1.3cm AN, non-surgical options?

[dbala007]

Hi,

I am interested in non-surgical options for my 1.3cm growing AN.  Am 42yrs old. 

Am told radiation is not effective.  Am worried about surgical risk and post-surgical issues like hearing loss, balance issues, facial weakness  etc.

Any ideas welcome.

Bala
Singapore

[jbbrown15]

I had fractionated stereotactic radiation therapy in Philadelphia, Pennsylvania, that killed my 2.9 cm AN.  I think a lot of us have tumors larger than yours that have been treated no-surgically, but I don't know what non-surgical options are available to you in Singapore.  Are you able to travel, if necessary?

[jlynloh]

Hi Bala,

I am fr Singapore. Left AN was 1.9cm at the time of diagnosis at SGH. I had 26 sessions of FSR Novalis at the NCC in Sept 12. Did a MRI 2 weeks ago. Scan shows swelling and darkening of the tumor.

Which dr did you see? Were you advised against radiation by the dr?


Jocelyn

[arizonajack]

Left AN was 1.9cm at the time of diagnosis at SGH. I had 26 sessions of FSR Novalis at the NCC in Sept 12. Did a MRI 2 weeks ago. Scan shows swelling and darkening of the tumor.

The swelling and darkening of the tumor are normal and means that the radiation treatment was likely successful.

The darkening is the necrosis (death) of the tumor. The necrotic tissue no longer absorbs the contrast.

Here's an image showing the progression over a period 36 months post radiation. At 6 months you see the darkening and swelling. From then on the tumor shrinks.

http://ars.els-cdn.com/content/image/1-s2.0-S0360301612004336-gr3.jpg

Here's another image 6 months post radiation. Darkening and some swelling.

http://www.gkcairo.com/wpimages/wp180f6b80_06.jpg

Talk to your doctor and verify that's how it works.

[arizonajack]

Hi,

I am interested in non-surgical options for my 1.3cm growing AN.  Am 42yrs old. 

Am told radiation is not effective. 

On the contrary. Radiation is often effective for small tumors.

Here's a couple of articles:

http://www.panarabneurosurgery.org.sa/journal/October2008/p1-10%20(551).pdf

http://emedicine.medscape.com/article/857604-overview#showall

Am worried about surgical risk and post-surgical issues like hearing loss, balance issues, facial weakness  etc.

Radiation is often successful in preserving hearing and avoiding facial weakness.

Unfortunately, the balance thing goes with the territory but the body and the  brain do adjust after a while.

I suggest, however, that if you still have enough useful hearing to be worth preserving you do your research and your consultations with experts and get it taken care of regardless of what method you choose. If you are already experiencing a gradual loss of hearing on the AN side it's only going to get worse over time.

[PaulW]

Singapore has a Gamma Knife
www.gammaknife.com.sg
Radiation is a very effective treatment for small AN's
I would seek a second opinion

[dbala007]

Thanks friends for all the replies.

The ENT specialist am seeing at Changi GH in Singapore has not fully ruled out radiation, but says surgery is more effective, especially at my age (42), even though my AN is small (1.3cm)

I am planning to take a second opinion for non-surgical options in Singapore...welcome any suggestions on specialists/hospitals.

I also thinking of travelling out of singapore, if necessary, for treatment.  Any suggestions around Asia welcome.

Thanks for your replies again...very helpful

Bala

[Tumbleweed]

Hi, Bala:

Radiation is just as effective as surgery for small and medium-size ANs and typically results in far fewer and less serious side effects. In particular, the chance of facial paralysis is typically exponentially smaller with radiation compared to with surgery. But surgery can also pose a risk of chronic headaches and cerebrospinal fluid leaks, which are virtually never an issue after radiation treatment.

If you do elect to have surgery, ask your doctor if they would take a middle-fossa or retrosigmoid approach. That would give you a chance of retaining serviceable hearing post-op. Also ask your doctor to order an ABR (auditory brainstem response) test; that will give your doctor an indication as to whether your hearing nerve is strong enough to withstand the trauma of resecting the tumor. If your ABR results are poor (i.e., they indicate a very weak hearing nerve), you will stand a better chance of preserving your hearing by having radiation -- which is non-invasive -- instead of microsurgery.

Here is a helpful thread that compares different types of radiation treatments with surgery (look for my post about 40% of the way down the page):
http://anausa.org/smf/index.php?topic=6670.0

I hope that helps.

Best wishes,
TW