Clival Chordoma: Meet Renee
Renee Ofner, a 64-year-old nurse who works at a children’s nursing home in Westchester, New York, knows that having a symptom may be a sign of a disease. However, in May 2023, when Renee suddenly began to experience double vision, the idea that she may be ill had never crossed her mind.
“At first, I thought the double vision was caused by a new medication my doctor started me on, so I called the doctor’s office and told the nurse the medication was giving me double vision,” says Renee. “The nurse spoke to the doctor, and then came back on the phone and said, ‘The doctor wants you to go straight to the emergency room.’ My husband and I left immediately.
In the emergency room, Renee underwent a CT scan and was shocked to learn the she had a clival chordoma, a rare soft tissue tumor that occurs in the bones of the skull base (the clivus) and spine. Chordoma tumors usually grow slowly, often without symptoms at first, and then might cause symptoms for years before being diagnosed. Clival chordomas can often cause headaches, neck pain, and double vision.
Surgery and Radiation are Standard of Care
For patients with a newly diagnosed chordoma, surgery followed by radiation therapy is known to provide the best relapse-free survival. “As soon as I learned I needed to have surgery, my family helped me find Theodore Schwartz, MD, a neurosurgeon at Weill Cornell Medicine.”
Dr. Schwartz performed endoscopic surgery to remove the clival chordoma, a challenging procedure due to the involvement of critical structures such as the brainstem, spinal cord, and important nerves and arteries. “I was very fortunate that my chordoma was located in a relatively easy spot, between two arteries,” says Renee. “Some people have a chordoma that is wrapped around one of the arteries, which is a lot more difficult to remove.”
A few months after her surgery, Dr. Schwartz recommended that she undergo proton therapy, a type of radiation therapy that lets physicians deliver radiation that conforms to the shape and depth of the tumor, sparing much of the surrounding, normal tissue, and with fewer side effects than traditional radiation therapy. “Proton therapy was exactly what I needed because I was having radiation into my brain,” explains Renee. “It needed to be precise, down to a point, because a large diameter of regular radiation therapy would kill surrounding brain cells. I felt confident that proton therapy was the best approach for me.”
Dr. Schwartz connected Renee with Arpit Chhabra, MD, radiation oncologist at the New York Proton Center (NYPC). Dr. Chhabra specializes in proton therapy for central nervous system tumors, head and neck cancers, as well as malignancies of the gastrointestinal and genitourinary tracts.
“Proton radiation therapy is highly effective for clival chordoma due to its precision in delivering high doses of radiation directly to the tumor while sparing surrounding healthy tissues and critical structures, especially in the complex anatomy at the skull base,” explains Dr. Chhabra. “Proton therapy’s unique ability to halt at a specific depth reduces radiation exposure to nearby sensitive areas, like the brainstem and optic nerves, which is crucial for minimizing side effects and preserving neurological function. This targeted approach enhances treatment effectiveness and improves long-term outcomes for patients with chordomas, which are challenging to treat with conventional photon therapy.”
In August and September 2023, Renee underwent 35 daily proton therapy treatments with minimal side effects.
A Warm and Caring Welcome
“Every morning, I drove down to the New York Proton Center by 6 or 7 o’clock in the morning, and when I was finished, I drove myself to work,” says Renee. “The security staff in the parking lot were a huge help, and they would walk me to the entrance from the parking lot.”
“The patient coordinators were also wonderful,” she continued. “They always accompanied me upstairs, and we were on a first name basis, walking and talking together. They really get to know who you are, and they’re very, very caring. You feel like when you walk in, they’ve got their arms wrapped around you.”
Renee recalls the special relationship she had with one of the nurses, Astrid Amoresano, RN, OCN. “I love her, she was beyond wonderful,” says Renee. “We had such a great personal relationship. I really felt she was looking out for me.”
“Dr. Chhabra, who I saw weekly, was also wonderful,” continues Renee. “He listened to all of my concerns. I remember I had a friend who was very ill and was dying while I was undergoing proton therapy, and he listened to me and let me talk about it, and he never rushed me. It was wonderful.”
Now, a year and a half after her last proton therapy session, Renee is feeling good and is hopeful that her cancer is behind her. “I’m about to have my year and a half MRI,” she says. “I’m looking forward to the time when they tell me I don’t need to come back anymore.”
“I am very lucky,” continues Renee. “Chordomas are very rare tumors, but Dr. Chhabra and the staff at NYPC were very familiar with this kind of cancer. I’m so thankful for their expertise, thoughtfulness, and care.”
Skull Base Tumors Treated at New York Proton Center
We treat benign and cancerous skull base tumors at our center including acoustic neuromas, meningiomas, chordomas, and chondrosarcomas.
