Surgery after Radiation?

[proudmomof3]

Hello again, (Please note I changed my name from cpayne101 to proudmomof3, just for privacy reasons ~ I wasn't thinking when I put my name as username)

First of all, I want to sincerely thank everyone for their responses and help. I don't even know you guys, but you have been so honest and helpful. Though I am facing a huge decision ahead of me, I feel that I have gained a ton of information over the last week and again I thank you all for that.

I am leaning towards GK, only because I want to get this done with quickly and not have it interrupt my life too much. My thinking is...my kids are so young right now, if GK doesn't work, I have some time before I would have to have it surgically removed. Which brings me to the next question...

If you have already had Gamma/radiation, and then had to have surgery, does it make the surgery more difficult if you have had GK? I read somewhere that it does.

I know a lot of you have had radiation, then had surgery. What can you advise about surgery AFTER GK?

Thanks,

Cheryl

[CHD63]

Hi Cheryl .....

Others will be replying soon, I know.  However, just for what it is worth ..... at the ANA Symposium in Chicago in August, 2009, I sat in on a session with two surgeons doing a presentation that included a video of surgical removal of an AN.  During the Q&A the question was asked "If you experience regrowth after radiation, does this make surgery more difficult?"  The answer was "Somewhat, because of the need to work around scar tissue.  But this would also be true in a second surgery."  So, we were left with the impression that it means it would take a bit more time for the surgeon, but not more dangerous for the patient.

Hope that helps.  Clarice

[mk]

Hi,

Sorry you are facing this dilemma.
I chose radiation for exactly the same reason that you mentioned. My kids were too young at the time I was diagnosed. I wanted to buy myself sometime. Which I did - 3 years. Unfortunately eventually GK did not work for me (usually it does work, but my tumor was large to begin with), and it started to grow again. But I am now in a much better posiition, both from the family point of view and at work - I had all the time to seek consultations, make a decision and now I have scheduled surgery in a couple of weeks time.
I have consulted with many doctors, and of course asked this question. 5 out of 6 said that in their experience removal of a radiated tumor is no more difficult, in spite of what is usually thought. It may be stickier or not, but this is also true for non-radiated tumors. They also mentioned that sometimes radiated tumors are less vascular, which makes it actually easier. One doctor mentioned that  because of the scar tissue there may be increased risk for CSF leak. And one out of 6 gave me a 100% chance for facial paralysis, because the radiated facial nerve will have thinned out.
I did find a study from the House some time ago, I wish I still had it, which mentioned that removal maybe more difficult, but they didn't find a statistically significant difference in facial paralysis.

There have been quite a few cases in the forum of microsurgical removal following radiation (CK or GK) and the results vary, similar to all other cases. Some had excellent results.

Well, I guess I will find out soon, so I will let you know my experience.

Marianna

[Tumbleweed]

Marianna has already given you the most informed response you're likely to get without consulting multiple doctors yourself. That said, I'll throw in my two cents. What I heard is that a very skilled surgeon will have no trouble working with a tumor that has already been irradiated and that the doctors who say it's problematic are simply not the best.

But with only about a 2% failure rate for GK (when performed by the best doctors), it doesn't make sense to worry about followup surgery. (I mean it doesn't make sense from a statistical standpoint. Believe me, I worried about it, too, initially and I understand your concern and laud your due diligence.) If you have chosen GK over microsurgery for all the usual reasons -- far less chance of facial paralysis and (in some cases) hearing loss, very negligible chance of chronic headaches and other complications following treatment, much shorter recovery time, much less invasive, etc. -- then why even consider choosing microsurgery now because there is a 2% chance you might have to in the future?

Please don't misunderstand me. Microsurgery is a godsend for those who need it because radiation is not viable in their case (due to tumor size or location, or because, as with Marianna, radiation failed to halt the tumor's growth) or who personally prefer it over radiation because, for example, they want the tumor completely removed and not just killed. But especially if this is your first course of treatment, it's important to realize that every form of treatment has its risks and failures.

If GK has been recommended by your doctors as a viable treatment choice for your particular tumor, and it is your preferred treatment, embrace it (I know, this is very hard to do!) and don't worry about the 2% stuff. GK is an excellent therapy with an excellent track record of success. The chances are overwhelming that it will be a successful operation for you.

Best wishes,
TW