It Takes a Team: How Collaborative Care Treated a Brain Tumor

Christopher McNamee just wanted to be a good uncle.

He loved playing with his rambunctious young nephews, but, in his early thirties, he found himself too winded to keep up. This was a concerning development for Chris, who plays an important role in one of his nephew’s care.

He was experiencing other troubling symptoms, too: weight loss, hair loss, vision problems, sexual dysfunction, and extreme exhaustion. In the dead of winter, he’d get out of his car in a t-shirt and be drenched in sweat by the time he got inside.

Worsening Symptoms and Few Answers

For a while, Chris attributed these changes to aging and maintaining a busy lifestyle. He became used to the fatigue and continued to push through. He’d always had 20/20 vision, but both his parents wore glasses, so he assumed his failing eyesight was genetic. Still, something didn’t feel right.

Chris had always been responsible about his health, so he went to his long-time primary care physician to try to find the root of the problem. Blood tests revealed an imbalance in his thyroid, so he began medication to attempt to correct it.

At subsequent checkups, his numbers continued to worsen, so his doctor increased the dosage. This cycle continued several times. In the meantime, his symptoms progressed. This went on for a few years until a change in insurance prompted Chris to find a different practice.

New Doctors and a Surprising Diagnosis

Chris’s new physician, Dr. Christopher Zipp of Atlantic Health ran a different battery of bloodwork, which returned with additional abnormalities in his thyroid numbers. While it could have been a fluke, the doctor advised repeating the test in a few weeks. Chris put it off for a few months, but his condition continued to deteriorate.

Finally, he returned for more lab work, which came back with concerning news: his hormone levels suggested a tumor. An MRI confirmed the diagnosis: a non-cancerous walnut-sized growth on his pituitary gland. Despite this, the doctor was optimistic.

“I remember he said, ‘You should be good by the Fourth of July,’” Chris recalled. That was in December 2023.

Over the next few months, Chris saw several specialists, including endocrinologist Dr. Elkin Nunez and otolaryngologist Dr. Giant Lin at Summit Health, as well as Dr. Yaron Moshel, chairman of neurosurgery at Morristown Medical Center and neurosurgeon at Atlantic Brain and Spine (ABS).

Dr. Moshel explained that the type of tumor Chris had was relatively common, and smaller ones could be treated with prolactin-suppressing medication. Unfortunately, Chris’s was large and sat on top of his optic nerve, causing him to gradually lose his vision. Surgery was his best option.

A Team Approach to Tumor Treatment

One of the standout features of the Brain Tumor Center is its multidisciplinary approach, uniting specialists from all necessary fields to collaboratively review each case and create a personalized treatment plan.

Chris was impressed by the seamless coordination between all the different specialists. They shared his records, kept his medications up-to-date, and were even able to get him appointments ahead of schedule. The doctors were always aligned on his care.

“The whole team was phenomenal,” he said. “They just kept telling me, ‘Don’t worry, we’re going to take care of this.’”

Even some of the unusual elements of Chris’s tumor – its size and the way it had grown – didn’t faze the team. He appreciated Dr. Moshel’s reassuring reminders that this was all routine for them.

Collaboration in the Operating Room

The surgery took place in March 2024, just a few months after his diagnosis. Dr. Moshel and Dr. Lin performed the operation together in the specialized neurosurgical suite at Overlook Medical Center.

Using a minimally invasive trans-nasal approach Dr. Lin first accessed the skull base through Chris’s nostrils and sinuses. Dr. Lin then worked together with Dr. Moshel to open the skull base to access the tumor. Using a team approach with endoscopic technology and angled lenses that provided a view of the surrounding anatomy, Dr. Moshel was able to remove most of the mass. The removal required expert precision in order to avoid where the mass bulged in between loops of the carotid artery which capped both sides of the tumor. The tumor had been compressing the optic nerves which were cleared free of any tumor tissue during surgery.

The entire procedure took about three hours, and Chris spent several days recovering in the ICU. Dr. Lin visited him frequently, as did Dr. Moshel and his team. Elizabeth Gold, an advanced practice nurse specializing in neurosurgery, stopped by every day to see how he was doing and give him updates about his recovery.

“I’m so lucky to have doctors like Dr. Moshel and Dr. Lin so close by, let alone in my insurance plan,” Chris reflected. “Even after the surgery, I still felt like they were collaborating on what was best for me. Beth was like an angel, coming in to see me each morning amidst the buzz of the ICU.”

Chris credits his medical team for helping him get back to playing with his nephews.

Getting Back to What Matters Most

Within a couple of months, Chris felt almost back to normal. With the tumor gone, his hormone levels started to stabilize, and his vision and energy returned. Because the surgery was performed through his nose, he doesn’t even have a visible scar.

Just as Dr. Zipp had predicted, he was feeling like himself by the Fourth of July. He celebrated the holiday on a boat with friends.

Chris still sees his specialists for follow-ups, and his prognosis is excellent. “Long-term, Chris should do great,” said Dr. Moshel. “These tumors are almost always benign, and we enroll all patients with these tumors into a long-term monitoring program. Any recurrence can be treated, if needed, with CyberKnife^® stereotactic radiosurgery.”

Most importantly, Chris is back to doing what matters most: playing with his nephews. They’re looking forward to taking a family trip to the Bahamas this summer.

“Being able to take him to the beach, or chase him on his bike, or teach him the things I like to do – that feels really good,” says Chris. "My life is so much better for having met Dr. Lin and Dr. Moshel.”