Another gamma vs cyber

[ROCKYB]

I am set to have gamma the doctor said mine is so small 5mm that gamma is the better choice for something that small. Dr Chang in stanford said cyber is better for my tumor who do think is right my hearing is almost perfect and the gamma is right where I live.

[HeadCase2]

Rockyb,
  In my opinion both GK and CK can effectively treat AN.  And there are many people on this forum who have been treated successfully by one or the other.  I would lean toward a treatment team that has lot's of experience treating AN with the machine they plan to use.  The treatment is only as good as the treatment plan (what amount of radiation goes where) created from their experience and expertise, and their knowledge of your AN.  CK is CK, and GK is GK, but the treatment would be slightly different from each treatment team.  Find the team with the most expericence treating AN you can locate.
  Good luck with your AN.  If you're like most of us, investigating the various treatment options, weighing the odds and statistics amoung uncertainties, and making a decision for treatment, can be the toughest part.
Regards,
  Rob

[ppearl214]

Hi Rocky,

I am in total agreement with Rob....

One point you may want to consider in the decision process.

GK, as many here will note, can be used when hearing levels are very small %.... the thought process is... by "fractionating" a radio-treatment (ie: CK, Trilogy, FSR, Proton, etc).... it has a slightly higher % of hearing preservation.  Maybe a thought to consider... but, again, I'm in total agreement with Rob about finding a team with the most experience treating AN's of your size, location, current hearing levels, etc.

Just a thought... pose this to the docs on the CK Patient support board as they are very well versed on all radio-treatments for AN's.... 

http://www.cyberknifesupport.org/forum/

They can give you a professional input to the question. Both are extremely viable treatment options for AN's.... so I also have faith in you to go with your gut.... you will know what is best for you.

Phyl

[leapyrtwins]

Rocky -

I just wanted to reinforce what Phyl said.

In the end you will know what is right for you; so go with your gut 

Please let us know what you decide.

Jan

[km5]

Also,
if your hearing is excellent, and your AN is so small, you might consider "watch and wait" for at least 6 months, get another MRI, and determine whether the AN is growing.  Of course you would have to take the chance that your hearing might deteriorate during that time.  Only you know whether it has been recently getting worse.
Katherine

[Mark]

Rocky,

I would agree with the responses you've received from the others so far. If the issue you're asking about is solely hearing preservation then 3 fraction CK as Dr. Chang alluded to will increase your probability of maintaining your current hearing by about 15% over GK (approx 60% for one dose vs. approx 75% for fractioned CK) . Said another way. 6 out of 10 people who go the GK route will retain their current hearing, 3 out of 4 will do so with CK.

Treatment teams experience with AN's is always a plus but less of an issue for me with radiosurgery than surgery. I wouldn't feel comfortable with a surgeon until they had done 400-500 procedures but given radiosurgery is so computerized, has so many people involved in the treatment review and AN's are one of the easier things to do relative to other types of tumors, personally, I would feel comfortable with any team in the 50-100 range. The experience curve just isn't as steep relative to microsurgery.

Mark

[Nancy Drew]

I don't think I could be any more confused about GK vs CK.  The best we have here where I live in Devner is GK.  CK is new in Boulder.  Does anyone know anything about CK if Boulder?  Their website didn't look so hot.  I hear their commercials on the radio and tv, but other than that I don't know much more.  Maybe I'll try to find out more about CK in Boulder.  It always scares me when something is new and nothing to compare to in the area.  The GK seems to have a good reputation here from what I hear.  I want the GK to work, but I am so confused because it sounds like CK is better suited for those who want to preserve their hearing.  I would love to hear lots and lots of positive GK stories.  Helpppppppp.  Nancy

[Mark]

Nancy,

Actually, the Rocky Mt CK center at Boulder Community is one of the more established CK centers going. It was set up by Dr. Dave Martin who was working with Steve Chang at Stanford when I was treated in 2001. I think they were up and running in 02 or 03. Dr. Martin is no longer there but I understand they have a fairly top notch staff. I chatted with a lady from Denver about 4 years ago and she was treated there and is doing well. If you prefer CK over GK, I would not hesitate to go to Boulder. As far as the differences between CK and GK, I thought Tumbleweed's earlier post today was one of the best I've seen.

Mark

[Tumbleweed]

Here's a direct link to my post that Mark alluded to (thanks for the kudos, Mark):
http://anausa.org/forum/index.php?topic=6670.0

I hope you find it helpful.

I would encourage you to take your time in making your decision. There should be no rush to treat a small tumor, unless your symptoms are bad and/or getting worse. If your tumor is slow-growing, you could possibly avoid treatment for 10 years or more. Dr. Derald Brackmann (famous neurosurgeon at House Ear Clinic) counseled me that he's seen some ANs not grow for 20 years! (Unfortunately, mine thinks it's in a race to finish first! ::)All forms of treatment (even CK and GK) have potentially damaging side effects and should be sought, IMO, only if and when necessary.

I've personally opted for CK because of the statistically higher chance of preserving my hearing (and because of other factors detailed in my post linked to here). But it's a very personal decision. The decision YOU make is the best one for YOU.

Best wishes,
Tumbleweed

[Nancy Drew]

Mark,

I didn't know that about Rocky Mountain Center in Boulder.  I have looked on their website, and I didn't get very much info from it.  As for a list of doctors, it said that page was under construction.  You would think that if they have been around since '02 or '03 the they would have a better more informing website.  They advertise a lot on the radio and tv.  Maybe I will start a thread about CK in Boulder.  It always helps to go to the source with patients who have been through the process.  Thanks.  Nancy

[Mark]

Nancy,

The physician page is under construction which maybe nothing more than aN infamous webmaster tinkering with the format or adding content which they are apt to do.  The rest of the web site actually looks pretty comprehensive to me for a community based hospital. You might want to ask Dr. Medbery over on the CK board who the "go to docs" are there since he trains a lot of them. Other options would be to the Boulder community web site and look up radiation oncologists, it might reference those involved in the CK program

Mark

[Nancy Drew]

Thanks Mark,

I was so closed minded about the CK in Boulder that I had pretty much crossed it off my list.  In past postings a couple of years ago when I first found out about my AN, I asked about the best docs in Denver area for any kind of treatment.  The Denver folks told me about the docs here who do surgery and GK, but I never got anything about the CK in Boulder.  Hate to say it, but a lot of people here in Denver believe Boulder is 30 square miles surrounded by reality so I have never thought to go there for info.  I should give Boulder a break I guess.  Sorry if I have offended anyone from Boulder, and I really do enjoy visiting over there (only thirty miles away from Denver).  I have just never heard of anyone getting treatment in Boulder except for routine stuff.  So I am being a little judgemental, and I need to give them a chance.  I think I read though that Denver might have a CK when I googled, but I didn't have time to check it out.  I'm going to do it now.  Thanks for helping me see that Boulder could actually have some reality in there.

Nancy

[Mark]

Nancy,

As a graduate of the University of Colorado, Boulder, I could not agree more with your characterization that the town is 30 sq miles surrounded by reality. I went to the college of business which is about the only part of the population that can probably relate to the rest of the world  . It's a great town and was a great place to go to school but the general mentality does tend to follow the Kingdom of Berkeley 

Mark

[Nancy Drew]

Mark,

I am confused.  Did you have your CK at Stanford or Boulder?  I guess I didn't catch your Boulder connection.  How funny!  I went to graduate school (social work) at University of Denver, and many of my classmates were from Boulder.  Some of those folks were kind of out there, but it can be true for my profession anyway.  I think University of Colorado is a fine school, but they do know how to party (and, I'm not saying that is a bad thing!).  I looked again, and it does seem that Boulder has the only CK in CO. 

Thanks for not taking my Boulder comment the wrong way.  Nancy 

[Mark]

Nancy,

CK was at Stanford as I've lived in the Bay area since 1992. College "education" and other antics occurred at CU and I lived in the Denver area for most of the 80's

Mark