When would radiosurgery NOT be an option in small-medium sized tumors?

[Jesse]

Greetings,

I was wondering if any of you have heard of cases where radiosurgery was NOT an option for patients with small to medium sized tumors. If radiosurgery was not an option, what might the reasons be? I understand for large tumors, typically 3cm or greater, radiosurgery is typically off the table due to the size. But I am wondering about other reasons where an unbiased neurosurgeon would discourage radiosurgery for small/medium sized tumors.

Thanks!
-Jesse

[sunfish]

First of all, I'm not a doctor.  I think sometimes they don't want to use radiosurgery if the AN is really pressing into the brainstem.  My AN was/is "mildly deforming" the brainstem, and they still did CK.

[jacobson69]

I've also heard when the AN is a cyst (liquid inside).  -- Hui

[leapyrtwins]

Sometimes age, or medical condition/history, is a precluding factor.

Location is another.

I'd also question if the doctor you are referring to really is unbiased.  Docs who do radiation will usually say that it's the way to go and tend to steer patients away from surgery.  On the other side of the coin, docs who only do surgery tend to frown upon radiation.

Your best bet is to talk to a doctor who treats ANs with both methods (surgery and radiation) or to talk to multiple doctors (some who do surgery, some who do radiation).  You want a well-rounded opinion.

Jan

[Jesse]

Hi all,

I just thought I'd follow up with what I learned from the support group meeting at Stanford. I asked Dr. Chang this question and he said there were three circumstances where radiosurgery would not be recommend assuming size was not a consideration.

1) the tumor is severely impacting the trigeminal nerve, and patient is experiencing symptoms typically associated with it (facial pain/numbness).
2) the MRI has a funny look to it, and calls into question whether or not it really is an AN.
3) patient preference - if a patient has a strong preference for open surgery over radiosurgery.

Whether or not the tumor is cystic, Dr. Chang does not feel is a consideration in choosing radio vs. open surgery.

I hope this helps other people in making the choice.
-Jesse