ANA Discussion Forum
Archive => Archives => Topic started by: GM on April 25, 2005, 09:21:35 am
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Has anyone had to have another radiation treatment? Looks like my tumor wants to be a bit stubborn. It originally measured as 1.8 and is now up to 2.1. I had my GK treatment in Nov of 2003. My follow up MRI have seen a swelling of the tumor (normal in 35% of patients), it is showing signs of darkening, but hasn't stopped/shrunk yet. If I go back in October and it still hasn't shrunk...looks like I may have to have another treatment. Has anyone had to have more than one treatment as a GK patient?
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I have not had another radiation treatment, but have a story similar to yours. I had radiosurgery at Shands in Gainesville, FL in Feb. 2000 at which time my AN was 2.20 x 1.50 x 1.10. After the first year it showed some swelling/growth. By the second year(2002) it measured 2.20 x 1.70 x 1.50 and Dr. Friedman thought the treatment had failed, but said to have another MRI in 6 months to make sure. The 6 month MRI showed no change and all MRIs since showed no change. I talked with Dr. Friedman's office last week and they said it looks good and I can wait 3 years to have another MRI (I'm not sure I want to wait that long)
I am optimistic that it has stopped growing now. I know you must be worried, but maybe this will give you some hope. :D
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From all the info I've gathered, retreatment with radiosurgery or resection should not be considered until 2 years after the original radiosurgery, unless there is significant growth beyond what can be caused by swelling due to central necrosis, or the swelling causes severe symptoms that constitute emergency surgery.
Here's some info from IRSA you may find comforting:
"Shrinkage actually is found in the vast majority of tumors when they are followed long enough. One year after the Gamma Knife treatment, shrinkage is confirmed in about one-third of the tumors. After four years, two-thirds of the tumors are smaller, and by 10 years, more than 90% have shrunk.
Signs of lack of response to radiosurgery, in general, appear within one to three years of treatment. At least in my experience, failure is extremely unlikely to occur when five years or more have elapsed. This statement may not apply for acoustic neuromas associated with neurofibromatosis 2 (NF2) in which case recurrence may occur later following Gamma Knife treatment as well as microsurgery.
I have found that Gamma Knife treatment can be repeated without increased risks if the acoustic neuroma did not respond as expected (unchanged size/shrinkage) to the first treatment. Microsurgery can also be selected, depending on the patient's preference.
Acoustic neuromas sometimes increase in size temporarily as a reaction to the Gamma Knife treatment. This is actually a favorable sign indicating a brisk response. Such swelling usually is most obvious between 6 and 18 months after the procedure. It should not be confused with increase due to lack of response in which case the tumor size will not return to the baseline but continue to increase. A definite assessment should be made two years after the treatment: was the swelling merely temporary or did the tumor fail to respond to the treatment? In any case, resection should not be considered during this two-year wait."
http://www.irsa.org/acoustic_neuroma.html
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A good friend of mine had the same increase as the one you report. Seven years after, it has not shrank back but grew impercetively by one more millimeter. Her doctor thinks it is now stable and that it will not change again. In feb. it will be 8 years and she chose to forget the whole thing
So, do not worry so much, and wait some more. It was a bit over 2 years when it stopped completely.
ant
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I wouldn't wait 3 years for your next MRI, I was told to have one every year for the next 5 or more years, if there is no change at that time to come back every two years. The Doctors at the Mayo also said that this has to be monitored for the rest of my life. Don't take chances this is your health.
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The Doctors at the Mayo also said that this has to be monitored for the rest of my life.
I believe it's recommended that all treated patients be monitored for life, not just radiation patients. Resected tumors have recurred after 10 plus years. But I've read it's pretty rare in either case for recurrence after five years, and I think the monitoring after that point mostly serves research purposes. I think alot of patients discontinue follow-up, maybe they wouldn't if MRI's weren't so expensive.