Here is a list of questions I have developed for deciding what type of treatment and which doctor/medical center should perform the treatment for my AN (an acoustic neuroma is also known as a vestibular schwannoma). I hope people find this list helpful.
Questions for both neurosurgeons and radiation oncologists:
1. What are the tumorÃ¢â‚¬â„¢s overall dimensions in mm?
2. How would you treat this, microsurgery or radiosurgery?
3. Why have you decided against the treatment not recommended?
IF RESECTION (MICROSURGERY) IS RECOMMENDED:
4. Which surgical approach would you take for my tumor and why?
Retrosigmoid (AKA suboccipital)
5. How many vestibular schwannomas have you treated using this approach in the past year? Since you began using this approach?
6. Would my vestibular and hearing nerves have to be completely removed on the affected side?
7. Would you opt for near total resection over complete removal of the tumor if it might preserve hearing and reduce risk to the facial nerve?
8. Will I be awake for any part of the surgery, for example to perform brain mapping? If so, will I feel any pain or discomfort?
IF RADIOSURGERY/RADIOTHERAPY IS RECOMMENDED (radiosurgery is one dose/treatment, while radiotherapy is multiple, smaller or "fractionated" doses):
9. What type of radiosurgery/radiotherapy do you recommend and why?
Other fractionated stereotactical radiation
10. How many treatments, spaced how far apart?
11. What will be the total biologically eequivalent dose?
12. How many vestibular schwannomas have you treated using this approach in the past year?
13. How many vestibular schwannomas have you treated since you first started using this protocol?
WITH EITHER TREATMENT:
14. What are my chances in percentage terms) for:
Preserving my current level of hearing long-term (at 5 years post-treatment or longer)?
Preserving normal function of the facial nerve (House-Brackmann Grade I or II)?
Preserving normal function of the trigeminal nerve (CNV)(if affected by the tumor)?
Side effects from the procedure (headaches, hydrocephalus, infection, bleeding, behavioral or cognitive changes)?
15. How long of an observation period, with follow-up MRI to confirm tumor growth, can I reasonably afford to take before undergoing treatment?
16. Do you recommend I have any additional tests before treatment?
17. If the tumor is still growing, what additional neurological symptoms might present before treatment that I should watch out for? Would they likely come on suddenly or slowly? For example, would I likely have some ipsilateral facial tingling or weakness before numbness or paralysis, or might advanced neuropathy occur suddenly?
18. If you werenÃ¢â‚¬â„¢t performing the treatment, which medical center and neurosurgeon or radiation oncologist would you recommend to treat me?
19. If there are no complications, how long would my hospital stay be?
20. How long after treatment would it be before I can: A. walk, B. go back to work, C. do strenuous exercise?
21. Will I need to take medications before, during or after the procedure? What kinds?
22. Will you use an intraoperative MRI, Xrays, nerve monitoring or other aids during the procedure?
23. What specialists will be on the treatment team?