. So we plan all that out and then we spend that time in the operating room. Some of these surgeries can be three hours. The longest surgery was 17 hours and it was an engeoma, just because we have spent a long time manipulating and getting around the brain tissue so we don't injure it. And then in addition to that research, I work with undergraduate students, graduate students, medical students and residents to train them, be good assistance in the operating room and prepare them to be doing the same surgery one day. So we work with our colleagues on doing that. Then in our free time, actually work with our medical and radiation oncologists on clinical trial development and working with these patients that we're going to put into a trial.
Some of them are surgical trials and improving how much we can remove. So I'm blessed to have a variety of very interesting and exciting things to happen on a daily basis for me to be in a variety of different locations, including the clinic, OR and in the lab.

Dr. Peters:
It sounds like you get to collaborate with colleagues like me, neuro oncologists.

Dr. Sherman:
Yeah, that's a lot of fun. I mean, to me, we can talk about this at national meetings. We can, if I have a question about what's available, if I don't have a trial available at my institution, I can call you, which I've done many times. And especially when I was in the DC area, I called some of my colleagues at different locations around the district to see what's available and what we're thinking. And sometimes we have actual, almost like case conferences, between different specialists. Like friends of mine that are also neurosurgeons that do this and thinking of what's the best avenue to minimize any damage to normal tissue and things like that. So I get to work with a lot of wonderful colleagues to help really find the best way to remove tumors and manage patients afterwards.
And sometimes they need rehabilitation and figuring out how to get patients to the right place to do that. So yeah, it's a team effort.

Dr. Peters:
Yeah, it is definitely a team effort and I am really excited to learn more about the hot topic, virtual reality. Can you just describe more in-depth of exactly what you're doing with virtual reality for brain tumor patients?

Dr. Sherman:
Yeah, so in 2015 I learned about this company called Surgical Theater, and I was very concerned about conflict of interest with any company. So I made sure that I was never going to be a consultant with any of these companies, including that one. But I said, the best thing we can do is improve the outcomes of our patients. So what I learned about this company is we could actually create a patient engagement room where patients can come in, we can take their own imaging and reconstruct it. And so you get a 360 degree reconstructed image of their own skull and brain and where the tumor is. And what I used to think of how well I explain patients with my hand motions and things like that in two-dimensional imaging. Now we actually explain that using our three-dimensional imaging in the operating room.
So we have a patient engagement suite, we have a tech that pretty much breaks down all of the imaging for every patient, and then it links to the operating room. So we can actually, after the patient leaves, we can plan the surgery. Then we go in the OR and we have a navigation, it's like GPS for your brain. So we can navigate all that while we're in the operating room. So it's like we have a [inaudible 00:33:35] that will tell us, "Yep, this is where we want to be. This is where we are." We do that surgery and then we use the virtual system for that. We can actually have the 360 degree reconstruction in the OR. We can put the headset on again right before surgery and just get that last plan in our mind's eye and what we're seeing. And then afterwards we bring the patient back and we make a video.
So everyone gets a CD. Anything on the microscope that we use, we can actually use that. If we're using the microscope, we can do an augmented reality overlay. We can look at the brain and through the brain we can see a augmented view of what the tumor is. So we don't have to move the brain yet. We can say, "Oh, if I move the brain here, I'm on this part of the tumor. If I move the brain here..." And we can see that through a microscope. We can put that back onto our video so that the patients can see it and then they go home with a CD that shows kind of what our pre-plan was, what we saw in the operating room and what our post-op imaging looks like. And then they have that, which patients always want to see what we did. Now we have a better way of doing that. So that's where we incorporate augmented reality and virtual reality. So lots of different things we're doing.

Dr. Peters:
I really enjoy the fact that you're partnering the patients with this. I can imagine that they really feel a part of their healing process.

Dr. Sherman:
Engaging them is critical, right? You want patients to not feel like they're not part of the team. They're kind of passerbys in their own life as they're getting prepared for surgery. So by engaging them where they can really look at imaging and say, "All right, well this is really my brain and this is really what you're doing." And sometimes patients or their families, some might not understand it as good as others. So we ask family members to come, be part of the team too. That, is there someone in your family that might better understand this? Let's have another clinic visit and bring them in so that they can be part of that. That way the patient's engaged, the family members that are going to help maybe take care of them for a short time after surgery, are engaged. And then that's why we call it patient engagement because patients, we know if they have a more positive disposition going into a procedure, they actually do better.

Dr. Peters:
I completely agree and I love how you're elevating that patient experience and really in a way, moving it from that 2D, what is believed to be happening to really a 3D virtual reality. And you mentioned the caregivers and the loved ones. And in my interview with actor Craig Russell, his wife was instrumental in getting him to the physicians that actually ultimately made his tumor diagnosis and then perform the neurosurgical procedure. Now, what tips can you share with caregivers of patients with brain tumors?

Dr. Sherman:
I think the key is that you know your family members better than anybody else. And it's very common that even things that we see in the clinic sometimes that are subtle, we wouldn't know the difference between a patient that doesn't have a brain tumor. I mean, the obvious things like weakness and major speech impediments are the easy ones to diagnose. It's common in middle-aged patients, young patients, but really in elderly patients where those subtle memory changes, those personality changes where a patient maybe typically was easygoing and suddenly it's very anxious. Or never yelled and now suddenly is getting angry all the time. Those are the things that the patient's family members can notice. I think that the sooner we find out about these things... As I said, these things grow slowly, but as they get bigger, they're more challenging. So the sooner we know, the better patients can be and the quicker we can get them to treatment.

Dr. Peters:
I completely agree. And I also want to share some last thoughts of hope with our listening audience. Being diagnosed with a brain tumor is often extremely scary. Patients are very fearful, so are their loved ones. Can you give us some hope of the future of, I guess, treating brain tumors or maybe even hopefully someday going for a cure?

Dr. Sherman:
Yeah, I think the majority of meningiomas are curative type tumors. They're non-cancer tumors. I think the truth is there's so many different trials and treatments that, in an ideal world, one day by imaging we can identify a tumor and by some non-surgical treatment, take my job away, which I'm fine with. It wouldn't even have to do surgery. We can just give a medication and have a minimal risk to the patient. I think with the science of understanding the various genes and various things that cause tumors to happen, will give us a better chance of treating them as we move forward. So yeah, we're in a great place in the world of neuro-oncology right now with all the different smart people out there trying to figure out how to best treat these tumors. And with a real focus, especially on the connectomic side of understanding, if we can understand where the important structures are in the brain, we can minimize injuring them and patients do well.
So as we're studying these areas that we're just still learning about, I think over the next 10, 20, 50 years, the outcomes are going to even be better than they are now, and we're going to be minimizing how much surgery we have to do. And with less invasive, we're going to have better outcomes. I think we're in a great place right now to do that for our patients.

Dr. Peters:
Well, thank you so much, Dr. Sherman, for your insights and your expertise with us on brain tumors, particularly meningiomas.

Dr. Sherman:
Well, it's my pleasure, Katy. I really appreciate the opportunity. Dr. Peters, one of the top neuro-oncologists in the country, always enjoyed chatting with you, and I know that we'll be working together with a lot of patients in the future. So look forward to that, and I just really appreciate the opportunity to be part of this podcast today.

Dr. Peters:
Absolutely. You can come back anytime and thank you to our Brain & Life Podcast listeners. I'm wishing all of you brain wellness.

Dr. Correa:
Thank you again for joining us today on the Brain & Life Podcast. Follow and subscribe to this podcast so you don't miss our weekly episodes. You can also sign up to receive the Brain & Life magazine for free at brainandlife.org. Don't forget about Brain & Life in Espanol.

Dr. Peters:
Also, for each episode, you can find out how to connect with our team and our guests along with great resources in our show notes. We love it when we hear your ideas or questions. You can send these in an email to blpodcast@brainandlife.org and leave us a message at 6-1-2-9-2-8-6-2-0-6.

Dr. Correa:
You can also find that information in our show notes, and you can follow Katy and me and the Brain & Life Magazine on many of your preferred social media channels. We are your host, Dr. Daniel Correa, connecting with you from New York City and online @NeuroDrCorrea.

Dr. Peters:
And Dr. Katy Peters, joining you from Durham North Carolina and online @KatyPetersMDPhD.

Dr. Correa:
Most importantly, thank you and all of our community members that trust us with their health and everyone living with neurologic conditions.

Dr. Peters:
We hope together we can take steps to better brain health and each thrive with our own abilities every day.

Dr. Correa:
Before you start the next episode, we would appreciate if you could give us five stars and leave a review. This helps others find the Brain & Life Podcast. See you next week.

Actor Craig Russell on Staying Positive during his Brain Tumor Diagnosis

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