Surgery after Gamma Knife

[ch3an]

Wondering if anyone has had a similar experience to mine and can give any insight to issues and challenges with surgery after Gamma Knife.

I had most of a 3.5CM AN removed through Microsurgery in May of 2000.  As a result of that surgery I lost the hearing in my right ear but had no other complications.  In the fall of 2002 a follow up MRI revealed that the remaining piece of the AN, not removed during surgery, had begun to grow. 

I underwent Gamma Knife treatment at NYU in January 2003 to stop the growth of the AN.  The treatment went well with no complications and I assumed that would be the end of my treatment.  I was wrong, MRIs in August of 2006 and March of 2007 have made it clear the AN is growing again. 

The recommendation from the Doctor is to go under the knife again and remove the AN.  That is probably what I will do but I am concerned about surgery after GK and what additional complications that may bring to the table.

Again, any insights would be appreciated.

   Bob

[Richey]

Bob, I have talked to several doctors and they all said that surgery is more difficult after radiation but manageable. I don't know how much difference a previous surgery would make if any.

Good luck

Rich

[Derek]

Hi Bob...

So sorry that GK has not been successful particularly so after having also been subjected to invasive microsurgery. I just wondered if you had discussed with your neuro whether a second GK treatment or CK would be options for consideration and whether you had considered obtaining a second opinion prior to making your final decision?

Best of luck with whatever option you decide upon.

Derek

[ppearl214]

Hi Bob and welcome.  I have heard about potential facial nerve issues if surgery is done post-radiation (due to potential weakend facial nerve from GK)  but hoping others here more familiar with that will chime in.  I have heard of some CK and FSR failiures that did lead to micro-surgery and have to follow up on Derek's comment about doing CK to help.  I know that those of us that had CK can be re-CK'd again, but not all that sure about doing CK post-GK.

Recommendation:  There is a CK Patient Support website where dr's (radio-oncologists) that do both GK and CK volunteer their time to answer our questions. The link to the forum board is:

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

I'll bet you that if you pose this question there, they can answer from a clinical standpoint of what you are up against.  Dr. Medbury (who volunteers there) performs both GK and CK and I bet he'll give you an answer to help you out... just a suggestion....

I'm sorry you are running into this... but if we can help, well... that's why we're here.

Hang in there.
Phyl

[Betsy]

According to the doctor I saw yesterday (an ENT who focuses on "AN Managment"), radiation makes later surgery "more tedious", but not impossible.  It's not a high-volume AN facility, but he has been part of surgeries where the patient had radiation, then surgery.  I'm new at this, but I'm already suspicious of any medical professional who speaks in absolutes when it comes to ANs.  Best of luck to you.