Hi, Dan:
Man, you're in a tough situation. You're also a brave guy.
As you probably know, if your AN tumor is smaller than 3 cm, you're a candidate for radiation treatment, which, while certainly easier than microsurgery, carries its own risks, including possible nerve damage. If your tumor is a viable candidate for radiation, I would suggest looking into FSR (Fractionated Stereotactic Radiosurgery) which is done in protracted, low-dose treatments and carries less risk as well as being, like the traditional radiation protocols, relatively quick and painless.
As my signature shows, I had both surgery and FSR last year. I'm pleased to report that I'm doing splendidly, today. If you met me, you would never guess that - 11 months ago - I had a fairly large AN tumor beginning to press on my brainstem, suffered from severe disequilibrium, fatigue, loss of appetite (I lost over 30 pounds before having the AN removed) and was unnaturally lethargic. The surgery was performed to reduce the size of the tumor and allow it to be radiated. My neurosurgeon and the radiation oncologist who collaborated on my treatment plan gave me a four -month 'break' between the surgery (which was uneventful - 4½ days hospitalization) and the radiation. The FSR treatments were spread out over 5 weeks, 5 days per week (Monday through Friday) and lasted about 20 minutes each. I suffered no pain or discomfort while undergoing the FSR treatments. My radiation oncologist told me that another AN patient receiving similar treatments in the same cancer center dropped by after work, had his treatment and went home to dinner each night, just a bit later than usual. He kept up his regular work schedule all during the time he was being treated. I'm retired but could easily have continued to work while undergoing the FSR treatments. An MRI scan that was taken two months following my FSR treatments showed the beginning of tumor necrosis.
I'm sorry that your circumstances make the demands you describe. I can't imagine that kind of stress. I hope your AN is small enough to be treated with radiation and that whatever option you eventually chose will be successful.
Of course, should an MRI show your AN tumor to be too large for radiation, surgery will be your only realistic option. Few doctors will attempt to radiate a tumor much larger than 3 cm. Remember, not all AN surgery carries disastrous consequences so don't allow the 'horror stories', while unfortunately true, to keep you from doing what needs to be done. My surgery was almost 9 hours long and I came out of it basically 'intact', although tired and a bit nauseous from the anesthesia and hospital meds I received. I was driving in two weeks and resumed my normal activities within a month. I'm not that much of an exception. Having a throughly experienced neurosurgeon - my surgeon had 30 years experience removing acoustic neuroma tumors - is the key to a successful surgery. Prayer doesn't hurt, either
Wishing you all the best as you deal with this medical crisis.
Jim
