Patients with a rare form of brain tumor are being kept awake during a lengthy operation so that they can talk to the surgeon and help ensure their speech faculties are not damaged.
The pioneering surgery is carried out under a local anesthetic to the scalp so that patients feel no pain. They remain fully conscious and communicative while the doctor removes tumors that have become embedded deep within the brain.
The surgery, known as awake craniotomy, has been performed occasionally on epileptic patients but very rarely on those with brain tumors. Now the technique is being used on such patients as they might otherwise have a much shorter life span.
A BBC television documentary to be screened today shows 30-year-old Adrian Theobald being diagnosed with a low-grade glioma -- a benign tumor that would nevertheless kill him through its growth without surgery.
His neurosurgeon, Henry Marsh, is the only doctor in Britain to perform the procedure for patients with these tumors. When Marsh first diagnosed the condition last autumn he had to warn Theobald that there was a risk in cutting so deep into the brain to remove as much of the growth as possible: the parts of the brain which govern speech, language or personality might be affected.
The documentary followed the fortunes of Theobald, who survived the procedure despite falling into a coma after the surgery. During the four-hour operation he had the top of his skull removed and Marsh then started to remove as much as possible of the 6cm-long growth because it was pushing dangerously into the left frontal lobe near the speech area of his brain.
As parts of the tumor were removed they were given to pathologist Peter Wilkins who carried out an immediate biopsy to ensure that it was tumor rather than healthy brain tissue which was being excised. Sometimes the tumor is too close to the other parts of the brain to know which kind of tissue is being cut out.
Marsh said the issue of awake craniotomy is "very controversial."
"I have a fairly aggressive approach in trying to remove as much of the tumor as possible. I have to make a decision about what to recommend to patients, without having any clear body of evidence to guide me. I believe that this is the right thing to do."
Although there are American surgeons who carry out the same procedure, one surgeon in Paris, one in Munich and Marsh in London do the bulk of such surgery for the whole of Europe.
At his clinic at St. George's hospital in south London, Marsh has around 100 patients but will carry out one of these operations a month.
"The difficulty is that you are operating very close to the regions of the brain that affect people's thoughts, feelings and speech. It could change their personalities forever," he said.
"You have to tell patients all the possible dangers -- but provided it is not prohibitively dangerous, I feel the work is justified."
Theobald, an insurance broker from south London, has recovered well, after Marsh managed to remove 98 percent of the tumor. He was not available for comment this weekend.
‘IN A DIFFERENT PLACE’: The envoy first visited Shanghai, where he attended a Chinese basketball playoff match, and is to meet top officials in Beijing tomorrow US Secretary of State Antony Blinken yesterday arrived in China on his second visit in a year as the US ramps up pressure on its rival over its support for Russia while also seeking to manage tensions with Beijing. The US diplomat tomorrow is to meet China’s top brass in Beijing, where he is also expected to plead for restraint as Taiwan inaugurates president-elect William Lai (賴清德), and to raise US concerns on Chinese trade practices. However, Blinken is also seeking to stabilize ties, with tensions between the world’s two largest economies easing since his previous visit in June last year. At the
UNSETTLING IMAGES: The scene took place in front of TV crews covering the Trump trial, with a CNN anchor calling it an ‘emotional and unbelievably disturbing moment’ A man who doused himself in an accelerant and set himself on fire outside the courthouse where former US president Donald Trump is on trial has died, police said yesterday. The New York City Police Department (NYPD) said the man was declared dead by staff at an area hospital. The man was in Collect Pond Park at about 1:30pm on Friday when he took out pamphlets espousing conspiracy theories, tossed them around, then doused himself in an accelerant and set himself on fire, officials and witnesses said. A large number of police officers were nearby when it happened. Some officers and bystanders rushed
Beijing is continuing to commit genocide and crimes against humanity against Uyghurs and other Muslim minorities in its western Xinjiang province, U.S. Secretary of State Antony Blinken said in a report published on Monday, ahead of his planned visit to China this week. The State Department’s annual human rights report, which documents abuses recorded all over the world during the previous calendar year, repeated language from previous years on the treatment of Muslims in Xinjiang, but the publication raises the issue ahead of delicate talks, including on the war in Ukraine and global trade, between the top U.S. diplomat and Chinese
RIVER TRAGEDY: Local fishers and residents helped rescue people after the vessel capsized, while motorbike taxis evacuated some of the injured At least 58 people going to a funeral died after their overloaded river boat capsized in the Central African Republic’s (CAR) capital, Bangui, the head of civil protection said on Saturday. “We were able to extract 58 lifeless bodies,” Thomas Djimasse told Radio Guira. “We don’t know the total number of people who are underwater. According to witnesses and videos on social media, the wooden boat was carrying more than 300 people — some standing and others perched on wooden structures — when it sank on the Mpoko River on Friday. The vessel was heading to the funeral of a village chief in