Born Fighter

May 22, 2019

On a warm summer night in 2012, Margaret Coppotelli prepared dinner for her husband, Donald, and herself. The 65-year-old Freehold, New Jersey, resident moved deftly through her kitchen—cleaning, chopping, boiling, sautéing—when suddenly she slipped and fell. The back of her head hit the floor so hard that her glasses flew across the room. Shaken and sore, she sat for a few moments, then got up and continued cooking.

Three months later, the back of her head was still sore, so she visited her primary care physician to see if something was wrong. Her doctor ordered X-rays and a CT scan, which showed an abnormality. An MRI then confirmed that she had a small benign tumor, called a meningioma, located right where the two hemispheres of her brain communicate. The position of the tumor made it inoperable. The tumor had likely been there for decades and never caused her any problems until now.

“If I hadn’t taken that fall, I would’ve never known it was there,” says Margaret, who worked as a dental assistant for 35 years. “I guess it’s a good thing I’m so clumsy at times.”

The causes of a meningioma are unclear, and a small, slow-growing one that doesn’t cause any symptoms may not even require treatment, like radiation or surgery. But doctors wanted to keep an eye on Margaret’s, just to be sure.

Margaret began seeing William Maggio, M.D., who specializes in neurological surgery, at Jersey Shore University Medical Center annually for routine MRIs to monitor the tumor’s growth.

For five years, the tumor showed little to no change, and Dr. Maggio was happy to continue with yearly monitoring.

New Options, New Hope

But in 2017, Margaret felt differently. “It just really started to bother me knowing that it was there,” she says. “I never knew if it would start presenting problems, and I didn’t want it to start showing signs when I reached my 70s or 80s, when treatment would be riskier.”

Margaret wanted a non-invasive treatment. Jersey Shore radiation oncologist Douglas Miller, M.D., presented her with a new treatment option: the Edge® Radiosurgery System, which uses a state-of-the-art, knife-like beam to deliver large, targeted doses of radiation to kill cancer cells while minimizing the damage to surrounding healthy tissue.

With this non-surgical approach, treatments can be fully delivered in less than 15 minutes, often completing the treatment course within a week, and it provides a more comfortable experience for the patient. “It’s a highly sophisticated system that can arrest further growth or even decrease a tumor’s size in as little as two to five treatments,” Dr. Miller says. “It’s fast and less claustrophobic than previous treatment methods. In fact, we obtain a CT scan immediately before treatment for treatment accuracy of 0.01 cm.”

Dr. Miller and his Jersey Shore team are thrilled to be one of the first hospitals in the state to offer the Edge treatment to complement the CyberKnife program within Hackensack Meridian Health, an additional radiation technology available at Riverview Medical Center that can also precisely treat brain tumors and other cancers. “We have access to the most advanced radiation technologies within our system and send our patients where they achieve the best possible outcome,” he says.

Margaret began her treatment on a Monday in July 2018, and by Friday, she was done. Though some people experience a few side effects during treatment—like headaches, hair loss, nausea and fatigue—Margaret was lucky and felt nothing.

“I may have been a little more tired here and there, but that was it, and it may have just been in my head,” she says. “After each treatment, I left and went about my business running errands and did whatever I had to do.”

Four months after completing treatment, Margaret visited Dr. Miller to check on the size of the tumor, which showed no growth and stable findings. With treatment, some tumors can take up to two years to disintegrate. He told her that as long as she’s feeling well and showing no symptoms, she doesn’t have to have another MRI until November 2019. “I’m so happy. I don’t have to do a thing until then,” she says.

A Full Life

Margaret, who has three adult sons and two grandchildren, is plenty busy since her treatment. Not only does she regularly watch her granddaughter, Gianna, 14, and grandson, James Jr., 12, she also takes care of her elderly parents.

Her mother has a condition that causes a weakening of the muscles, making it difficult to eat and move, and her father is in the early stages of dementia. “It doesn’t get me down, but most days, I feel like I’m pulled in a million directions,” she says.

Yet somehow, she has found time to resume her favorite exercise program: CrossFit. Several times a week, she makes it to her CrossFit gym to lift weights, do burpees and flip tires with a group of sweaty, like-minded individuals.

Margaret’s especially appreciative of her coach, Nick Mezzacappa, who tailored her favorite exercises to build strength to prevent a future fall. “The weights are the best for strengthening my bones,” she says. “But I have weak ankles, so I can’t run anymore.”

Dr. Miller is hopeful that Margaret will go on to live a long, healthy life, and Margaret doesn’t expect to slow down any time soon. “My plans are to retire to an active adult community,” she says. “I feel great.”

Learn how to train your brain to function better as you age.

Dr. Maggio is board certified in neurological surgery. To make an appointment, call 800-822-8905.

Dr. Miller is board certified in radiation oncology. To make an appointment, call 800-822-8905.

Learn more about cancer services at Hackensack Meridian Health.