That was my most pressing question--what if gamma knife fails? I just do not want that surgery. Most of the people I talked to said that in some cases they can repeat. It depends on location I think. I personally would lean that way because if it works, you are done. If it fails, you get the surgery. The surgery is a little tougher after radiation, but I think the sentiment is that good surgeons who do this all the time say it is not that big a deal. However, this would all depend on location, how fast it is growing, your age, etc. There is minimal chance of cancer from radiation the first time, however, those odds surely go up with a second dose, though I don't know by how much. Hearing would probably be totally gone, and the remaining question is how much damage to the facial nerve. I also don't know if they radiate the whole tumor, or just the new growth. That would also make a difference.