Ask him how it WOULDN'T?
Now that comment is for someone with a small tumor completely within the internal auditory canal, with the tumor surrounding the nerve.
If you have some big chunk of tumor distant from the nerve, then nuke away.
I'm in doubt that is the case, or else why wouldn't they have removed that while they were in there??
Remember, a Schwann cell, which is what these tumors start out as, (both ANs and FNs), is like the plasitc insulation around a wire.
That is, in fact, what they do. They insulate tiny, consecutive sections of a nerve, which speeds message transmission down the nerve.
Now, returning to the visual model of a wire, - the insulation surrounds the wire. Is smack-dab TOUCHING the wire.
Jump back to my prior post in this thread describing the cloud of radiation created by a gamma knife, etc.
It is hottest at the center, and the energy gradually dissipates toward the periphery, as we approach the outer edge of the target (tumor).
Had I nuked my tumor, not knowing what it was, . . . The nerve ITSELF would have thus recieves the HIGHEST dose of radiation. AND DIED.
They can't program the radiation to kill one type of cell (tumor) and simultaneously spare a different type of cell (nerve).
They can only control WHAT revieves the radiation.
I am not only a patient treading these waters currently, but am an Emergency Medicine physician.
As such, I have a pretty good idea of what can and can't be done.
That being said, I am NOT a neurosurgeon, a neuro-otologist, a nuclear physicist, nor nuclear technician.
I would get a second and even third opinion, befre I let someone radiate my head if I were you.
I would demand a THOROUGH explanation of what is being radiated, and how the nerve won't be.
Nerve cells are fragile, and in the body, are the FIRST cells to DIE when deprived of oxygen.
Now I know that oxygen deprivation is NOT the mechanism by which stereotactic nuclear radiosurgery works; I only offer that up to emphasize how delicate neural tissue is.
FAT cells, which is basically what a Schwann cell is, (and hence these tumors) is a dumb, lazy, cell that doesn't do as much, and as such is more resiliant, and probably takes MORE radiation to kill, than a nerve cell.
Radiating a TRUE AN is one thing and sometimes still results in facial weakness or hearing loss.
Radiating a FN, at whose center is the facial nerve itself, seems ludicrous.
I may be mssing something, but doubt it.
I know I will NEVER get MINE radiated.
It was debulked to some degree.
It was unroofed to reduce pressure.
That is all for now.
If, down the road, I develop a troubling enough facial palsy, . . .
We go back in, excise the tumor, perform the nerve graft, and then that is the end of the story.
The palsy resolves to whatever degree it will resolve.
Move on.
Ask lots of questions, and get 2nd and 3rd opinions before you nuke that thing.
Make sure you talk to neuro-otologist, neurosurgeons, and nuclear
med physicians.
For more cut and dried cases: you can generally anticipate the recommendation based on who you ask : a surgeon will want to cut it out of you, and a gamma knife doc will want to nuke it.
Be careful
make sure you understand WHY you are doing something.
Ask lots of questions.
Aces,
doc
Btw
why in the world would you do anything now??
Wait a while it may be months before we see where the current FN defecits will settle out.
I was told it could be 15 to 35 years before I needed something else done, if ever
just my $0.02 worth
