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I was just sitting in my office one day and it felt like all of a sudden on my
left side, I went completely underwater like my hearing just went.
And when they looked at the MRI, they saw that I had an acoustic neuroma.
That's when I started doing research on where would be a good place to go and
I ended up here in Duke.
>> Skull base tumors occur underneath the brain, so
in the space where the brain rests on top of the skull bones.
Some ability that you have that you cherish is governed by some portion of
your brain that can be affected by a tumor.
>> When we're talking about lateral skull base tumors, we mean things that are in
and around the ear and affect hearing, balance, and facial function.
>> The most common tumor we see in the lateral skull base is known as an acoustic
neuroma or vestibular squanoma.
The second most common is a meningioma.
Both of those are benign tumors.
Because they arise near the structures of the inner ear patients often present with
hearing loss.
>> So once they come in, they usually will have a hearing test.
>> Cowboy, baseball.
>> And what's called an ENG, a vestibular test to test their balance.
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>> Hear them but can't undestand them.
>> The skull base team really places the patient experience as of critical
importance, and the nurse navigators is really central to that mission.
>> I'm in communication with both the ENT and the neurosurgeon,
I work with both of them.
>> We have one person who is there to help the patient through the entire process.
I always tell patients, she is gonna be your new best friend.
>> What we do is we are there as a liaison and a coordinator and a point person.
We see them from their first initial consult.
We help educate them.
We help in some cases reassure them.
>> Trish wanted to say hello.
>> Hi Deb.
>> Good to see you.
>> Good to see you too.
>> [LAUGH] You are awesome.
>> Thank you.
>> It enables the patient to have one point of contact for somebody that knows
exactly what they're going to have done, what they're going through.
>> The nurse coordinator is just somebody it's easy to reach out to and
talk about just even planning on what hotel to stay at,
what should I tell my family things like that.
>> In our program, we have a very strong philosophy that the quality of life is as
important as the quantity of life.
And so, every time we see a patient with a skull base tumor,
we spend some time getting to know the patient and
getting to know what's important to them, what gives their life meaning.
And then we can use that information to talk together and
decide as a team what would be best for that individual person.
>> We want to match the threat posed by
the tumor to the risks that accompany the treatment.
>> Historically, many of these tumors were operated on, but there has been a trend in
recent years to observe more and more of these tumors since they are benign.
With regards to actually treating the tumor, there are typically two options.
One is microsurgery to go in and remove the tumor.
The good thing about this treatment option is that,
we are able to get rid of the tumor.
A lot of patients like knowing that the tumor has been removed,
they don't have to think about it anymore.
>> Dr. Francis spent a lot of time with me going through here's all the options.
And it really came down to at this point, because of the size of the tumor,
it was surgery.
>> The third option in treating these tumors is known as stereotactic radiation
therapy.
>> And our goal is really to prevent them from growing and causing more problems.
Basically our goal is to stop it dead in its tracks.
>> I felt very comfortable and confident that they listened to me and
that they explained everything thoroughly.
They had the level of experience.
These are the type of things where it's not very common.
So you want somebody who's has a lot of experience doing these.
>> They're rare but they're not rare for our team here and I think it's important
for a patient to seek out a center where the tumor isn't rare.
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