How many treatments(Novalis)?

[sree]

Hi,
I've met one more Radio surgeon last week to get a second opinion.I have a 6.8mmx4.2mm AN in my right ear.
Have some hearing left but none according to my audiology test.So the doctor does the treatment with Novalis
and said in my case he recommended single treatment since there is no serviceable hearing left.He says now we don't have to think about preserving the hearing and we have to think about killing  the tumor.
Now my question is not about saving my hearing but what about the other side effects like facial nerve damage etc.
I thought if we have more divided dosage that taking single dose would pose less risks.
I am confused right now about single vs multiple treatments. My doctor says there is no evident data on side effects with
single or multiple doses.All he wants now is to kill the tumor effectively.
Thanks

[Jim Scott]

Sree ~

I'm not a doctor but I can offer you my experience: in 2006 I underwent 27 FSR treatments (total of 27Gy) on a 'debulked' AN with no side effects.  The radiation did the job - the tumor died. 

Jim

[Ruthie Mac]

I talked to several doctors that believe strongly that fractionated radiation sessions have the greatest chance of keeping the remaining hearing in the AN ear. There was some debate among them on the advantages of 4-5 sessions vs. 27-30.
I still have full hearing in my AN ear, so I was recommended NOT to have the one shot dose (Gamma) or (Proton).
From what I understood, tumor control was more an issue of the overall dose of the radiation and not the number of sessions.
As far as the other side effects I was told there was no documented difference, as everyone has a unique experience. Some people have no problems at all, while others can have a pretty tough time for awhile. I guess I'm somewhere in the middle.
I chose the 4 sessions on the Varian linear accelerator. It's been 3 months and I still have dizziness and balance issues, some fatigue, but am able to work and exercise and do yoga, golf, biking.
If you want any references for Radiologists in the Boston area - let me know - all the Doctors I consulted were wonderful.
Ruth

[sree]

thanks,
I don't know how to convince my doctor to go for multiple sessions.
He thinks one treatment is enough since I don't have serviceable hearing.
My audiology test 0% word recognition  but somehow I can still hear the phone
We live in San Francisco Bay area and I have to go to Sacramento for the treatment.

[Ruthie Mac]

I found that each Doctor I consulted felt strongly that their plan was the best. So in order to get what I wanted I had to pick the doctor that offered what I wanted.

Doctors at Mass General Hospital wanted to do a 1 shot Proton, similar to the Gamma (which they feel is outdated) Docs at Beth Israel suggested 30 sessions of Cyberknife, and the Doctor at UMass Memorial suggested 4 sessions on the Varian Linear Accelerator.

I talked by phone to radiologists at Yale New Haven Cyberknife who prefers 4 sessions and another doc in Princeton NJ (send him my actual MRI) who also prefers the 4-5 sessions. Plus, there's a doctor in NYC who actually gives out & answers his cell phone and will give you a very convincing argument for the 4 sessions.
Because of the wide range of opinions, I decided to follow the suggestion of someone I knew that had the same size tumor (1cm) and was the same age at the time of treatment (55 yr.) and had positive results.
That was the Doctor at UMass (Dr. T.J. Fitzgerald) who was great!

My insurance only covered me for Massachusetts, but I found that doctors across the Country were accessible and really nice about phone consultations. By talking to lots of doctors I felt more confident in my local doctor's decision. None of the doctors were insulted by my endless questions and in fact, encouraged research and want you to be completely confident with your choice of treatment.
Hopefully your Doctor will feel the same.
Ruth

[Nannybee]

Sree,
I had single dose with the Varian Trilogy almost a year ago. After a few tough months where my symptoms got worse, now my hearing is better than before treatment! There are almost as many opinions out there as there are doctors. Just my experience with single dose.
NB