The gift of a tumour-free life

Nancy Hotson was excitedly preparing for the arrival of her second child when she felt a strange sensation creep across her face.

“I just felt these pins and needles,” Nancy says motioning to the right side of her face. “I figured it had something to do with the pregnancy.”

The uncomfortable tingling continued to be a nuisance, even after Nancy gave birth to a healthy baby girl named Melanie in 2011. Tests on her sinuses and hearing turned up nothing out of the ordinary. Then a neurologist suggested that a magnetic resonance imaging (MRI) scan could get to the bottom of the problem.

“I went to my follow-up appointment thinking this is nothing, it’s just a formality,” she says. “Instead, the neurologist said, ‘We’ve found something in your head. It’s a tumour and it’s growing’.”

Nancy’s MRI uncovered a barbell-shaped tumour called a trigeminal schwannoma at the base of her skull.

“I had a four-month-old baby, and a two-year-old at home. It was terrifying. Rapidly growing tumours are never a good thing. I said ‘Please put me in touch with the best neurosurgeon possible’.”

Fortunately for Nancy, her next appointment was with Dr. Fred Gentili, a neurosurgeon at the Krembil Neuroscience Centre (KNC) who specializes in skull base surgery. This surgical approach is considered high risk, since it targets tumours located underneath the brain.

Dr. Fred Gentili

“This type of surgery is very difficult because it goes to the most difficult regions to reach in both the brain and skull,” says Dr. Gentili. “The challenge is accessing a tumour while avoiding the critical blood vessels and all of the nerves that are packed in there.”

Over the last 30 years, Dr. Gentili has pioneered a host of complex treatments for tumours located in difficult to access places. His endonasal surgical approach has garnered worldwide attention and led hundreds of medical students and other surgeons to pursue training at KNC.

“The first time I met Dr. Gentili he said, ‘There’s no need to worry, everything will be fine’. He is so calm,” says Nancy. “At the time I almost wanted him to be more concerned, but now I know it’s because he’s so capable.”

Despite Dr. Gentili’s assurances, Nancy began to prepare for the worst. She put together a parenting wish list for her husband, which was designed to help him care for their children should something go wrong.

“I was planning for the worst-case scenario. I had two children and needed to consider, practically, how are they going to be cared for.”

On Oct. 27, 2011, five months after her diagnosis, Nancy underwent craniotomy surgery at KNC under the direction of Dr. Gentili. The 12-hour surgery was a success and Nancy was released from hospital less than a week later, just in time for Halloween.

“I was so excited because trick-or-treating was starting,” she says. Son Bradley dressed as a monkey while daughter Melanie went as a ladybug. “I was able to get to two houses before my family came out and brought me back inside. But it was the first step and it felt great.”

While the bandages came off a few weeks later, some of the emotional and psychological effects lingered. It was during this period that Nancy decided she needed to give back to UHN and Dr. Gentili.

“He’s so unbelievably skilled as a surgeon, his determination and expertise allowed him to remove the entire tumour, even though it was a difficult shape. Because of this, my risk of tumour regrowth is negligible, which is the best outcome a patient can have.

“Dr. Gentili gave me the gift of living a healthy tumour-free life.”

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