Author Topic: What size AN is considered too big for watch and wait?  (Read 6664 times)

SonDek

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What size AN is considered too big for watch and wait?
« on: September 30, 2011, 09:27:35 pm »
Sorry if this is a stupid question ...

What size AN is considered too big for watch and wait?
My mom was diagnosed with a 3cm by 3cm by 3cm  AN September 2011.  Translab surgery with Dr. Izukawa and Dr. Chen on October 14th 2011.  Facial nerve saved but thinned.  Gold weight.

leapyrtwins

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Re: What size AN is considered too big for watch and wait?
« Reply #1 on: October 01, 2011, 06:36:16 am »
Not a stupid question at all.  In fact, no questions are stupid.

I'm not 100% sure of the answer to your question, but I'd imagine an AN that is considered large (3 cms+) would be something you wouldn't want to watch and wait. 

Although larger ANs (especially in the 4cm+ range) should be dealt with sooner rather than later, most of the time you can watch and wait (regardless of tumor size) for at least a short period of time - since ANs are slow growing.   

On the flip side, with a smaller AN that is causing big problems - balance, hearing, etc., - it might be in your best interests not to W&W.

Your best bet would be to ask your doctor; he or she knows the specifics of your case and can advise you accordingly.

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

Jim Scott

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Re: What size AN is considered too big for watch and wait?
« Reply #2 on: October 01, 2011, 11:02:55 am »
SonDek ~

Jan offered good advice, i.e. consult your doctor.  I would add that the location and growth pattern of the tumor will have a a bearing on whether or not to address it (surgically or with radiation) at a specific time.  From what I've read, as soon as your doctor notes definite growth (usually over at least a year) he/she will want you to consider 'doing something'.

Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

SonDek

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Re: What size AN is considered too big for watch and wait?
« Reply #3 on: October 01, 2011, 05:57:21 pm »
Thanks for the replies! I'm writing on behalf of my mom.

My mother's AN is 3cm and aside from loss of hearing and the one dizzy spell that landed her in the hospital, she has no other symptoms.    I don't feel that her doctors have been all that helpful.  I understand it's ultimately her choice, but we don't have a good gauge on whether it's a huge risk to watch and wait at this point.  They actually have given her a surgery date already -- in two weeks from now, so we need to decide pronto. 

My mom was diagnosed with a 3cm by 3cm by 3cm  AN September 2011.  Translab surgery with Dr. Izukawa and Dr. Chen on October 14th 2011.  Facial nerve saved but thinned.  Gold weight.

PaulW

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Re: What size AN is considered too big for watch and wait?
« Reply #4 on: October 02, 2011, 04:52:53 am »
Most doctors recommend treatment once it reaches 2.5-3.0cm or above.
10x5x5mm AN
Sudden Partial hearing loss 5/28/10
Diagnosed 7/4/10
CK 7/27/10
2/21/11 Swelling 13x6x7mm
10/16/11 Hearing returned, balance improved. Feel totally back to normal most days
3/1/12 Sudden Hearing loss, steroids, hearing back.
9/16/13 Life is just like before my AN. ALL Good!

mk

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Re: What size AN is considered too big for watch and wait?
« Reply #5 on: October 02, 2011, 08:25:15 am »
When was your mother diagnosed? If she was diagnosed recently and she already has a surgery date this means that the doctors think that it should be operated upon soon. In Ontario if they don't consider it urgent it can take quite a few months to schedule surgery.

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.

rm516

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Re: What size AN is considered too big for watch and wait?
« Reply #6 on: October 02, 2011, 10:38:12 pm »
 
I have  between 2.7 cm & 2.9 cm diameter AN or  meningioma - but stable &  Asymptomatic per last MRI in Aug/11 ...
On Surgeon's advice, I am on W &W...
My hearing in right ear is not perfect  (> 80 % OK, clogging), tinnitus & head gets  Wonky, when I am tired. On good days (weekends) there are no issues ...    Just normal ...
I will love to have oral medication (under clinical trial), and HOPE FDA approval comes faster than I have to decide for surgery..
« Last Edit: October 03, 2011, 03:55:10 am by rm516 »
Diagnosed AN in 2008,  3.2 cm CPA round, retrosigmoid surgery performed by Dr. M. Sisti, Columbia Pres.Hospital  NY, in Jan 2013, After surgery no major issues, Hearing retained (>50% ). However, 2 YRs post surgery MRI shows a further decrease in the size of residual AN! No GK or any therapy needed.

alabamajane

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Re: What size AN is considered too big for watch and wait?
« Reply #7 on: October 03, 2011, 08:01:30 am »
HI, first let me say I am NOT a doctor,, however, we have all been told these are benign, slow growing tumors which generally allow for time for research and consultation. . on that note, unless she has been told this is an emergency situation that needs to be treated immediately, I would think another opinion would be wise.. most Drs if  they are surgeons,, will advise to proceed to surgery. I have been seeing one Dr (neurosurgeon) for three years and his advice is to proceed to surgery. One option is to send her MRI out to House Clinic in Los Angeles (HEI.org, I believe) for a free no obligation phone consult. You send it overnight Express Mail and a Dr will call you I believe within 48 hrs usually with an opinion. I did this two yrs ago and again sent this yrs MRI .. the first yr he said watchful waiting was ok and then this yr due to some growth and it pressing on brain stem, he suggested I move forward with surgery (symptoms had also worsened,, headaches, tinnitus, dizziness/nausea, balance issues etc,,,,).. I received more info in that phone call than I have in three yrs with local Dr.. most reassuring!.. so bottom line, unless it is emergency surgery indicated,, I believe you should not feel forced into surgery of this magnitude unless you/ she is comfortable with that decision.. and only valuable, in depth info and explanation of location, size, and outcomes will give her that comfort.. just my humble opinions here as someone who has been w&w and now must move forward....by the way,, mine is 2.8cm..so large but not huge!!
translab Oct 27, 2011
facial nerve graft Oct 31,2011, eyelid weight removed Oct 2013, eye closes well

BAHA surgery Oct. 2014, activated Dec. 26

Mickey

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Re: What size AN is considered too big for watch and wait?
« Reply #8 on: October 03, 2011, 09:48:14 am »
I`m not an expert on the subject but over the years come up with some conclusions. With parameters pretty much set at 1.5cm medium size 3.0 large before that small. Other things come into play, symptoms, location, age. With so many variables I think most important is to get the best doctors for yourself after youv`e digested the above, find out where he is most comfortable and take it from there...Best wishes, Mickey P.S. New study in our ANA booklet indicated that after 5 years of W+W "stable" AN seem to stay that way... As far as symptoms ???

SonDek

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Re: What size AN is considered too big for watch and wait?
« Reply #9 on: October 06, 2011, 05:04:32 pm »
Thanks again everyone ...
I wish I could say that we've had all questions answered and have achieved clarity and arrived confidently at a decision ... but with one week prior to surgery date, my mother still feels unsure and is just so overwhelmed by it all. 

My mom was diagnosed with a 3cm by 3cm by 3cm  AN September 2011.  Translab surgery with Dr. Izukawa and Dr. Chen on October 14th 2011.  Facial nerve saved but thinned.  Gold weight.