David Silva's Brain Tumor Story
A Decade of Living with a Brain Tumor:
When I was 22 years old I was diagnosed with a Craniopharyngioma brain tumor. The primary side effect was peripheral vision loss. In order to treat the tumor, I decided to have Transsphenoidal brain surgery, which is the most common way to remove pituitary tumors. That year I had my first surgery at a major academic hospital in the Bay Area by a very experienced neurosurgeon, but he was not able to get the entire tumor out, and he said it would never be possible to remove its calcified roots, so the tumor came back and one year later I had the surgery again followed by gamma knife radiosurgery. But the radiation also didn’t work and the tumor came back once more. Then I had another surgery followed by external beam radiation. The tumor was left but remained dormant for nine years.
When the tumor started growing again, I had the same surgical approach for the fourth time, but the tumor came back again one year later and I had yet a fifth surgery followed by another round of external beam radiation, which I was told had a potential side effect of going blind from being over-radiated. I did it anyway because I felt I had no other options. I lost the third cranial nerve that controls movement in my left eye and eyelid but my vision remained intact. Six months later I found out that the surgery didn’t work, the surgeon was unable to remove the entire tumor and the tumor began growing again, this time at a faster rate. By this point I had been seen by expert surgeons at two different prominent California hospitals, and thought I was out of options. Surgery was no longer an option. They offered me “experimental” chemotherapy and little hope for successful treatment.
Finding Hope at Stanford:
Then I learned about a new doctor that had just joined the Stanford Neurosurgery Department, so we decided to go to Stanford to meet with him. Dr. Juan Fernandez-Miranda told me he had a more advanced surgical approach and unique expertise he was bringing to Stanford and that I would be a great candidate. He was extremely personable and I felt that he really wanted to help me. I appreciated his confidence in my case and he made me feel secure when I thought there were no other options left, so I decided to do it. In the Fall of 2018, Dr. Fernandez-Miranda and his team performed the endoscopic endonasal approach for resection of my “inoperable” craniopharyngioma. In spite of having had 5 previous operations through the nose and radiation three times, they were now capable of completely removing the tumor, including its roots, with no complications.
The hospital stay was seven days long. Stanford Hospital is wonderful, and the staff, doctors, and nurses that took care of me were amazing. Recovery took a few months and as of the latest follow-up MRIs, now eight months post-surgery, the tumor is still gone. Dr. Fernandez-Miranda was able to do what no other surgeon could, he completely removed the tumor and saved my life. Today I feel great in a way I have never felt before, I have no more headaches, my vision has improved, and the stress is completely gone knowing the entire tumor was removed. Even my pituitary gland is working well. I highly recommend Dr. Fernandez-Miranda and his team!
Written by: David Silva
Surgical footage of David Silva's procedure at Stanford. Includes voice-over explanation by Dr. Juan C. Fernandez-Miranda.
Endoscopic Endonasal Surgery for Craniopharyngiomas at Stanford
Craniopharyngiomas are tumors that arise from the pituitary stalk, a thin structure that connects the pituitary gland to the brain’s hypothalamus. Long considered pathologically benign, craniopharyngioma is now classified as a low-grade malignancy that shortens life expectancy. They are known to be one of the most difficult intracranial tumors to treat, but they can potentially be cured. The optimal treatment for most craniopharyngiomas is maximal surgical removal using the endoscopic endonasal approach. Dr. Fernandez-Miranda is a surgical innovator and world-renowned leader in endoscopic endonasal surgery, as he has developed advanced techniques and unique expertise for the successful removal of the most complex craniopharyngiomas, many considered by experienced surgeons as “inoperable” or “very risky”. At Stanford we have assembled the most talented multidisciplinary team for the successful treatment of both pediatric and adult craniopharyngioma patients.