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Suze Orman's Schwannoma

— Financial guru talks about her "most vital and stupid mistake"

MedpageToday
A photo of Suze Orman

Financial advisor, author and former CNBC host Suze Orman has always stressed that it is a mistake for people to ignore their money problems. Now she wants you to know that "the most vital and stupid mistake I could ever make ... [was] not in my wealth, but with my health."

Orman began to have symptoms in October 2019, when she noticed difficulty climbing up a short flight of stairs. While walking, her knee would sometimes buckle. But she was busy working on her book (published in February) and her "" podcast, and ignored her symptoms.

But while in quarantine, she noticed that her right arm was getting weaker -- she had a hard time holding onto her fork and had difficulty writing. Her wife, Kathy "KT" Travis, pointed out that she was losing muscle in the back of her right leg. Then, her thumb and index finger on her right hand went numb. She went to her doctor who ordered 3 MRIs -- one of which was for her brain. She said that she didn't want to believe that there could be something wrong, so she put off getting the tests for another few months.

In July, she finally convinced herself it was time to get the tests, and an MRI showed that there was a 3.2-cm tumor, called a schwannoma, that was compressing her spinal cord. In fact, 80% of her spinal cord had been cut off by the non-cancerous tumor, located in her neck between vertebrae C1 and C3. She : "I was one fender-bender away from being paralyzed, probably even a quadriplegic."

Within days she was in Boston. Michael Groff, MD, vice chairman of neurosurgery and the director of spinal neurosurgery at Brigham and Women's Hospital, performed a nearly 12-hour surgery to completely remove the tumor. Groff told People: "Her surgery was more difficult than the typical case. The spinal cord was draped over the back of the tumor, so we only had access to a very small part of the tumor.... We can't move the spinal cord out of the way, so we have to work around it."

Three months later, she is making a good recovery although Groff says it may take a year until she feels like she is "back to normal."

Now Suze is coming forward with her story to people that health is more important than wealth: "Too many Americans put off going to the doctor," she says. "Take action, everybody."

Schwannomas

A schwannoma is a tumor of the peripheral nervous system or nerve root. It develops from Schwann cells, which form a protective lining around most of the nerves and nerve roots of the peripheral nervous system. The peripheral nervous system carries signals from the brain and spinal cord to the muscles and tissues of the body. The nerve root is the first part of nerve leaving the spinal cord which then becomes a peripheral nerve. Schwann cells provide support by wrapping around nerves and nerve roots but also produce the fatty insulation called myelin that surrounds nerves and helps nerve signals travel fast.

Schwannomas are considered rare (affecting fewer than 200,000 people) but are still the most common type of peripheral nerve tumors in adults. They can occur in people of all ages. These tumors are almost always benign, but occasionally become cancerous (called a malignant schwannoma).

Cause

In most cases, it is not known why a schwannoma develops. Most schwannomas are not inherited. The vast majority occur by chance and as a single tumor.

In some cases, a schwannoma develops in association with an underlying genetic disorder such as , , or . These disorders may cause multiple tumors to develop. When a schwannoma is a feature of a genetic disorder, there is a genetic mutation that causes an increased risk for tumor growth. It is inherited in an autosomal dominant manner.

Symptoms

Schwannomas may grow slowly and may be present for months or years without causing symptoms. Therefore, some people may never experience any symptoms. Others may experience radiating pain, muscle weakness, tingling, a "pins and needles" sensation, or numbness. Symptoms vary depending on the peripheral nerve which is affected. The following are examples of symptoms that may occur due to a schwannoma in a specific nerve or area of the body:

  • Vestibular nerve (the nerve connecting the ear and brain) -- hearing loss, dizziness, balance problems, and/or ringing or buzzing in the ear.
  • Facial nerve -- facial paralysis, swallowing problems, difficulty moving the eye, facial pain, and/or loss of sense of taste.
  • Spinal nerve root -- symptoms similar to a herniated disk such as radiating arm or leg pain, numbness, tingling, and muscle weakness.
  • Arm or leg nerve -- localized pain, "pins and needles" sensation, carpal tunnel syndrome (if on a wrist nerve), and tarsal tunnel syndrome (if on an ankle nerve).

Diagnosis

A schwannoma may be difficult to diagnosis at first because, depending on its location, the symptoms it causes may be similar to the symptoms caused by other health problems. The following tests may be used to rule out other causes of the symptoms and confirm the diagnosis:

  • X-ray
  • Ultrasound
  • CT scan
  • MRI can help determine if a tumor is on the outside of a nerve or part of a nerve and if it involves other nearby structures
  • Biopsy of the tumor to confirm the diagnosis. In some cases, a schwannoma is discovered incidentally (by chance) when a person has imaging studies for another reason

Treatment

Treatment for a schwannoma may depend on the location of the tumor, severity of symptoms, and whether the tumor is benign or malignant (cancerous). A benign schwannoma causing symptoms or affecting a person's appearance is typically treated with surgery to remove as much as the tumor as possible, while keeping the affected nerve intact. It is often possible to remove the entire tumor. Surgery usually quickly relieves the related symptoms, although if muscle weakness was present before surgery, the muscle may not return to full strength.

Sources: ,

Michele R. Berman, MD, and Mark S. Boguski, MD, PhD, are a wife and husband team of physicians who have trained and taught at some of the top medical schools in the country, including Harvard, Johns Hopkins, and Washington University in St. Louis. Their mission is both a journalistic and educational one: to report on common diseases affecting uncommon people and summarize the evidence-based medicine behind the headlines.