Well I'm back from the consult with Dr. Akagami and I've had a couple of hours to digest it. I've decided on surgery as my best option, not that I'm filled with delight at the prospect of someone splitting open my head, but at least I think I have found an extremely capable neurosurgeon in Dr. Akagami.
I've opted for surgery for a number of reasons but the main one is that my tumour is not a good candidate for radiation. For one thing it is getting up there in size, the biggest he said they do with radiation is 3.0 cm. Due to it's size there is a significant amout that is in contact with healthy brain tissue. A certain amout of this tissue would get radiation as well (increasing as you go up in tumour size). Also irradiated tumours often swell before they shrink and due to the way the nerves are stretched by the tumour this swelling could cause problems. Having said all that he did say that if I was adamant that I wanted radiation it could be attempted.
He didn't give me good odds on preserving my hearing but did say that he felt it was worthwhile to make the attempt, hence the retrosigmoid approach, according to him I've got a 40% chance of still hearing afterwards but at a reduced level (my hearing is still quite good, about 80% or so). I was surprised to hear that (hah hah) as I had pretty much written off my hearing and accepted that I will likely be SSD. Facial paralysis he said there will be some but that I should recover within 6 weeks to 6 months, back to virtually normal. There is a small risk that I could experience significant paralysis. Fingers crossed on that one, I'm not ready to speak like Jean ChrÃ©tien just yet.
That's about it, I'm on the list and waiting for a date, in the meantime I have to go get another MRI with contrast to give him a better picture of the tumour and surrounding nerves and blood vessels.
Oh, and I asked him if the brain tissue that is currently compressed by the tumour will decompress and he said "absolutely" and then I asked "Will I be smarter after?" Hah, hah, he answered me seriously though, apparently not, bummer, should be some benefit to a brain tumour!
As always, black humour and my wonderful wife keep me sane during this journey.
Next on the list, tell my employer, that should be fun...