Hi Tisha,
Since your doctor is suggesting wait and watch, I'm guessing your tumor is still relatively small, which is a good thing. I was diagnosed with a 2.5 cm AN last summer (way too big for my taste but still considered "mid-sized" in the scheme of things). After lots of research and multiple consultations, I decided to go with Cyberknife. Here is what I concluded:
* Surgery and radiation have about equal success rates -- the treatments are successful around 95-99% of the time, which is amazing in both cases.
* There is virtually no risk of facial nerve injury in radiation, but there is a meaningful risk of facial nerve injury in surgery. That risk increases with the size of the tumor but it is always present.
* You are much more likely to lose hearing in surgery. The translab approach guarantees hearing loss. Other approaches give you a moderate chance of hearing preservation, especially if your tumor is small. On the other hand, with Gamma Knife, 40-65% of patients with useful hearing retain it after the procedure. With Cyberknife, the percentage is more like 75% and maybe more. My hearing is still unaffected about 14 months after treatment.
* The medical studies I have found show that patients treated with radiation have a better quality of life after treatment than those who have surgery. Below are the examples. Hopefully, the medical community will continue to publish work in this important area. I did not find any studies showing that surgery patients have a better post-treatment quality of life than radiation patients, but would appreciate being pointed to some if they exist.
http://www.ncbi.nlm.nih.gov/pubmed/16823303?ordinalpos=13&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSumhttp://www.ncbi.nlm.nih.gov/pubmed/12450031?ordinalpos=45&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSumhttp://www.ncbi.nlm.nih.gov/pubmed/15854240?ordinalpos=21&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum* The post-treatment complications from surgery can be quite problematic. For example, some patients lose moisture in their affected eye, requiring an intensive regime of daily eye care. Some patients experience debilitating headaches for some time. Radiation patients do experience post-treatment symptoms, such as dizziness, head fullness, fatigue, and depression. After my own treatment, I experienced wide fluctuations in symptoms, which I describe in detail in my website (see my signature line below). The issue of post-treatment symptoms is difficult to evaluate, since there simply isn't enough objective information available. However, to my mind, the information that is available (such as the studies above) suggests that overall, post-radiation symptoms are less problematic and less debilitating than post-surgery symptoms.
* Another important difference, of course, is that in surgery the tumor is removed while in radiation it is merely killed. Psychologically, this is a powerful pull towards surgery. However, what I learned from speaking with doctors is that unfortunately, removal of the tumor does not eliminate the symptoms associated with the tumor. Yes, the tumor is gone, but you still have daily reminders of its former presence with ongoing post-treatment symptoms. The same thing generally is true with radiation. There are lingering side effects from the treatment that improve slowly with time. But as I see it, the radiation symptoms are less intense and have less of an impact on your daily life, plus you get a good shot at keeping your hearing and you save your facial nerve, two other important factors that affect your sociability and overall lifestyle.
These are the reasons I chose the treatment I chose. Needless to say, this research is about averages and statistics. Some patients have superb outcomes in surgery, and some radiation patients have intense post-treatment side effects. Lots of folks will say go with your "gut" when it comes to a treatment decision, and I agree with that completely. But first do the research and speak to multiple doctors (both microsurgeons and radiotherapists). Once you have the facts, and once your questions are answered, you will know which treatment is right for you.
You can read more details about my research, along with some more tips and resources, in the website below (in my signature line). Be well and please feel free to contact me if I can help in any way.
Best,
Francesco
