Aaron O’Keeffe, 39, from Dublin, Ireland was diagnosed with a non-cancerous Craniopharyngioma when he was just 8-yrs old. His non-cancerous inoperable brain tumour has left him having 14 brain surgeries and 2 courses of Radiotherapy over 31 years.
Here is Aarons story:
When were you Diagnosed?
Originally in 1989, I had begun to suffer more and more with regular headaches. My mother had a long history of recurring migraines so visits to the local G.P. were passed off as a runs-in-the-family migraine problem and I was prescribed painkillers and sent home.
This continued for about 2 years until in November 1991 one of my schoolfriends recommended bringing me to see another local doctor in the area. Upon seeing him he initially thought it probably was a migraine-type problem but just to be certain he referred me to a nearby hospital for a C.T. scan.
When the scan results came back, they showed a brain tumour located near my pituitary gland.
1st Brain Surgery
‘Craniopharyngioma Day’ is marked in the calendar on my phone November 12th every year, the anniversary of the day in 1991 when I had the C.T. scan. I don’t remember much of the day, the scan itself, or talking to any doctors but I do remember me and my little sister Naomi spotting a 20p piece on the floor under the edge of the vending machine in the waiting room and the two of us managing to retrieve it from its hiding place. We were so excited to have found the mountainous sum of 20p and could not wait to splash it all on chocolate and sugary sweets!
When we turned to show our parents what we had found they were talking to a doctor on the other side of the room and everything had changed. The doctors told my parents what to look out for and we were sent home while an appointment for surgery was arranged for some time in the new year.
A craniopharyngioma tumour is located normally around or beside the pituitary gland, but when it grows it can put pressure on the two optic nerves which cross in that area. One of the problems of this type of pressure can be visual disfunction, such as short-sightedness or narrowing visual fields.
Other than the headaches these visual problems were consistent symptoms for me in the early days. I am still short-sighted and wear glasses, I have done for years now and problems with narrowing visual fields were often times an initial sign that the tumour was growing again.
For a long time getting my visual fields checked was a regular 3 monthly occurrence, but it was something I could check roughly myself and we generally knew if the visual fields were narrow the tumour was on the way back.
After the C.T. scan and being sent home my parents were asked to watch out for any visual problems or if anything changed to contact the hospital immediately. We made it through Christmas and were watching TV on December 27th when I told them I couldn’t see the quiz show answers on the television set, they were too blurred to read. My parents contacted the hospital and I was admitted for surgery the next day. I spent 3 weeks over the new year and into January in the childrens ward in the local hospital.
Because of the location of the craniopharyngioma they weren’t able to completely remove all of the tumour cells and warned us that a reoccurrence was certainly possible. I recovered fine from the surgery itself and was generally ok, happily showing off the 27 metal staples they had removed from the now-healed incision on the right side of my head to any visitors willing to see them.
The main concern for the doctors post-surgery and after I was discharged was to get the balance right with all the new medication I was taking, plenty of blood tests and doctors appointments kept a close eye on my progress.
Pretty soon I was back in school and getting back to normal.
2nd Brain Surgery
The doctors monitored me with regular visual fields tests and 6-monthly MRI scans, one of which picked up new tumour growth about 18 months later, in June 1993.
I was again brought in for surgery in July with the same surgeon but this time in a different hospital, going back in through the reopened incision on my right temple and adding another bunch of staples to the growing collection.
The location of the growth made it difficult for the neurosurgeon to remove all the tumour material, or as much as he’d have liked to anyway, and any remaining tumour cells were likely to spark regrowth over time.
The proximity of the tumour to the pituitary gland and to the brain matter itself had meant that the surgeon was restricted during the first surgery in how much of the tumour cells he could remove without impacting brain function.
This time, in order to maximise the chances of stopping the tumour from growing again, the neurosurgical team decided to completely remove my pituitary gland.
3rd Brain Surgery
Another regularly scheduled MRI scan detected tumour growth which again required surgery, this time in early December 1995.
The surgery was to be performed back in the same hospital as the first one in 1991 but I was referred to another neurosurgeon as my first neurosurgeon was no longer working there.
They reopened my scar on the right side of my head but due to the amount of scar tissue were unable to remove enough of the tumour material. I woke up back in the childrens ward Monday evening to be told that I’d be going back down to the operating theatre again on Wednesday morning.
On Wednesday they opened on the other side of my head, the scar stretching from the middle of my forehead to just in front of my left ear. I was discharged back home in time for Christmas and arrangements were put in place for me to start radiotherapy early in 1996.
The radiotherapy started late February 1996 and ran for 6 weeks. It was split into 30 sessions, one every weekday until early April. I was in 3rd year in secondary school at the time, left home as normal every morning before escaping classes around lunchtime and getting a train into the city centre to meet up with my Mum, who then accompanied me by bus to another hospital on the other side of the city. They first made a plaster mould of my head and from that created a transparent plastic mask that covered my entire head and face down to my mouth. When I lay in the radiotherapy machine, the mask attached to the bed behind my head and made sure I could not move during the sessions. After completing the radiotherapy sessions they gave me both the transparent mask which lived in the attic for years and the plaster mould of my head, which was painted and put on a shelf in my room.
They continued with the regular visual fields tests and MRI scans afterwards, every 3 months initially, then 6 and finally yearly. By all reports the surgery and radiotherapy had done their job and the tumour (or what was left of it) was behaving itself. There eventually was some new tumour growth seen on one of the MRI scans in 2001 but because of the radiotherapy, the growth was at such a slow rate that we didn’t have to do anything about it immediately.
5th Brain Surgery
The slow growth rate this time meant there was less pressure on when I had to have the surgery, I had a limited choice about when the operation was to take place. A close friend turned 21 that month and I was thrilled to be able to delay the operation until after the birthday celebrations! They reopened the large scar running from the middle of my forehead and removed as much of the tumour material as they could.
Thinking back now, I’m finding it hard to remember anything specific about hospital visits since around this time. My memory has slowly worsened over the years and odd as it sounds the separate hospital visits all get mixed up in my head. I’ll often muddle things that happened with other brain surgeries or hospital admissions and mix things up with events from other years. Eventually they become difficult to separate and the details about each surgery all run in together.
6th Brain Surgery
The tumour had regrown within a few months and I was back in hospital for more surgery in December. Navigating around the scar tissue of previous operations was getting trickier and trickier from the surgeons point of view and they were looking for other [less invasive if possible] options for removing or stunting the tumour growth.
In addition to removing the tumour material this time, they inserted an Ommaya reservoir into my head. It was similar to a shunt but it didn’t automatically drain the tumour itself, it had to be drained manually by use of a syringe. These reservoirs had also been used more frequently in other patients to inject or introduce cancer-fighting radioactive materials such as bleomycin directly into hard to reach cancer cell sites.
The reservoir consisted of a tube, one end of which was situated inside the cystic fluid-filled outer part of the tumour inside my head and ran to a point on my left temple, where it ended with a small rubber-type bubble just under my skin. The idea was that if the tumour grew in the right way and the end of the tube was in the right place the neurosurgeon could remove the tumour, or at least part of it without actually cutting me.
They could stick a small needle through the skin and into the bubble, and drain fluid directly off the tumour immediately with little pain and no need for an operating theatre. If it worked, and if the tumour when it grew back would grow in the right location it could be a way to avoid future visits to the operating theatre. If.
7th Brain Surgery
My Dad found me at home one day, having fallen quite ill. I was sleeping after being away for the weekend but had been vomiting which was unusual for me and was not right at all. They were still monitoring my visual fields and I was having regular MRI scans but it was the bout of sickness that indicated a problem this time and I endethd up back in hospital for more surgery.
The surgical team attempted to drain some fluid from the tumour using the reservoir but they weren’t able to remove anything significant.
They suspected that the tube leading from the tumour to the bubble on my temple might have become blocked and so they were unable to use it. They brought me down to the operating theatre again, where they cut me open and removed as much of the tumour as they could.
Before closing me back up they inserted a new Ommaya reservoir, this time leading to a smaller bubble on the top of my skull.
This new reservoir has since been used on a couple of occasions since its insertion. The amount of fluid drained has varied over the years between about 5 – 35ml and normally appears to be an oil-like substance. It is often coloured yellow or golden but has been drained as small amounts of brown or black fluid too.
Other than the needle being inserted initially there is no pain, just a very odd feeling descending from my head into my jaw as we reach the end of the procedure.
The closest I could get to describing it would be if you imagine a small balloon being slowly deflated inside your head. The feeling doesn’t last long, about 15-20 minutes or so and it is unpleasant, but it’s not painful. It does however feel very very odd.
8th Brain Surgery
The regular MRI scans had again picked up a growing tumour and I had to return to the hospital for more surgery. The first Ommaya was completely blocked at this stage and wasn’t working at all. The second Ommaya was working as far as my doctors could tell, but we still were unable to drain any fluid from the cystic part of the tumour.
It was most likely due to the way the tumour was growing inside my head that the end of the Ommaya tube was not in the right location to drain. At this stage, my neurosurgeon [#2] was heading towards retirement and had begun to hand me over to another surgeon [#3]. However, surgeon #2 took the lead with this surgery, with #3 assisting.
During this surgery, the neurosurgeon removed the bubble of the first [blocked] Ommaya reservoir but was wary of attempting to remove the tube as a certain amount of biological matter had grown around it. It might have been dangerous to me and was an unnecessary risk to try.
9th Brain Surgery
I recovered fine afterwards but a year later, the tumour had again grown to such an extent that surgery was required. My neurosurgeon (#3) wanted to try something different this time, the amount of scar tissue and leftovers from previous hospital visits made normal craniotomies more difficult than usual and if there was a way around it I was happy to go with the neurosurgeons recommendation.
He suggested operating using a transsphenoidal approach, where instead of cutting open my old scar [again!] they would access the tumour and remove as much material as was possible through my nose.
The hole made during surgery at the top of the inside of my nose would be very small, and sealed up afterwards using a small piece cut from my torso, just above my naval. I was left with a much smaller, one inch long scar.
The surgery went well and the recovery time post-surgery was much quicker and easier than normal. I was discharged and back recovering at home when I developed a cerebrospinal fluid [CSF] leak, where the spinal fluid from around my brain was very slowly leaking out through my nose.
Besides walking around with what looked like a mildly running nose all day this also meant that the hole between my nose and the inside of my head was open and would leave me at risk for a serious infection getting into my brain. I returned to hospital for more surgery.
This time they took another small piece from my torso to plug the hole in my nose again and inserted a lumbar drain into my lower back [not a pleasant experience!]. They kept me lying down flat on the hospital bed, bar an hour or so a day where I was allowed to sit up for meals, and constantly drained a small amount of CSF from my back to reduce any pressure on the surgical repair in my nose.
Every 5 days they would turn off the lumbar drain and allow me to get upright for a while, to check if the repair was holding back the fluid but the leaking never stopped. It took a long time and for a while it looked like I was heading back down to the operating theatre for more surgery as they feared the repair hadn’t taken.
My nose was still leaking fluid almost a month later and arrangements for another trip to the theatre had been made. They turned off the lumbar drain one last time before surgery and amazingly the leak had stopped!
In total, I was close to 6 weeks in hospital this Autumn, my longest single hospital visit.
10th Brain Surgery
This time the tumour was behaving itself and hadn’t regrown or caused any problems. I had picked up a bad cold after Christmas 2013 and was coughing quite severely. The fits of coughing eventually reopened the old wound inside my nose and again I started leaking CSF.
They brought me back into hospital for surgery. They operated through my nose again, this time using material taken from my right thigh [and left a longer 5 inch scar] to seal up the leaking hole.
They again inserted a lumbar drain, although this time I made sure they did it while I was knocked out! I recovered well and was discharged home soon afterwards.
This was the beginning of the worst stretch of my hospital visiting life. Another regularly scheduled MRI scan picked up the tumour growing and I was provisionally booked in for surgery.
I thought at the time it might have been down to staff shortages or just that the hospital was excessively busy but from what I can remember this was the first occasion I had to wait any amount of time to actually get into hospital for surgery.
I think initially I was supposed to be admitted in January but I didn’t have surgery until March that year.
From my previous visits I knew roughly how long my hospital stay should last. Though the recovery time after being operated on transsphenoidally was much shorter and less painful when compared with my previous standard craniotomies, especially in the first few days post surgery.
Normally, the time from surgery until discharge without any complications would take a full 2 weeks, minimum 10 days from previous experiences, but this time it felt like I was being pushed out. I had surgery on Tuesday morning and was told upon waking back on the ward that all going well I could go home on Thursday. This didn’t feel right to me and I didn’t want to risk going home too early.
In the end, I was discharged and back at home by Saturday. I was recovering at home but my wound wasn’t healing well and had slowly started to weep fluid from the scar in the section nearest to my left ear. I had also developed a severe and constant headache and my head had started to swell.
Although I was used to bad headaches I hadn’t really been suffering from them in any sort of regular fashion recently and anything outside the regular was cause for concern. I was eventually brought back into hospital the following month.
12th Brain Surgery
I was readmitted to hospital and back on the neurosurgical ward. I was still suffering from headaches and was very sensitive to bright lights and noisy places [I normally am, have been for years] so I asked if it was possible to take me off the 6-bed ward and put me back into a quieter 2-bed or private room like before if one became available.
My medical insurance had covered the cost of staying in single or semi-private rooms on previous hospital visits and they were normally happy to move me if there was a room free.
However, they told me that it was unlikely that I would be moved this time as all the semi-private and private rooms were already occupied and that I’d have to stay on the 6-bed. The next day I was suddenly moved to a single-bedded room.
My current neurosurgeon was on holidays during this visit so while he was away I was being looked after by another consultant neurosurgeon [#4] in the hospital. He came to see me not long after I was moved to the single room to talk about surgery the next day and to get my consent but no one had informed me at this stage of what was going on. I hadn’t been told what was happening or even that more surgery was needed.
I refused to sign the consent forms until I was told what was happening and he left. I’m sure he was furious at me initially, and possibly at the staff looking after me too as eventually the staff nurse on the ward came to my room, sat down and told me that I was suffering from an MRSA infection in my head. This is what was causing the headaches, swelling etc and it meant I would have to go back down for surgery the following day.
I met with the neurosurgeon again and signed the consent for him to operate. They took me back down to the operating theatre and he cleaned out as much of the MRSA infected material as he could.
The ‘bone flap’ as it was called [which was the piece of my skull that they had cut into and removed for access to my brain in every surgery since 1995] was left out of my head altogether when they finished the operation. It was a rectangular piece of bone, about 2” x 3” which we had planned to replace later by a modern plastic composite.
They left it out this time in case the MRSA infection was lingering on it. When the wound on my head was stitched back up this time they didn’t use the metal staples and instead replaced them with normal fibre stitches.
I had long since stopped collecting [and counting!] the metal staples anyway, they no longer held any interest for me. The stitches stayed in a bit longer than usual, for about 3 weeks before they were removed and even then 5 or 6 of them located at the bottom of my old scar near my ear were left an extra couple of days. I was home again and we were all keeping our fingers crossed that the MRSA infection was gone.
I had been told when I received my first course of radiotherapy in 1996 that it was a once-in-a-lifetime thing, too dangerous and potentially harmful to dose me more than once. At this stage, the advances in the medicine, machinery and the way the radiation was delivered meant that my doctors felt it was safe for me to proceed through another series of radiotherapy sessions, the newer machines being able to deliver the radiation more accurately to the location of the tumour.
Any surgery to remove tumour material had become more and more difficult each time, there was so much scar tissue and internal damage from previous operations that avoiding surgery through radiotherapy if at all possible was preferable, to both my neurosurgeons and especially to me.
The greatest length of time between visits to the operating theatre since 1991 were the 7 years after my first course of radiotherapy, so I was happy to take the risk. My local hospital by this time had opened their own Oncology centre within the grounds so I did not need to travel across the city daily, it was just a quick 10-minute drive from home.
Again, I was fitted for a mask to keep me still during the sessions, much quicker and easier this time, using a plastic-like mesh and a hardening process afterwards to set the mask. The course lasted for 25 individual sessions this time, stretched out over 5 weeks in September and October.
I was a little bit sick at first but after 6 or 7 days they made some adjustments and from then on there were no problems. When I had completed the course, they again gave me my mask to take home. It has since been spray-painted, framed and mounted and is currently hanging above the stairs in my house.
13th Brain Surgery
In late May the following year a small red mark appeared on my left temple, not too far from my scar. It looked at first like a small spot but there was no head on it as it slowly grew larger.
It felt soft, like it was filled with liquid, and continued to grow. Occasionally some fluid would leak from it, I’d feel it slowly leaking down the side of my face or find the remains of it on my pillow when I’d wake in the morning.
I had my neurosurgeon on WhatsApp so I took a few photos of it and sent them on to him. He asked me to come into the hospital’s emergency department and he’d have some of his neurosurgical team waiting on me.
I was admitted again and though the operation was relatively minor this time I was once again visiting the theatre for surgery. He removed the ‘bubble’ as I named it and sent samples to the microbiology lab to check for any MRSA infected material. I was prescribed a long-term course of oral antibiotics, discharged from the hospital and sent home.
Although we all hoped for the best he feared the MRSA infection was still lingering and warned me that if the drugs didn’t work I would have to return to the hospital for another operation to clear out the infection.
14th Brain Surgery
I stayed taking the course of antibiotics into October that year. I had been driving up to the phlebotomy outpatients department every Wednesday morning since the surgery for bloods as I was on such a high dose of the antibiotics for so long, and I was attending his neurosurgery clinic every Wednesday afternoon to check my progress and get the results.
The antibiotics seemed to be working but not long after I finished the course a small red fluid-leaking mark reappeared on the side of my head. I sent a photo to the surgeon and he asked me to come back up to the hospital. They took bloods, sent me for a CT scan and swabbed the wound site directly in the emergency department.
The neurosurgeon told me he did not believe that another dose of antibiotics would work and that more surgery was the best option to clear out the remaining infection. He suspected that the MRSA infection had been persisting on the plastic-like tube from my first Ommaya reservoir, which was still in my head.
He thought that if he was able to remove it entirely that would give us the best option for completely cleaning out the MRSA, but that it would be risky and depending on what way the inside of my head had been growing around the tube, it might not be possible at all.
Upon returning to the ward post-surgery I was doing good and by all accounts the surgery itself had gone well. The neurosurgeon was very happy with how the operation had gone.
He had managed to remove the entire tube luckily without too much difficulty and by early accounts there was no MRSA infection left inside my head.
All post-surgery scans and lab results from microbiology indicated that any MRSA material had been either removed along with the Ommaya tube or otherwise cleaned out by the surgeon. Everything was heading in the right direction.
Mum texted me the morning of the second day after surgery but I didn’t reply. My Dad texted me also a little later but again I did not reply. My phone was normally glued to my hand so me not replying was unusual.
The little blue-tick message notifications were showing that my phone had received the texts but that I hadn’t checked them, again a little unusual. My Mum tried ringing me directly but I didn’t answer the call, she rang my Dad and he tried ringing me, still no answer.
A close friend was in the hospital that morning and texted my Mum to ask if it would be ok to visit. When she arrived on the ward I had been moved to a single room. She left a book she had brought for me and texted my Mum again as she left to say I had been asleep while she was there and she didn’t want to wake me.
Mum wanted to double check that I was ok and rang the nurses station on the ward, asked one of the nurses to look in on me. It was close to lunchtime at this stage so she left work and came straight to the hospital.
At the time the wards were shut down. This happened every afternoon, just after lunch they dimmed the lights and closed the curtains and the patients on the ward mostly fell back asleep or generally relaxed.
During this time visitors were not allowed to see patients [outside of exceptional circumstances] so Mum had to sneak through a locked door to get in. She asked the first nurse she saw on the ward to show her to my room and found me alone with the door closed, the windows wide open and me sitting up shirtless on the bed.
She asked me how I was and I replied that I was ok but had been feeling nauseous and very warm. I had not eaten my lunch and so she went to get me some ginger biscuits in the hope that they wouldn’t unsettle my stomach.
Not long after she returned we were joined in the room by a nurse we both knew a very long time, she had previously taken care of me during many of my hospital visits. She and my Mum were talking but when she asked me a question directly [something simple I should have easily answered], I just looked at her and gave no verbal reply.
My Mum asked me another simple question but again I just stared at them and gave no answer. Our nurse friend figured that something may have been wrong with me and left the room immediately and my Mum approached the bed and asked me if I wanted anything.
I started breathing unusually and making exaggerated gestures with my hands, repeatedly saying “no, no, no” which reminded Mum of the actions of my Grandmother, who had recently had a stroke. She rushed out of the room to the nurses station and told them that she thought I might be having a stroke and that I needed help quickly. When they returned to the room the nurse held up a biro in front of me and asked me what it was, “I don’t know” I replied. She asked me what would I use it for and again I replied, “I don’t know”.
The doctors had arrived at this stage and the room was getting crowded, my Mother was asked to leave and wait in the day lounge on the ward while they checked me out.
In the end, they got consent from my parents to knock me out again and inserted a tube to help me breathe. I was sent for a CT scan and all the usual tests were performed. The results came back as showing I had not suffered from a stroke but had a seizure of some sort.
Other than a febrile convulsion when I was about 18 months old and despite all the operations I’d been through and all the drugs I had been prescribed over the years, I had never before been through a seizure.
They moved me from the room I was in to the neurosurgical Intensive Care Unit that was part of another ward to keep a closer eye on me for a few days. Afterwards, when they were happy that I had recovered from the seizure I was moved back to a single room. It was another 3 weeks before I would be discharged home.
Now in June 2020, my main health-related problem now is tiredness and post-surgery fatigue. I notice a feeling like someone flicked a switch in my head and my brain just turns off, it stops processing information and I’ll have to apologise and just leave for somewhere quieter.
What is the toughest challenge a survivor faces?
For me, it is to keep going.
Many people who suffer through a brain tumour diagnosis, after going through surgery, radiotherapy etc, the toughest challenge can be keeping your head up and getting back to the way you were before.
Getting your body back to feeling how it used to be, returning to study or work. Being able to spend time with family and friends like you did before and get on with life.
It can be a long and arduous road getting back to feeling normal again. Having good people around you who understand, even on some scale, what you have experienced can be a massive help.
In my own case, because the tumour always persists in regrowing and my health problems have been such a large part of who I am, it can sometimes be tough to see past the downside and keep on going.
This little tumour has taken a lot from me and I’m sure shaped my life in ways I cannot see, but you’ve got to keep your head up and keep pushing forward! I’ve always thought about it as; as bad as I’ve had it, it could always be worse! There is always someone out there dealing with something much worse than I have.
Having been through a long-term ridiculous health situation that does not seem to have an end, but as bad as I’ve had it I’m still here! Two arms, two legs and a brain that still works! [at least most of the time].
My family, and my close friends have always been a massive crutch to me. I couldn’t have survived without them.
Any advice for people that get daunting diagnoses?
- Keep your head up!
- Find a way to stay positive! In whatever way you can, always look for the brightside in your life! No matter how small it is.
- Whatever your diagnosis there’s normally a support group for people in similar situations. They’ll quite often have experience with the doctors you’ll be seeing, the nurses who’ll be looking after you, the hospital you’ll be staying in and what’s available to help your recovery afterwards. Use their knowledge to help yourself through your journey. They’re normally more than happy to help in any way possible, and you don’t have to wait until afterwards before getting in contact with them.
- STAY AWAY FROM DR. GOOGLE!! There’s no filter on the information online and we always seem to focus on the negative aspects of whatever we are reading for some reason. If there’s a 2% chance of something bad happening that’s usually all we see.
- Use the nurses! One thing my parents told me about some of their early doctors visits when they were initially informed about my brain tumour or in the years afterwards [normally when we were getting bad news] was that having a nurse sit in on the meeting was very helpful afterwards in understanding everything that was said. Quite often, and especially if it’s something major or on the negative side, it can be easy to get sucked into one aspect of what you are being told and you end up ‘zoning out’ or focusing only on certain parts of what the doctor is saying. Having a nurse sit in on the meeting, particularly in the early stages, can be beneficial because they’ve dealt with it all before and they understand everything being said. After the meeting with the doctor a chat with the nurse can fill in the gaps in the conversation that you might have missed.
- Seriously! Use the nurses!! I’ve met tall ones and short ones, good ones and bad ones, students and old hands, inexperienced ones and the ones that know more than any doctors I’ve met. They’re all incredible and a completely invaluable resource in every hospital. They can make a massive difference to your recovery. I’ve known some nurses who have taken care of me since I was first in the children’s ward back in 1991, and still take care of me during more recent hospital visits. They remember me better than I remember myself sometimes. In my opinion, a great nurse is heaven-sent, and someone who can make a major positive influence on your life after surgery.
Aaron O’Keeffe you have been on the battlefield for a long time. Thank you so much for letting people read your story and understand the struggle a brain tumour warrior may go through. Your story about having 14 Brain Surgeries is very eye-opening. It shows how a non-cancerous brain tumour can be very dangerous and the word ‘benign’ does not mean it is FINE.