Linear accelerator

[patt]

Hi--

I was just at a Radiation Oncologist appointment this morning.  I am very confused.  I have a 2.7cc AN.  At this clinic they either have the CK or linear accelerator for treatment.    My Dr is very uncomfortable treating me with the CK - because of the size.   Have any of you been treated with the "linear accelerator"?    With that treatment --  I would have treatments 5 days a week for a total of 5 weeks.   I would appreciate your help.
               Thanks -- Patt from Minnesota

[tichinose]

My tumor is 2.8cm.  I had surgery less than  2 years ago and am doing the Fractional stereo therapy with the linear.  It last 5 days a week for 5 weeks.  Round trip for me is 80 miles everyday.  Either the radiation or the steroids they gave be seem to help.  Today was 4th treatment and I am getting used to teh mask.

[Lizard]

Pat,
Yes this sounds like fractionated radiation, but you should call the Dr.  with any questions, the are obligated to explain the treatment to you and unless you feel comfortable with what they are suggesting I would not start the treatment.  Make sure all your questions are answered.  I can be overwhelming when you are in the office, so in the future you might want to bring someone with you to take notes.
It sounds like you are on your way toward making a treatment decision.
Hang in there,
Liz

[jb]

CK also uses a linear accelerator, it's just a miniature one that's mounted on its robotic arm.  "Linear accelerator" (or LINAC) usually implies the full-size version though, usually with the 5-week FSR protocol.

There was a lady on here a year or so ago that was refused or discouraged from CK treatment in Minn.  I'm not sure if it was because of the size, her age, or something else. Anyway, she ended up going to Stanford for CK and is doing fine as far as I know.  Her screen name is Anomar11 (real name Mona).  She might respond to a PM or you could find some of her posts with the Search function.

I put some pics up awhile back of what swelling looks like on MRI.  You can see here http://anausa.org/forum/index.php?topic=7234.0 if you like.  It sounds like yours is about the size of mine at 4-7 months post-CK (middle pics in link), when I had the most swelling.  Most people don't have that much swelling, but you can see how it pushes things around inside your head if it does happen.

Not sure if more fractions would mean less swelling or not.  It doesn't seem unreasonable (in my non-expert opinion), but probably almost impossible to prove with all the other variables involved.

It's a tough decision.  I wish you well.
JB

[ppearl214]

geesh, JB... you're good!


Hi Patt;

From what it sounds like... based on 5 days/week over 5 wks.... sounds more like the FSR (possible Novalis?) radiation option, which is also a very viable treatment option for AN's.  One of our moderators... Jim Scott... comes to mind, as he had his large AN "debulked" (ie: hollowed out) via surgery, then did FSR (such as you note) for the remaining AN that could not be removed during surgery. Jim is doing just fine (I have met him numerous times) and he would be a good reference here as one that had the type of radiation treatment you are noting.

Now, FSR (which actually stands for Fractionated Stereotactic Radiation) is a term that is used for many types of radio procedures that are broken out over time vs. 1-dose deal (such as GammaKnife). JB is quite right that Cyberknife (another LINAC accelerator) is another that can be broken out over a number of days (I had CK done over 4 years ago... "fractionated" over 5 days) as well as Trilogy and Proton radiations.

Usually... typically..... the cut off point for size of AN for radiation is approx 3cm (your's is smaller than that) but other factors also come into play (ie: exact location of the tumor, is it "kissing" the brainstem, etc). Your doctor, who has read your films and radiation oncologists that you consult would be best to discuss the option if it will be a good treatment option for you.

Hope this helps.
Phyl

[Jim Scott]

Patt ~

Phyl is correct.  I underwent 5 weeks of FSR treatment ((26 40-minute sessions) to 'zap' my remaining AN (approximately 2.5 cm - reduced from 4.5 cm via surgery) and they used a Linear Accelerator.  It appears to have been successful.  My symptoms never returned and my last MRI (in '08) showed necrosis (cell death) and some slight shrinkage.  Both doctor and patient were extremely pleased.  I found the FSR to be relatively painless but a bit tedious.  I had to make a 60-mile round trip every day (weekends off) and I did so, unaided.  No nausea or hair loss. The plastic face mask you have to wear (molded to your facial contours) is a bit uncomfortable but I didn't find it to be a huge problem.,

As I believe I posted in an earlier reply to you on a different thread, I would recommend FSR if your doctor prefers it but, as always, the final decision is yours, alone. 

Jim

[tichinose]

did any of the facial and balance problems get better with radiation...