Author Topic: Huge Tumor  (Read 18656 times)

Ronan

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Huge Tumor
« on: March 18, 2008, 09:08:46 pm »
Hi

Finding this site is a great, great help. My dad was diagnosed with AN two Saturdays ago. It was a huge one, 5cmm. His operation was scheduled for next Wednesday. The doctors say they will be taking only a part of the tumor out as taking the whole thing out will be too risky. Is this a normal procedure? He has been suffering from hearing loss for the 20+ years (and no other symptoms) and lack of knowledge on this illness is the main cause of the delay in diagnose. My dad is 65.

My whole family is worried sick. We have gone through the whole range of crying, feeling lost and just not knowing what to expect. We are really, really afraid.

Ronan

 

leapyrtwins

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Re: Huge Tumor
« Reply #1 on: March 18, 2008, 10:10:35 pm »
Ronan -

5 cm is certainly very big, but our own "Satman" had an AN that was 8 cm - the largest I've ever heard of.

Anyway, yes, it is standard procedure nowadays when removing large ANs to do surgery, leave some of the tumor, and then do radiation on what is left.  The theory is that it cuts down on surgical side-effects.  There are several members of this forum who had both surgery and radiation.

Don't be afraid, but make sure that your dad is being treated by docs who have a lot of experience in treating ANs - this is vital !  Where is he having the surgery? and who are his docs?  Maybe someone here has used them and can give you some feedback.

For some idea of what your dad can expect, try to read some of the posts on this forum - there is a lot of information here that will be helpful to you and your family.

Best of luck to all of you,

Jan 
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

Kaybo

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Re: Huge Tumor
« Reply #2 on: March 18, 2008, 10:16:01 pm »
Hi Ronan~
So sorry to hear about your dad - I am sure that you are all really scared.  How is HE feeling?  AN surgery can be a tough road, but it is something that can be overcome (w/ a lot of love & patience!).  I will be keeping you all in my prayers.  Please feel free to send me a PM if I can be of any help to you.  If you (or your family) would like to check out my blog, the address is below -- my AN surgery was 12 years ago -- you can see what my life is like now!
Peace to you,
K
Translab 12/95@Houston Methodist(Baylor College of Medicine)for "HUGE" tumor-no size specified
25 yrs then-14 hour surgery-stroke
12/7 Graft 1/97
Gold Weight x 5
SSD
Facial Paralysis-R(no movement or feelings in face,mouth,eye)
T3-3/08
Great life!

Ronan

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Re: Huge Tumor
« Reply #3 on: March 18, 2008, 11:53:00 pm »
Thanks for the reply. Thanks for the encouragement.

I do not reside in the US, but we have got the best surgeon we can find that specializes in brain surgery over here. My dad is also terrified, though he tries to put up a brave front. Yesterday, he spoke about his worries about dying on the operating table, which shocked us all. We try to spend every moment of time we have with him, telling him about all the success stories we have read over on this forum. We have also scheduled some appointments for him after the surgery in an attempt to make him know we expect him to keep them. But other than that, he is just resting a lot.

Ronan

sgerrard

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Re: Huge Tumor
« Reply #4 on: March 19, 2008, 12:33:57 am »
Hi Ronan,

Best wishes to your dad and your family. Fortunately the chances of the worst happening are very small, so there is every reason to be optimistic on that score. 5 cm is on the big side, so there will some recovery time needed, and there will probably be some side effects. I'm betting he will be around to complain about them, though.

We are all rooting for your dad, so hang in there, together you can make it through this.

Steve
8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.

ppearl214

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Re: Huge Tumor
« Reply #5 on: March 19, 2008, 05:56:59 am »
Hi Ronan and welcome (to you and your dad).  I'm sorry you (your dad) is/are joining our ranks but... thrilled you found us. Not sure where outside the States you are located.... we have many that participate here from all over the world and hoping they can help guide you, from a local level......

As noted, to "debulk" the tumor, then radiate the residual, seems to somewhat be a new standard for larger AN's.  Many factors go into this decision of treatment as I know dr's will do this to help save nerves (ie: facial, hearing, etc) and from what I read (I have also met some, face to face, that have had this type of protocol done), seems to work great.  It sounds like the dr's are doing what they can to help your dad's situation to the full extreme and I send my best wishes to your dad (and you) during this time. Please keep us updated on how the surgery goes.... know we are all here to help and cheer you all on!

Hang tough.... sending wishes for wellness to your Dad.... and again, welcome.

Phyl
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

Cheryl R

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Re: Huge Tumor
« Reply #6 on: March 19, 2008, 07:33:04 am »
All of us who have had surgery can relate to how nerve wracking the waiting is.     There is so much fear of the unknown. After surgery at least you know what you are dealing with.
Let him talk his fears out even if it makes you nervous.   I think most of us had the fear of that very small possibilty of dying during surgery.             It's ok to admit to him that you are nervous too.  Right now he just needs to know how he feels is being taken seriously and it's ok to feel what ever way he is feeling.   
    Afterwards he may have some off balance feel and that will improve with time.    I tried to do too much afterwards to prove to myself that I will be normal again and one just has to not push themselves too much too fast as it does improve.
    This surgery, even if just part of the tumor is removed, can be a long one so don't let that scare you also.   Surgery day is very hard on ones family.
                        I wish you all well,                Cheryl R
Right mid fossa 11-01-01
  left tumor found 5-03,so have NF2
  trans lab for right facial nerve tumor
  with nerve graft 3-23-06
   CSF leak revision surgery 4-07-06
   left mid fossa 4-17-08
   near deaf on left before surgery
   with hearing much improved .
    Univ of Iowa for all care

HeadCase2

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Re: Huge Tumor
« Reply #7 on: March 19, 2008, 07:36:39 am »
Ronan,
  Sorry to hear about your dad's AN diagnosis.  It is not unusual for AN to go undiagnosed or misdiagnosed for a long time.  I first had sudden hearing loss 25 years before a proper diagnosis.
  As leapyrtwins mentioned, having very experienced AN surgeons can be vital to the best outcome.  I don't know where you're located, but I know of one Skull Base surgery expert that travels internationally to perfom AN surgey,  Dr. Takanori Fukushima, see http://www.carolinaneuroscience.com/
  Best of luck with your familie's AN journey.
Regards,
  Rob
1.5 X 1.0 cm AN- left side
Retrosigmoid 2/9/06
Duke Univ. Hospital

GrogMeister of the PBW

Esperanza

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Re: Huge Tumor
« Reply #8 on: March 19, 2008, 10:29:30 am »
Just to add how sad I was to read your post.  My thoughts are with you all.

Profoundly deaf suddenly on AN side with vertigo January 3rd 2008.
12mm left side AN diagnosed 20th Jan. 2008.  MRI  in July shows no growth. What do I do now?????

4cm in Pacific Northwest

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Re: Huge Tumor
« Reply #9 on: March 19, 2008, 10:35:52 am »
Ronan,

Good for you to advocate for your father and to get on-line!  :) Welcome.

RE:
"The doctors say they will be taking only a part of the tumor out as taking the whole thing out will be too risky. Is this a normal procedure? "

What your father’s surgeons are advocating is de-bulking of the tumor. This involves removing the bulk of the tumor and leaving residual behind… and watching it via MRI to see if it shrivels up, disappears, or re-grows. If there is re-growth- it can later be treated with Radiosurgery (Gamma knife etc.) This de-bulking approach also has a higher chance of preserving the facial nerve. Because the tumor is big I advise that you and your Dad prepare for the reality that he could have some issues- post surgery. I initially had balance issues- 6 months later I am now fine there. I woke up with complete Bells Palsy. Almost at 7 months now - I have 60 % facial movement back but I developed synkinesis (this happens in ‘some’ cases). I think it is advisable to leave residual tumor as to not damage the facial nerve (I had 99% tumor removed and now I am thinking they should have left more tumor behind to preserve the facial nerve to which my tumor had completely incased). It sounds to me that your father’s surgeon is advocating the right thing. It is important to be realistically aware that the bigger the tumor the bigger the chance of residual effects- (post surgery). However know that the mortality rate for this surgery is VERY LOW- as technology has improved the treatment process tenfold (over this past decade.)

Here is some info from the Canadian group
http://www.anac.ca/endocs/Finding%20Qualified%20Medical%20Professionals%20-%20May%2020.pdf

And from our ANA site here
http://www.anausa.org/questions_for_physicians.html

It is imperative that you chose a well qualified and experienced "neurotologist and neurosurgeon team" to do this surgery. Also ask what sort of follow up care they offer (physiotherapy etc)

I highly recommend getting these booklets
https://secure.baxinternet.com/~anausa/for_sale.html

The Canadian group also has some booklets available
http://www.anac.ca/links.html

I wish I had bought these and read these before my surgery.

Again- know that the outcome of AN surgery is very different with each patient. There are people with tumors smaller than mine who have had long term lingering effects from surgery yet there are others with bigger tumors (than mine) that sailed through this with minimal post op complications. My only complaint now, with my surgery outcome, is the synkinesis that came as the facial nerve branches grew back and attached to the wrong muscles. I think that if your Dad’s physician is suggesting only removing part of the tumor this is good -as this will increase the chances of facial nerve preservation.

With a large tumor chances are - it will be a long surgery. I recommend that your father does a blood draw and donates his own blood... a couple weeks before his surgery- in case a blood transfusion is needed (as was my case)

Try to encourage your Dad to get on line and join us. This group was key in my successful recovery- and they are still supporting me as I cope with getting physiotherapy for the face (remember your Dad may not even have this issue- each patient is totally different).

Please remind you Dad that the mortality rate for this sort of surgery is VERY LOW now-a-days… Nevertheless for some of us it has been a life changing event and it is advisable to prepare yourselves with knowledge and information.

Here is a good link that explains treatment
http://www.umm.edu/otolaryngology/acoustic_neuromas.htm


Here are a few text book pages that explain this- if you are up to reading a medical text book
http://books.google.com/books?id=4NPQ8Mqt-QUC&pg=PA356&lpg=PA356&dq=debulking+large+acoustic+neuroma+tumor&source=web&ots=nahN6Rjc2b&sig=wspU-LOAxgaX527uqPPmm64e-sE&hl=en#PPA356,M1


Here is an on-line medical dictionary
http://medical-dictionary.thefreedictionary.com/
(to help you de-code their Greek-Latin language  :D)

If the surgeons are suggesting “multiple surgeries� I would be concerned- mainly because of your father’s age. I had a surgeon who wanted to space my treatment into 3 separate surgeries and I declined being that I had already has a one major non AN relate surgery -that year. (This may have worked for a younger patient but I was not game or up for it.) Basically you need to ask lots of questions of the surgeons -as to what surgical approach (translab or retrosigmoid) they are planning and how many successive surgeries are they planning to do to remove and/or de-bulk the tumor (not including radio surgery if there is re-growth).

Gee I hope I have not overwhelmed you. Send me a private post particularly if you have more questions about the 2 surgical approaches – retrosigmoid vs translab.

RE
"I do not reside in the US"

Remember that our forum is global and all are welcome. We have writers from all over the globe.

Which country are you in?

4
4cm Left, 08/22/07 R/S 11+ hr surgery Stanford U, Dr. Robert Jackler, Dr. Griffith Harsh, Canadian fellow Assist. Dr. Sumit Agrawal. SSD, 3/6 on HB facial scale, stick-on-eyeweight worked, 95% eye function@ 6 months. In neuromuscular facial retraining. Balance regained! Recent MRI -tumor receded!

Boppie

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Re: Huge Tumor
« Reply #10 on: March 19, 2008, 01:57:54 pm »
Take care to educate and calm yourselves so that you can give your Dad the best positive support.  There are lots of testimonies here to encourage you.  Remember that folks don't die on the table from surgeries today.  The AN is a space occupying mass made of benign cells.  Your Dad will recover in time. 
« Last Edit: March 19, 2008, 01:59:54 pm by Boppie »

Ronan

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Re: Huge Tumor
« Reply #11 on: March 19, 2008, 08:19:37 pm »
Thank you everyone for making a foreigner feel so welcomed. Thank you for all the links you have provided. They are a great help.

I live in Singapore and there is honestly not much anyone can read up on over here. Everything seems so flat and robotic over here. Unlike over in the US, we do not have any support groups (or at least I have not found any) here where we can find someone to talk to.  I am now determined to set up something over here after my dad's operation so that patients and family members can find someone to talk to. It is one thing to talk to doctors and nurses, I think it is more important to talk to people who have actually been through the journey to fully understand the pain and anguish.

I will keep everyone updated on his progress. I look forward to the day when I can tell everyone that he has recovered. Thank you very much once again.

Ronan

chocolatetruffle

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Re: Huge Tumor
« Reply #12 on: March 19, 2008, 09:41:45 pm »
ronan, I am from singapore too!!   the knowledge and experiences in this forum is excellent, so you came to the right place.  i will contact you offline.
chocolatetruffle


2.8 cm left AN
Translab @ House/St Vincent's 11/27/07
Drs. Brackmann, Schwartz, Wilkinson, Stefan

4cm in Pacific Northwest

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Re: Huge Tumor
« Reply #13 on: March 20, 2008, 11:34:32 pm »
Ronan,

You know House Ear Institute takes many international patients. Chocolate truffle actually had a team I too very seriously considered- particularly if I had gone the translab surgical approach.

Anyway food for thought if your dad wants to work with the most experienced neurotologist surgeon in the world :

Aka Grandpa Brackmann
http://www.houseearclinic.com/BrackmannDE_CV.htm
&
http://www.hei.org/news/bios/brackmann.htm


(Don’t let his age fool you! I met him and he is still sharp as a tack. He has all sorts of neuro-science awards from the British and Canadian Medical Boards. He is quite a remarkable man.)

Just a wild medical travel idea…
 ::)

4
4cm Left, 08/22/07 R/S 11+ hr surgery Stanford U, Dr. Robert Jackler, Dr. Griffith Harsh, Canadian fellow Assist. Dr. Sumit Agrawal. SSD, 3/6 on HB facial scale, stick-on-eyeweight worked, 95% eye function@ 6 months. In neuromuscular facial retraining. Balance regained! Recent MRI -tumor receded!

Brendalu

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Re: Huge Tumor
« Reply #14 on: March 21, 2008, 05:19:31 am »
Ronan,
I am keeping you all in my thoughts and prayers.  Read about the ninety plus year old woman who is a 25 year alumnus of the AN factor!  She should put your mind to rest about your Dad.  Have you been told how they will deal with the rest of the tumor they are leaving behind?  I am so sorry that your Dad is having to go through this as well as the rest of the family.
Hugs and happy thoughts,
Brenda
Brenda Oberholtzer
AN surgery 7/28/05
Peyman Pakzaban, NS
Chester Strunk, ENT