We needed to know the success rates of surgery and radiation treatment for meningioma. Chemo doesn't work very well against them (bromocriptine, possibly, but not much data anyway). Particularly for the radiation, the improvement of outcomes (if any) as radiation techniques had improved. OM and recurrence at 5, 10 and 20 years was collated from the 1950s. Preferably it would have been for skull based tumours, but such specificity wasn't available and was probably irrelevant as most meningioma exhibit the same symptomology.
From the results is was easy to determine that doing nothing could well be a very good option, as the OM after a second operation after regrowth was much higher (in all time frames) than after the first operation, so there was justification for not buying into the hysteria of the radiologists and surgeons who were insisting that it was treated immediately. Of course, they hadn't a clue about these statistics and were not remotely interested. That wasn't their job. They just cut or burn.
However, as I said, there were no control groups. Nobody had done any research that I could find as to what happens if you did nothing. The clincher was when the surgeons couldn't tell us what the results of their operations were. They just didn't do any follow up. The operation lasted 12 hours, involved the complete removal of the ear and an approach through the roof of the mouth, with significant risk of damaging arteries, the optic nerve, pituitary gland, hypothalamus and brain stem. One surgeon finally remembered that one of his patients, a woman in her mid-thirties, was leading a reasonably independent life. Whatever that meant.
So we provided a control sample of 1. After a further 17 years (when it was estimated to be about 30 years old) it was finally operated on as the facial and eye symptoms were becoming excessive, but this time as keyhole surgery for 6 hours, discharged from hospital 9 hours later, and with sufficient cauterisation, lasering and burning that the remains of the tumour are continuing to shrink - i.e. it appears to have been killed.
Expand
