Health
Florida brain tumor patient plays guitar during his surgery: ‘This is wild’
The idea of having brain surgery while awake might seem amazing enough — but one Florida man took it a step further and played the guitar while doctors removed his tumor.
The neurological team from the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine wanted the patient, Christian Nolen, to play notes on the instrument so they could evaluate and protect his manual dexterity while being as aggressive as possible in removing the tumor.
The surgeon and patient both spoke with Fox News Digital about the experience.
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Nolen, who is an avid guitar player, had a tumor on the right frontal lobe of his brain that was starting to cause symptoms.
“Christian was having issues with the left side of his body, particularly his left hand,” Ricardo Komotar, M.D., director of the brain tumor program at Sylvester, told Fox News Digital via Zoom.
“He was noticing issues with his dexterity that affected his ability to play the guitar.”
The neurological team from the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine asked Christian Nolen to play guitar during his surgery so that they could evaluate and protect his manual dexterity. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
Nolen needed surgery to confirm the diagnosis and determine the type of tumor — as every tumor has different treatment options, Komotar noted — and also to remove as much of it as possible.
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The surgery was scheduled for 10 days after the tumor was discovered — and Nolen was surprised when the doctors asked if he’d be willing to remain awake and play the guitar for the procedure.
“When a tumor is involving or near a critical part of the brain — something that controls the ability to speak or understand language or move — we want to do the surgery awake to continually monitor the patient, so you know if you start to violate normal brain functions,” Komotar said.
Dr. Ricardo Komotar of Sylvester Comprehensive Cancer Center is director of the brain tumor program at the University of Miami Miller School of Medicine. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
When the patient is asleep, the doctor said, the surgery team doesn’t have the ability to get feedback.
“The surgeries actually become much more dangerous because you can take out a tumor that involves normal brain function and cause real harm without knowing it,” he said.
Given the importance of guitar-playing in Nolen’s quality of life, Komotar said there was “no better way” to monitor his manual dexterity and the effect of the tumor than to have him take up the instrument in the operating room.
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When the doctors posed the option to Nolen, he said that at first it “didn’t seem real.”
“I’d only really heard of procedures of that nature being done in shows and movies,” he told Fox News Digital in an email. “I felt like it was such a unique experience that I couldn’t pass up — especially with my motor skills being on the line.”
He added, “The risk of being sedated for the entire procedure outweighed any fear or anxieties around the procedure itself.”
Given the importance of guitar-playing in Nolen’s quality of life, his surgeon said there was “no better way” to monitor his manual dexterity and the effect of the tumor than to have him take up the instrument in the operating room. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
Prior to the procedure, Nolen said he was introduced to members of the surgical team and was told in-depth about what to expect.
The anesthesiology team put Nolen to sleep for the beginning of the open craniotomy, but he was awakened during a delicate part of the two-hour procedure. Once he was oriented on what was happening, the care team gave Nolen a guitar and asked him to play.
“Upon awakening, it was quite overwhelming to see everything around me and to fight the natural reaction to sit up,” Nolen recalled.
“I felt like it was such a unique experience that I couldn’t pass up — especially with my motor skills being on the line.”
After one of the members of the care team placed a “reassuring hand” to prevent Nolen from sitting up, he said it took only a second for him to remember what was happening.
“I just had to breathe and stay calm,” he said.
During surgery, he tried his best to play through some of the songs he had been practicing, including tunes by artists like the Deftones and System of a Down.
Nolen had a tumor on the right frontal lobe of his brain that was starting to cause symptoms. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
As the surgeons removed the tumor, they continuously monitored Nolen’s hand function while he played the guitar.
“As we were finishing the case at the very back of the tumor, we noticed that his hand function started to decline,” said Komotar. “The tumor was touching and interfacing with the part of the brain that controls hand movement. Fortunately, we were able to remove the entire tumor and not injure his hand.”
“This is wild,” Nolen said during the surgery.
What to know about awake procedures
While a patient playing guitar during surgery is not an everyday occurrence, Komotar told Fox News Digital that he and the rest of the specialized neurosurgical team perform awake surgeries several times a week, for a total of a couple of hundred times a year.
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“Most patients are intrigued by the process,” he said. “We tell them that they’re going to be able to speak and move their hands or limbs so we can constantly examine them.”
The doctors also reassure the patients that they won’t feel any pain, likely won’t remember the entire procedure, and will remain very comfortable — “which is the result of our world-class neuroanesthesia team,” added Komotar.
Research has proven the benefits of doing procedures with awake anesthesia instead of deep general anesthesia, the doctor noted.
Prior to the procedure, Nolen was introduced to members of the surgical team and was told in-depth about what to expect. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
“Surgery with continuous neurological exam leads to better functional outcomes and fewer neurological deficits,” he said.
There are also improvements in discharge and recovery.
“The less anesthesia you use during your procedure, the better the patient wakes up,” he said. “The faster they wake up, the sooner they are up and walking around, and the sooner they go home.”
Komotar added, “And inherently, the longer you’re in the hospital, the more complications you have.”
“Surgery with continuous neurological exam leads to better functional outcomes and fewer neurological deficits.”
Guitar-playing isn’t the only activity that patients can do during an awake craniotomy.
Anything that doesn’t increase pressure in the head, such as playing the violin, is fair game, Komotar said.
Some patients sing during brain surgery, which allows the surgeon to monitor their ability to form and understand words as they remove tumors in areas that involve language.
Before awake surgeries, the doctors reassure patients that they won’t feel any pain, likely won’t remember the entire procedure, and will remain very comfortable. Nolen is shown at left; Dr. Ricardo Komotar is at right. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
There are some risks involved with awake cranial surgery, Komotar acknowledged.
“Seizures can definitely be worsened by doing awake surgery,” he told Fox News Digital. “If someone has a history of seizures, we try to avoid electric brain stimulation, which is part of the technique.”
The biggest risk of doing awake brain tumor removal is that about 5% to 10% of patients don’t “tolerate” being awakened, Komotar said.
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“Even with world-class anesthesia, they might wake up either too startled or too in pain to be examined,” he said. “They might be confused, agitated or unable to follow commands.”
If that happens, the care team puts the patient back to sleep and proceeds with a more conservative tumor removal.
“He went home the day after surgery. He says his quality of life is better than it’s ever been, so I think his recovery has been remarkable.”
Without having continuous feedback from the patient, the surgical team can’t be as aggressive with the tumor removal, Komotar noted. “We only take out what we know is definitely safe, and we leave anything that’s questionable.”
The road to recovery
Nolen’s surgery went smoothly and the entire tumor was removed.
“Christian did terrific,” Komotar said. “He went home the day after surgery. He says his quality of life is better than it’s ever been, so I think his recovery has been remarkable.”
“The team at Sylvester Comprehensive Cancer Center in Miami has been very informative and has not left much to the imagination in the best way possible,” the patient said. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
The first couple of weeks after surgery were a little tough for Nolen, the patient said, mainly due to post-surgery restrictions.
“The days were really dragging,” Nolen told Fox News Digital. “However, with a strong support system, I’ve been able to focus on the positives.”
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He is now back to working out at the gym and playing the guitar, with significant improvement in his left hand.
“A case like this spotlights the value of multidisciplinary care.”
He’s awaiting the final pathology results, with follow-up treatment likely consisting of six weeks of radiation and chemotherapy.
Both Komotar and Nolen emphasized that the success of the surgery hinged on the collaboration of the entire care team.
“The team at Sylvester Comprehensive Cancer Center in Miami has been very informative and has not left much to the imagination in the best way possible,” said Nolen. “They have also provided me with quite a few programs for emotional support.”
“A case like this spotlights the value of multidisciplinary care,” added Komotar.
“It’s not possible to remove a tumor like this and get the patient home so quickly and in such good health without an entire comprehensive team — neuro anesthesiologists, great intensive care specialists, nurses, techs, great oncologists — all working together.”
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Adult patients experienced significant relief from pain and anxiety after just five minutes of in-person prayer, as found in a randomized controlled trial.
The study, led by researchers at the University of Maryland School of Medicine’s Department of Family and Community Medicine, compared the effects of direct prayer to the effects of listening to music, revealing that prayer provided greater and more sustained relief for both symptoms.
“Prayer is powerful and beneficial on many levels,” Jesse Bradley, pastor of Grace Community Church in Washington, told Fox News Digital.
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According to statistics cited in the study, prayer is the most used form of complementary medicine in the United States, relied on by 43% of Americans.
The researchers focused on a practice known as proximal intercessory prayer (PIP), which is defined as in-person, face-to-face prayer directed toward another individual’s well-being.
The researchers tracked changes in the participants’ self-reported pain and anxiety levels at multiple intervals: immediately after the five-minute session, at two weeks and at six weeks. (iStock)
The research team recruited 180 adult patients from a family medicine waiting room, according to a press release. All participants had previously reported experiencing moderate to severe pain, anxiety or both.
Following their standard medical appointments, the patients were randomly assigned to one of two groups: the prayer group, in which participants received five minutes of in-person Christian prayer delivered by a trained volunteer, and the music group, where they spent five minutes listening to music.
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The researchers then tracked changes in the participants’ self-reported pain and anxiety levels at multiple intervals: immediately after the five-minute session, at two weeks and at six weeks.
“It was very well-received,” Katherine Jacobson, MD, assistant professor of family and community medicine at the University of Maryland School of Medicine, told Fox News Digital. She noted that 97% of participants said they were “neutral or supportive” when asked about having this kind of prayer available as part of their medical visits.
An expert described the transformative power of prayer through “healing and comfort,” and shared that he himself once went through a long, painful recovery process. (iStock)
The study, which was published in The Annals of Family Medicine, revealed that while patients in both groups showed improvements, those in the prayer group reported substantially greater relief.
Bradley, who was not involved in the study, described the transformative power of prayer through “healing and comfort,” and shared that he himself once went through a long, painful recovery process.
“Daily prayer was essential in my healing journey,” he shared.
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For pain reduction, the individuals who received in-person prayer experienced greater drops in pain intensity immediately following the session. This superior level of relief remained evident during the two-week follow-up compared to the music group, the researchers found.
For anxiety reduction, the benefits of prayer were even longer-lasting. The prayer recipients reported significantly greater reductions in anxiety immediately after the session, and these positive effects remained statistically significant at both the two-week and six-week checkpoints.
The prayer recipients reported significantly greater reductions in anxiety immediately after the session, and these positive effects remained statistically significant at both the two-week and six-week checkpoints. (iStock)
“We expected that patients who expected prayer to work would benefit more, but that wasn’t what we found,” Jacobson said.
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“Religious affiliation, religious intensity and expectancy of healing did not predict who improved,” he went on. “Benefits appeared across a wide range of patients, including those not of the Christian faith and those who did not expect the intervention to help them.”
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The study had some limitations, the researchers acknowledged, primarily that it could not prove that prayer itself caused the improvements.
The team also noted that patients receiving prayer had human contact, while the music control group did not. The eye contact and gentle laying of hands from the prayer volunteers may have had an impact, as that type of contact is known to reduce pain.
The researchers suggested that PIP could serve as a low-cost, non-pharmacologic and effective complement to standard medical care. (iStock)
The authors hope to conduct future studies with a control group that receives interpersonal contact but no prayer.
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“For physicians and health systems, the study supports continuing to ask patients about spiritual care preferences as part of whole-person care, and considering whether trained Christian volunteer prayer practitioners could be integrated into outpatient settings for interested patients,” Jacobson said.
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The researchers suggest that PIP could serve as a low-cost, non-pharmacologic and effective complement to standard medical care.
Rather than replacing traditional treatments, the authors indicate that this type of brief, faith-based intervention could be integrated into primary care settings to help manage pain and anxiety.
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For many, surviving cancer comes with an automatic new lease on life but other survivors continue to experience physical and emotional challenges long after treatment ends.
Yoga may significantly reduce the insomnia, fatigue and mood disturbances many survivors endure after remission, a recent clinical trial found.
Mood disturbance and insomnia are “two of the most pervasive and troubling side effects experienced by cancer survivors for years after completing adjuvant treatments,” the researchers reported in the Journal of Clinical Oncology.
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They noted that both symptoms can substantially inhibit survivors’ ability to perform everyday activities.
The study, funded by the National Cancer Institute, compared 204 cancer survivors receiving standard survivorship care alone with 206 survivors who paired standard care with the Yoga for Cancer Survivors (YOCAS) program. Most of the participants were female breast-cancer survivors.
A clinical trial showed that yoga may help ease symptoms cancer survivors experience after treatments. (iStock)
YOCAS is a four-week intervention that incorporates two types of yoga – hatha, which is traditional and more active, and restorative, which is more passive. Both forms involve slow, gentle movements, breathing exercises and mindfulness, according to the American Society of Clinical Oncology (ASCO), which published a news release on the study’s findings.
Participants in the YOCAS group practiced yoga, on average, for 180 minutes each week over the course of three sessions.
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At the end of the trial, the YOCAS participants reported overall improvements to mood, anxiety and fatigue, while the standard care group did not.
“Additionally, improvements in insomnia stemming from YOCAS yoga may be mediated by changes in overall [mood disturbance] and fatigue,” the researchers wrote.
“[The study is] an important advance because it offers survivors, who are likely already managing multiple medications, a non-pharmaceutical solution for reducing four different side effects at once,” Fumiko Chino, MD, a cancer researcher and associate professor in breast radiation oncology at MD Anderson Cancer Center, told ASCO.
Cancer survivors often continue to struggle with physical and mental-health challenges after the disease has been successfully treated. (iStock)
Timothy Pearman, Ph.D., director of supportive oncology at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, told Fox News Digital he was not surprised by the results of the study.
“Yoga is one of the most widely studied and validated interventions for managing cancer-related fatigue, mood disturbance and overall physical health,” Pearman said.
Pearman said his wife, Jenny Finkel, is a yoga teacher and received her continuing education at Duke University’s integrative medicine program, which focuses on yoga for cancer patients.
“There are now a number of cancer-specific yoga teacher training programs nationwide,” Pearman said. “Yoga is a wonderful thing because it is very modifiable, meaning that even for people who have significant physical impairment, the exercises can be modified so that anyone can participate.”
He added that yoga is affordable, too, because “all you need is a mat and someone to show you how to do it.”
Osteoporosis, an increased risk of cardiac problems and issues with balance and stamina are other physical symptoms related to cancer treatment that yoga can help mitigate, Pearman said.
Cancer survivors who took part in an average of three yoga classes a week for four weeks reported reduced anxiety and fatigue, according to a recent study. (iStock)
Shari Botwin, a licensed clinical social worker based in Pennsylvania, is a thyroid-cancer survivor who specializes in working with victims of trauma, including cancer. She turned to yoga months after her diagnosis and told Fox News Digital the practice has been “transformative.”
According to Botwin, cancer survivors she’s worked with have dealt with emotional challenges that affect their healing process, including depression and survivor’s guilt. In addition to the physical relief yoga can provide, she said it can also offer “a supportive environment of peers, some of which are cancer thrivers.”
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Botwin added that yoga can help survivors who have lost parts of their body reframe their thinking.
“It supports us into moving into a place of self-compassion rather than shame and self-hatred,” she said.
Yoga can help cancer survivors who struggle with guilt or shame to find a community of understanding peers, according to some experts. (iStock)
Almost any type of exercise can be beneficial for cancer survivors, Pearman said. He advises his patients to stick to the type of exercise they enjoyed prior to cancer.
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He also noted that free yoga classes geared toward cancer survivors are widely available through various non-profit organizations.
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