Author Topic: Option: Surgery or Gamma knife.  (Read 5755 times)


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Option: Surgery or Gamma knife.
« on: June 13, 2007, 12:35:25 pm »

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        Hi, I was told last 05/29/07 that I have an AN on my left ear, about 3cm and was scheduled for surgery on 08/29/07 at Kaiser Permanente in San Diego under Dr. Bill Mastrodimos and Dr. Roberto Cueva using Translabyrinthine Approach.  At that time, with so many informations to grasps, looks like surgery was an option to me, eventhough, the doctors told me that I will completely loose my hearing and the possibility of facial nerve damage. Yesterday, I  had a second opinion with Dr. Samuel Whitaker at Long Beach hospital.  He gave me the option of Gamma knife which is sound better than the surgery.   

        I want to explore the radiation option. I would really appreciate if there's anybody who can share any studies they did about gamma knife and the experience and complications of those who had it. 

        I also want to sent my MRI to the House Ear Clinic for 3rd opinion, if anybody can tell me how.

        I have lots of questions and worries, I'm glad I found this site.


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Re: Option: Surgery or Gamma knife.
« Reply #1 on: June 13, 2007, 01:53:47 pm »

Generally, 3 cm. is right about at the limit for radiosurgery. If you contact House, they will definitely recommend that you have surgery. That's what they do.

A good place to get information is at the University of Pittsburgh neurosurgery website:

They cover all options and do a good job of breaking down the technical information.

 There is also a site which is an index to articles in medical journals. If you use the search term acoustic neuroma, you'll get access to the articles. One interesting short article is an editorial in the Journal of Neurosurgery, Nov. 2006 by Jason Sheehan. The link should be

If that doesn't work, you can use Google or pubmed to find the journal.

Good luck with your decision.



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Re: Option: Surgery or Gamma knife.
« Reply #2 on: June 13, 2007, 05:52:05 pm »

As Mac indicated, a 3 cm AN is right on the cusp of being able to be treated with radiosurgery. There are a number of factors in terms of the physical impact of the tumor on the adjacent structures as to whether it was preferable to surgically remove or if treating it with radiation is safe. That being said, I am aware of several people who have have similar size AN's treated with GK or CK and are doing well, so I think it would be worth your pursuing an opinion on that option.

Kaiser does not do radiosurgery and has a hard time deviating from their "playbook" of solutions. Those who know my story are aware I do not have a high personal opinion of the Kaiser HMO as a "cutting edge" place for the best practices available. I think they are a wonderful medical provider providing your healthy  ::). I was able to escape kaiser and get into a PPO option, but I do know Kaiser will send people to Radiosurgery in network if you push it. They have a relationship with Stanford for CK treatments and given the size of your AN I would go there if you want an opinion as to whether you're a candidate. I would recommend Dr. Steven Chang who was my neurosurgeon, he does both options and I think he would recommend which was best for you.

Here is a profile on him
Steven D. Chang, M.D.
Assistant Professor of Neurosurgery
Director of Cyberknife Radiosurgery
Stanford University
Curriculum Vitae (CV)

Patient appointments:
(650) 723-7093 Neurosurgery Clinic

Dr. Chang specializes in the treatment of vascular disorders and tumors of the brain and spinal cord. He is the Neurosurgery Director of Cyberknife Radiosurgery. His cerebrovascular work focuses on the use of surgery and radiosurgery for cerebral aneurysms and vascular malformations (AVMs). He also specializes in surgical and radiosurgical (Cyberknife) treatment of brain tumors such as acoustic neuromas (fractionated radiosurgery), meningiomas, brain metastases, and pituitary tumors. He is one of the few physicians in the world today specializing in radiosurgery treatment of tumors of the spine. His research focuses on the development of new methods of utilizing stereotactic radiosurgery and Cyberknife â„¢ for the treatment of tumors of the brain and spine. Dr. Chang has also published numerous articles, abstracts and book chapters on the subject of cerebrovascular disease and radiosurgery treatment of brain and spine tumors.

Good Luck

CK for a 2 cm AN with Dr. Chang/ Dr. Gibbs at Stanford
November 2001


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Re: Option: Surgery or Gamma knife.
« Reply #3 on: June 20, 2007, 09:46:15 pm »
Hi there, my AN was also 3cm. My doctors at the Mayo Clinic in Minnesota, said they were not comfortable doing anything but the translab with a tumor that size. They said a translab, though I would lose my hearing, was the best way for them to get a real clear view of my facial nerves. Even though the literature said other procedures had good outcomes, my docs said that for them personally, it was so much easier to protect my face if they went in translab. I am 5 months post op, doing great, 99% back to normal, but with SSD. Life is good. Best wishes, Yvette
3cm translab Jan. 2007 performed at Mayo Clinic MN. by Drs. Link and Driscoll. SSD but doing great!


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Re: Option: Surgery or Gamma knife.
« Reply #4 on: June 24, 2007, 05:19:17 am »
Hi.  While this information may not directly address your concern, I do hope it provides some insight for you and I pray that you have a healthy resolution to your situation.

I was diagnosed with two very large tumors, a AN and hemangioblastoma.  I was declined as a patient by a very well known center as I learned that Proton or Gamma knife treatment is something that can most likely be done on smaller tumors but not on llarge tumors as mine were.  The center's staff was extremely kind and compassionately advised me that my tumors were considered inoperable due to size and involvement of various nerves.  They however offered me the names of Dr. Cuevas and Dr. Mastradimos as perhaps two specialists that had addressed simiilar challenges with surgery and perhaps they could help in my case.

I contacted Kaiser and scheduled my MRI's, records, etc. to be sent there.  I met and found both doctors to be very compassionate, kind and straight-forward.  I can emphatically say that their level of expertise, reputation and committment to nuerosurgery is superior and they are well respected by their peers.  I am aware that every specialist at this level and in this discipline will be talented and this is certainly true of them.  They spent over 9 1/2 hours performing my 1st surgery to carefully cut around countless involved nerves thus minimizing further damage to me and somewhere around 6 hours for the 2nd surgery 7 months later.

They saved my life.

Recuperation is nearly over and I expect to be leading a normal life quite soon, minus my right ear which the tumor destroyed.

I hope this helps in your decision.