“Only three to five percent of people with glioblastoma survive as long as I have,” he says.
Peet credits Eisenhower Health’s Farhad Limonadi, MD, Board Certified in Neurological Surgery, with saving his life. Their remarkable doctor-patient journey began in December 2013.
“I first saw Mr. Peet in the emergency room,” recalls Dr. Limonadi. “His sister brought him in because he’d undergone an abrupt change in behavior, was confused and had lost the ability to express himself or understand anything.”
Dr. Limonadi immediately ordered an MRI of Peet’s brain which revealed a tumor in the left temporal area, close to the area that controls speech, and significant swelling in the superior temporal gyrus, which is involved in auditory and speech processing, accounting for his inability to comprehend.
“We gave him high-dose steroids which helped to improve his speech and comprehension,” Dr. Limonadi says. “Then we performed a stereotactic brain biopsy to obtain tissue samples of the tumor.” In this procedure, imaging is used to precisely guide a thin needle as it is inserted into the brain to extract tissue that is examined under a microscope.
The biopsy showed that Peet had glioblastoma multiforme, the most aggressive type of brain tumor. About 13,000 Americans are diagnosed with GBM each year and it accounts for nearly half of all primary malignant brain tumors. Surgery to remove the cancer, followed by radiation therapy and chemotherapy — the gold standard treatment for this type of cancer — was recommended.
“I immediately started looking around the country for a surgeon,” Peet says. “As it turned out, I learned that I already had one of the nation’s top neurosurgeons right here at Eisenhower.”
On January 29, 2014, Dr. Limonadi performed what’s called an awake craniotomy with brain mapping and cortical stimulation. When a tumor is near an area of the brain that controls critical functions such as speech and language — as Peet’s was — an awake craniotomy is the best way to pinpoint and safely preserve these abilities.
During this procedure, the patient is awakened during surgery and helps “map” their own brain function through a series of neurological tests. The neurosurgeon stimulates the part of the brain near the tumor by sending an electrical current down the nerves. At the same time, the neuroanesthesiologist engages with the patient to test their ability to respond to questions or commands, assessing whether the stimulation affects the patient’s neurological function. This guides the neurosurgeon as to how much brain tissue he can safely resect (remove).
Dr. Limonadi and the neuroanesthesiologist take time to learn what’s important to each patient in order to personalize their neurological exam during surgery and talk about the things that are important to the individual patient.
“What Mr. Peet talked about most during surgery was his children,” Dr. Limonadi says. “It was quite touching to hear him talk about how much his kids mean to him while I was operating on his brain. I am always aware of how each of us affects people we come in contact with as our timeline crosses, however, in that moment it became so vivid and real how I was going to affect not only Mr. Peet’s life, but also his children, as they were affecting mine.”
“We walk a fine line in these procedures,” he adds. “Mr. Peet is a relatively young man and I wanted to be as aggressive as possible with the resection, but not too aggressive to cause any functional damage. I wanted him to see his children grow up.”
The 7 ½-hour operation was successful. Peet has some memory issues and hesitancy in his speech but is able to maintain an independent life and, most importantly, raise his children. “Hey, part of my brain is gone,” he says. “I write things down so I can keep track of what’s going on.” He also has a circle of supportive family and friends.
Peet’s three children — a 14-year-old daughter and 11-year-old twin boys — are “half me and half egg donor,” he notes. Before his late husband, humanitarian Earl Greenburg, died of melanoma in 2008, Peet set things in motion for them to have a family. “The major part of my life today is my kids,” he says.
After his brain surgery, Peet went on to undergo radiation therapy and chemotherapy overseen by his oncologist Amy Law, MD. He continues to see her every three months for imaging to monitor any potential recurrence of his cancer.
He also sees Dr. Limonadi once a year on January 29 — the anniversary of his surgery.
“He and I will sit down and just talk for 30 to 45 minutes,” Peet says. “It’s always a wonderful conversation. That he takes this time for me, it blows me away.”
Dr. Limonadi feels a real connection to Peet as well.
“I truly believe that my fate and that of my patients are intertwined,” he says. “I had a sense of familiarity with Mr. Peet from the very beginning. We entered this earth in the same month and year, and I feel quite blessed to have had a positive impact on his life as he has had on mine. It’s a pleasure and an honor to continue to be part of his life.”
While Peet has defied the statistical odds for surviving this type of cancer, Dr. Limonadi is not surprised.
“I believe that patients with cancer need to experience life without fear or pain, and to live life with hope,” he says. “That’s why I typically don’t share statistics with my patients. They reflect median survival and averages, and I tell my patients that most of us are not averages in any other part of our lives, so why should we consider ourselves average as to when we leave this earth?”
David Peet gratefully concurs.
For more information about Eisenhower Neuroscience Institute or for an appointment, call 760-837-8020 or visit EisenhowerHealth.org/Neuro.