Found 1.2 x 1 mm neuroma, Radiation or Surgery?

[nearpoint]

Hello,

My dad (Age 59) has an acoustic neuroma 1mm x 1.2mm. He has done a lot of research and talked to different doctors about his option and there seems to be no conclusive answer as to which treatment option would be the best.

Some doctors say Radiation therapy is the best for small tumors like this and some doctors say Surgery is the better than radiation.

What are your experiences with this, radiation or surgery? Let me know if you need more information! Thanks so much! I appreciate the help.

[Jim Scott]

Hi ~

Your father's AN is relatively small and probably a candidate for radiation, which is easier than surgery but certainly not a panacea. 

In 2006, I underwent Retrosigmoid Approach surgery to debulk my large (4.5 cm) AN and sever it's blood supply.  Ninety days later, in a planned procedure, I underwent radiation (FSR) to destroy the de-bulked tumors ability to re-grow.  Both procedures were effective with no real complications.  However, debulking is only practical on larger tumors.

Radiation is non-invasive and many have good success with it.  Surgery is harder but removes the tumor and is often successful.  Obviously, outcomes can never be guaranteed and there will always be some risk no matter what path your father chooses.  Ultimately, your dad has to make the final decision.   

Jim

[arizonajack]

Welcome to the site.

I suggest you spend lots of time here reading the variety of experiences of our members. You'll find that pretty much everybody here has experienced surgery, radiation, or watch & wait.

You can read my experience at:

http://www.anausa.org/smf/index.php?topic=18287.0

Has your father lost any hearing on the AN side?

[nearpoint]

So far no hearing has been lost. He has noticed some minor side effects like ringing in the ear.

He has done research on his own and is leaning towards radiation Gamma knife procedure in hopes it will provide the easiest recovery. But then again some experiences have reported a very long recovery for Gamma knife since the tumor grows at first.

Also there is a concern that Gamma knife radiation won't work and then it would make surgery harder to perform. But then again we heard that most places have above 90% success rate with Gamma knife.

The main concern he has is recovery. Is the recovery from Radiation therapy in general much easier than recovery from surgery for a small tumor this size?

Thanks!

[Mickey]

Hi Nearport! Sounds very similiar to me.... A little over 6 years ago @ approx. 58yrs. with almost the same size AN as your dad`s I was diognosed. Here I am now awaitng my latest MRI @ almost 65 yrs. with no change and actually feeling better than when first diognosed. What did I do? Take a look at the W+W Brigade posts and  see if this way of treating is possible for your dad. We all are different, symptoms, personality, etc.  Just offering what I think   is a very good choice. Wishing you and dad the best, Mickey

[nftwoed]

Hello;

   Is the AN showing growth? Many middle aged and elderly do not need Tx as oftentimes, ANs stop growing.
   If it is very active still, my feeling as a mere pt. is either approach would be satisfactory.
   Of course, if the AN has proven to be fairly aggressive, my personal choice is to have it surgically removed. Radiation leaves it in. Recall an old song? "Just wishin, and hopin, and thinkin and prayin"? for the thing to stop growing, become necrotic ( dead ) and maybe even disappear if radiation is the Tx method.
   How well does Dad hear that side?

[grammyslim]

Had radiation on my AN a year ago about the same size I was same age as your dad.  I chose radiation because I Could. After talking to both radiologist and surgeon Inknew it was best foe me.  I did one treatment at Methodist Hospital in Houston, TX  I had already lost my hearing which led to the founding on my AN have no balance on the AN side but body condensated for that prior t o treatment.  I just could not justify surgery for myself.  I have a few issues that are totally manageable and I am please that I chose radiation.  If you dad would like to chat let me know.

[nearpoint]

I am 57 year old and have near perfect hearing. Doctors at U of M are recommending surgery for my small 1.2mm tumor. Visited a doctor in Midland that specializes in Gamma Knife and he is recommending Gama Knife Surgery for my small tumor. My main objective is to preserve my hearing. Has anyone had Gamma Knife Surgery with near perfect hearing and found that their hearing has been preserved. My understanding is that the tumor usually swells after radiation and this can cause hearing loss as well as other complications such as dizziness.

Would also like to hear from anyone that has had surgery via the Middle Fossa approach to preserve their hearing. How successful has been your surgery. Would love to hear from you as I am confused and do not yet know which approach would be the right one for me. My goal is to preserve my hearing.

[arizonajack]

Here's a couple of articles that give good marks to GK with regard to hearing preservation.

http://thejns.org/doi/pdf/10.3171/2012.7.GKS12783

http://thejns.org/doi/pdf/10.3171/2012.6.FOCUS12192

One thing to understand if you are considering Watch and Wait is that the tumor eats up the nerve even if it doesn't grow.

Mine was 3mm x 4mm x 9mm when it was discovered and I had already lost 90% of my hearing on that side. By the time I had my second MRI after 6 months the tumor had grown to 4mm x 4mm x 12mm and I was 100% deaf on that side. I chose GK because (among other considerations) hearing was no longer an issue.

My only advice is get it zapped or removed ASAP while you still have all your hearing.

[phantagrae]

I am 57 year old and have near perfect hearing. Doctors at U of M are recommending surgery for my small 1.2mm tumor. Visited a doctor in Midland that specializes in Gamma Knife and he is recommending Gama Knife Surgery for my small tumor. My main objective is to preserve my hearing. Has anyone had Gamma Knife Surgery with near perfect hearing and found that their hearing has been preserved. My understanding is that the tumor usually swells after radiation and this can cause hearing loss as well as other complications such as dizziness.

Would also like to hear from anyone that has had surgery via the Middle Fossa approach to preserve their hearing. How successful has been your surgery. Would love to hear from you as I am confused and do not yet know which approach would be the right one for me. My goal is to preserve my hearing.

My goal with my AN has been to preserve my hearing and my facial nerve, as I am a professional musician--I need to be able to hear out of both ears and I need my facial muscles to make proper emboucher when I play.

I finally chose Gamma Knife, but done in 30 fractions, rather than in one treatment.  As I understand it, splitting it into several lower-dose treatments is easier on the surrounding structures.  That's what I am counting on, after discussing the various options with my ENT and the doctor who is doing the radiation treatments.  My doctor said that with the lower, spread out doses, I will be less likely to have swelling, etc, of the tumor.

I just started my treatments this past Monday and I will go daily (during the week) through the end of August.

Good luck!

[arizonajack]

My goal with my AN has been to preserve my hearing and my facial nerve, as I am a professional musician--I need to be able to hear out of both ears

That's right.

I never had the talent to be a musician but I have had a lifelong love of classical music. These days, even with my hearing aids and quality stereos (or even live orchestras) it just doesn't sound right anymore.