I also agree with Robin that this text shows a very troubling bias towards surgery. They may be very good at surgery at House, but is it too much to ask that our physicians give us objective, unbiased information to help us make informed decisions? I would not be surprised if House physicians read this forum, and if they do, I would encourage them to re-evaluate the compromised ethics of writing of "possible surrounding brain damage from the radiation." I've never heard that stark description used anywhere before. Ever.
I hope the forum mediators don't think I've crossed any lines of forum etiquette, but I think this is really quite shocking.
Petrone
Petrone, the one quoted is from the USC website not from the House website. You should amend your encouragement to USC's new center. I have cut and pasted the info from the House website below.
In most cases, it’s definitely best to actively treat a growing tumor by surgical removal or stopping its growth with radiation treatment. But in some people, monitoring the tumor at regular intervals to be sure it isn’t growing can be an appropriate alternative. This approach, also referred to as “watchful waiting” or “observation”, is usually used only in older patients who might be poor surgical candidates or those with other medical problems that make having surgery undesirable. You must have follow-up MRI scans of the head, using contrast material, as often as every six months for the first year after diagnosis. If the tumor hasn’t grown, repeated MRI’s are done at the discretion of your doctor, perhaps as often as yearly. Any change in symptoms also calls for an MRI to check for tumor growth. Because these tumors can grow rather suddenly, great care must be taken to treat the tumor before it’s so large that complications are more likely. Remember, the smaller the tumor at time of active treatment, the better the outcome of treatment is likely to be. On the other hand, some tumors do not grow or grow only very slowly.
The House Clinic is a high volume acoustic neuroma center, with specialized physicians trained to treat this condition, and hundreds of surgeries performed each year. Surgical procedures offered to treat acoustic tumors include translabyrinthine, middle fossa, and retrosigmoid approaches.
Surgery for these tumors, as well as the pre- and postoperative care, is performed and assisted by a team. This team includes an internist, an anesthesiologist, a specially trained surgical nurse, a neurosurgeon and a neurotologist.
The choice of surgical approach depends upon the size of the tumor and amount of remaining hearing. It’s possible to save hearing in only a minority of cases; if hearing preservation is successful, the preserved hearing will not be better than the preoperative level and can be worse. The larger the tumor is, the lower the chances for hearing preservation. In some cases with poor preoperative hearing or a larger tumor, it’s better to sacrifice the hearing in order to remove the tumor. All procedures are performed with the patient under general anesthesia. The surgeons look through an operating microscope, and special equipment is used to ‘monitor’ the facial and possibly hearing nerves to prevent injury.
In recent years, stereotactic radiation therapy has been used to treat acoustic tumors.
This type of radiation therapy is different than radiation used for cancer. It’s highly focused on the tumor, with only low levels of radiation affecting most of the brain. This type of treatment has proved effective for certain patients with acoustic tumors. Tumors up to 3.0 cm (small or medium) have been treated with radiation. While patients of all ages can be treated, stereotactic radiation therapy may be best for older patients, since the long-term effectiveness (20 years or more) has yet to be determined. As with surgery, there are risks to hearing and to the facial nerve.
In small tumors, it’s sometimes possible to save the hearing while still removing the tumor. When tumors are larger, however, the hearing is usually lost in the involved ear as a result of the surgical procedure. Following the surgery in these situations, the patient hears only with the remaining good ear. Many people function quite adequately with only one hearing ear.
