Six mornings a week, as neighboring shop owners are just opening their doors for business, John Caparella faithfully stands at the stove of Mother Anna’s, his family’s 83-year-old North End Italian restaurant, making tomato sauce. From scratch.
Watching John, 73, you would never know that just a few months ago, he underwent four-hour surgery to remove a golf-ball-sized brain tumor. The need for the procedure snuck up on John.
After feeling slightly light-headed for months, John instinctively knew something wasn’t right and asked his primary care physician for a brain scan. Two weeks later, John’s PCP called to say the MRI showed a pituitary tumor that would likely require operating, and that he would be referring him to Dr. Julian Wu, Associate Chairman of Neurosurgery at Tufts Medical Center.
Understandably nervous, John brought his wife, Anne, and his brother, Bob, to the first appointment with Dr. Wu. From the moment Dr. Wu sat down to talk with them, John says, “everyone felt confident we were with the right doctor. He explained everything so clearly, showed me the MRI, told me exactly what he was going to do.”
Wu explained that he would remove John’s pituitary tumor, or adenoma, via endoscopic neurosurgery—inserting a scope through the nostril, to access and remove the growth with no incision whatsoever. Minimally invasive endoscopic procedures like this exhibit the cutting edge of neurosurgery. Years ago, Wu says, removal of a pituitary tumor would have required more involved surgery.
According to Wu, this type of brain adenoma is typically treatable via surgical removal and almost always benign. “About 10,000 pituitary tumors are diagnosed in the U.S. each year,” says Wu, explaining that while some cases (such as prolactin-secreting tumors) respond to medication, recurrent tumors often require Gamma knife treatment (an advanced radiation for small-to-medium growths), and large tumors are usually treated with surgery.
While the recommended surgery wasn’t an emergency, Dr. Wu strongly advised John to have it done. And yet, John remembers, “He didn’t pressure me. It was May when I met with him, and I asked him if I could wait until after the summer”—a busy time for the family restaurant. Dr. Wu said that would be no problem, and scheduled the surgery for September.
Performed by a surgical team comprised of Wu, an anesthesiologist, nurses, residents, and an otolaryngologist (the ear, nose and throat specialist providing access to the tumor), the operation “went like clockwork,” John remembers. “I was in the hospital for four days, and everything with the hospital itself—the nurses, the medical team…you couldn’t ask for anything better. Even the fella’ who brought up the food…the fella’ that swept the floor…” John pauses, gratitude in his voice. “Everybody was so nice. They really did a great job.”
Following a mandatory six-week post-op recuperation—insisted upon by Dr. Wu and Caparella’s sons—John returned to the restaurant as though nothing had ever happened. “I went back to normal—going in, making the sauce, doing everything I have to do.”
Regular follow-up appointments have proven time and again that the operation was a great success. “John has done very well,” says Wu of the surgery and subsequent visits. “I typically see each patient about a month post-op, at three-to-six months with an MRI, and then yearly if the patient is stable.” In January, Wu compared the results of a new MRI to John’s original scan—visual proof that the tumor is gone.
Today, Dr. Wu says, “John’s prognosis is excellent.” While there is always a chance of relapse, “these are slow growing tumors,” says Wu. “Sometimes they can grow back so they need to be monitored by his endocrinologist and myself.”
Though his routine is back in its regular rhythm, John will always be grateful to his surgical team and moving forward, plans to make Tufts MC his one-stop-shop for all medical needs. “To me, it [this experience] was a blessing, and I couldn’t thank my PCP enough for referring me to Dr. Wu.”