Author Topic: Gamma knife vs surgery  (Read 6298 times)

trev0024

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Gamma knife vs surgery
« on: January 26, 2012, 06:16:47 pm »
I am 31 years old and have new diagnosis of a 2.0 cm acoustic neuroma. The MD's all recommend surgery vs the radiation. Their reasoning is my young age, higher risk surgery if radiation fails, scaring tumor tissue, little to no long results out on gamma, <1% chance of bad/metestatic tumor development etc.

Are there any younger people that have went with the radiation? Can you make a solid argument for this vs surgery? Just want to make the best decision possible.
New dx 2.0 x 1.9 cm AN

james e

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Re: Gamma knife vs surgery
« Reply #1 on: January 31, 2012, 02:06:40 pm »
I am not younger...62. I had surgery after deciding on radiation, but changed back to radiation and then back to surgery. Hard decision. My surgery came out just fine. I met with several doctors, and would suggest that you do the same. I would give you the reason I decided on surgery, but it would not apply to you. Take your time. Read everything on this site. You will find a doctor that you have full faith in. Expect to change your mind several times...but sooner or later, the answer will come to you.

James

mindyandy

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Re: Gamma knife vs surgery
« Reply #2 on: January 31, 2012, 02:14:05 pm »
Trev
I too had the hard decision of surgery vs radiosurgery. I was 29 I found out and 30 when I had CK done. That was 4 years ago...now I am facing surgery  :(  As much as I don't want to have surgery I cannot wait to get it out and hopefully not have worry about it anymore.

Mindy
14mm dx 9/07. CK done Seattle  1 year MRI showed some shrinkage. 4 year MRI 2mm growth nothing conclusive. Trigminal nerve involvment Retrosigmoid Friedmand/Schwartz HEI March 7,2012

trev0024

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Re: Gamma knife vs surgery
« Reply #3 on: January 31, 2012, 10:35:18 pm »
Thank you for sharing your experiences. I guess that if the gamma knife fails the surgery then becomes more difficult and with added risks. Does this sound right?
New dx 2.0 x 1.9 cm AN

mk

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Re: Gamma knife vs surgery
« Reply #4 on: February 01, 2012, 07:35:54 pm »
There have been quite a few younger patients that chose to do radiation. This option can be particularly attractive for young people who have demanding careers, young families etc, as long as some conditions are met, i.e. size of the tumor, proximity to the brain stem etc. The thought that radiation is only suitable for older patients is old school. Data for GK exist for at least since the 80s, and even older than that, but the protocols (i.e. higher radiation doses) where different back then. There are quite a few comprehensive published studies, mainly by Pittsburgh, which span many years - if you are interested I can try to dig them up.

That being said, I did have failed GK for a larger tumor, followed by surgery. I consulted with many experienced surgeons, and most of them concurred that in their experience removal of a radiated tumor is not necessarily more difficult. They have seen very sticky tumors that were not radiated, and vice-versa, so it is hard to get any hard evidence on this. Even in publications where it is claimed that removal after radiation is more difficult, if you read carefully, the results are not statistically significant. When I asked my neurosurgeon after my surgery he said that in some areas my tumor was easier than average to remove and in some areas harder. I ended up with no complications, no facial nerve damage and an excellent recovery.

All I want to say with all this is that you shouldn't be scared away by claims of surgery being necessarily more difficult if treatment fails (which is rare anyway), scares of cancer (not proven that the incidence is higher than the general population) etc. Research as much as you can, so that you can chose the treatment that is best for you. Try to get opinions from both neurosurgeons, and radiation oncologists, and if you find someone who does both, that's even better. Dr. Chang in Stanford offers free consultations on CK and he is also a neurosurgeon, you may want to send your scans there.

Marianna
GK on April 23rd 2008 for 2.9 cm AN at Toronto Western Hospital. Subsequent MRIs showed darkening initially, then growth. Retrosigmoid surgery on April 26th, 2011 with Drs. Akagami and Westerberg at Vancouver General Hospital. Graduallly lost hearing after GK and now SSD but no other issues.

james e

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Re: Gamma knife vs surgery
« Reply #5 on: February 03, 2012, 03:26:33 pm »
As Bill Clinton said "I said feel your pain." One of the benefits of an AN...if there is such a thing...you don't have to make up your mind real fast about what you are going to do. I just worried about it like crazy, and my wife did also. One of her friends had AN surgery and everything that could go wrong, did. She said she wished that she had radio treatment. My doc told me he wanted to do radio because the surgery is "brutal." Well, the friend is now happy about the outcome of the surgery. I found another doctor and had the surgery. It was not brutal...it was just another surgery...not a big deal.

Relax. Take your time. I feel your pain. The answer will come.