Pros and Cons

[lrobie]

Hi Forum Friends,

Several people I talk to tell me that it might make my decision easier if I write down what the pros and cons are between surgery and radiation.  It seems to me that most of us would come up with the same lists.  I would like to know what some of your pros and cons have been.

Thanks,

Lisa

[chloes mema]

I, also, would be very interested in that.

Karen

[leapyrtwins]

I think that pros and cons differ for all of us - it really comes down to what is important to you.

For example, I felt one of the pros of surgery was that the tumor is removed - but that's because I knew if I had radiation I'd worry about whether the tumor had stopped growing or not.  Others may or may not care if the tumor is removed, so my "pro" isn't necessary something that everyone shares.

Does this make sense?

Jan

[jaylogs]

Jan summarized it pretty good.  I had similar thoughts...I just wanted that out, I didn't want to worry about it regrowing as well.  Same thing for the watch and wait...I probably could have, but I wasn't getting any younger and there was no way of know if my AN had gotten any bigger.  So all in all, however you feel is the best way to make a decision is the way to go! I wish these were one of those things that someone can just tell you to this and do that and go there to this doctor...etc etc.  Anyways, good look as you continue to explore your options!
Jay

[lalala80]

Same as everyone, I think it really depends on your situation.  I think if the tumor is small, and there is a good chance they can get it out without sacrificing your hearing and other nerves, surgery for me would be a better bet.  Mine was considered medium sized though, and is in a tricky location, so they would have to sacrifice my hearing and I have a high chance of facial paralysis from surgery.  For me, I am choosing radiation, but if it had been smaller and they had given me better odds of saving hearing and not having facial paralysis, I would have chosen surgery just to get it out and not have to worry about it anymore.  However, surgery still does not guarantee you never have to worry about it.  Nobody really knows what causes these things, although there is evidence that exposure to childhood radiation and people who have endocrine system issues (such as hypothyroidism like I have) have a much higher chance of developing these tumors.  So even if you have surgery and remove it, another could grow in its place, albeit I don't think the likelihood is very high.  So here are my pros and cons:


Radiation pros - outpatient procedure, so no recovery time, much lower chance of facial paralysis and other detrimental side effects, no chance of death, higher chance of hearing preservation for larger tumors.

Radiation cons - tumor is still there, no long term studies (this is only a factor is you are relatively young when diagnosed, they have up to 20 year data on this but maybe in 25 years all people who have radiation end up with brain cancer, nobody knows at this point), may still have to have surgery and radiation could complicate it, you have to live with not knowing what side effects you may end up with in the coming years. 

Surgery pros - tumor is gone,  no exposure to radiation with unknown long term effects, you know right away what your symptoms are going to be and can begin to adjust and compensate, if your tumor is causing serious balance issues surgery corrects this much faster while radiation can take several years or not at all.

Surgery cons - higher chance of facial paralysis and damage to other nerves in that area, lower chance of hearing preservations particularly with medium to large tumors,  long recovery time, higher chance of death, it's brain surgery and they are going to be cutting a hole in your head.

[lrobie]

Thanks for your replies thus far.  Jan - Now that I've been pondering this, I do agree that the pros and cons could differ.  Especially based on the individuals personality and how they are able to handle tough situations.  After reading a story yesterday of someones journey with radiation, I don't know if I could handle not knowing when a symptom or complication could hit you.  This person kept having ups and downs for four years.  I don't know if I could pull myself out of the low points of that roller coaster ride.  These are what I came up with for my pros and cons.

Radiation Pros - 1. non-invasive 2. little to no time off work (provided your symptoms/complications don't get the best of you)

Radiation Cons - 1. playing the waiting game for symptoms/complications 2. MRIs for life 3. tumor still there 4. possible regrowth 5. unknown malignancy statistics

Surgery Pros - 1. knowing most complications/symptoms up front 2. total tumor removal (most of the time) 3. no radiation to my body 4. not as many MRIs in the future

Surgery Cons - 1. invasive 2. possible regrowth 3. time away from work (I currently have six weeks of sick leave and 30 vacation days - so truly not a con in that sense) 

Lisa

[leapyrtwins]

Lisa -

you are right about personality playing into this; I'm a very black & white type of person - not a lot of "gray" in my life.  I'm a very realistic person who likes to meet a challenge head on (no pun intended) and deal with whatever it brings me.  My bottomline in my treatment decision was getting the tumor removed so I could see what side-effects I was left with in order to deal with them and move on with my life.  So to me, surgery was the perfect solution.

I'm definitely not the watch & wait type - I'm a worrier; and radiation to me includes elements of watching & waiting.  Patience is NOT one of my virtues 

Not pushing surgery here, but I need to note that odds of regrowth where the surgeons feel they have removed the entire tumor are only 1-2%.  I say where the surgeons "feel" they have removed the entire tumor because AN surgery is a very "close" surgery done through a "window" in the skull using a high-powered microscope.  Docs try their best and truly believe they have removed the entire tumor if they tell you that, but even one cell of the tumor inadvertently left behind has the potential to grow.

Most docs will quote you a post op recovery time of 6 weeks, but that depends on the individual.  Some take 6 weeks; some take more, some take less - results vary and sometimes side-effects have a big effect on recovery time. 

I originally told my doc there was no way I was having surgery - and one of my biggest reasons was the time I'd be in the hospital and off of work; another was concern over who would take care of my children while I was laid up.  Once I decided that surgery was really what would work best for me I realized that surgery was "do-able".  In the end I returned to work 1/2 days @ 2 weeks post op and full days @ 4 weeks post op which was much better than I expected.  My boss would have let me take more time off, but in my case my doc and I didn't feel it was necessary.

Jan

[Suu]

Hi everyone.  Great reading, thank you 

I had no choice but I would imagine that if I was given more time, I'd say to get it out asap.   

Suu xxoo