Author Topic: Some questions about GK versus CK answered  (Read 9493 times)

MaryBKAriz

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Some questions about GK versus CK answered
« on: April 29, 2008, 05:01:47 pm »
Hi,

Just thought I would post two answers to an email I posted on the Cyberknife site. The answers were most helpful to me. Hopefully, it will help other, also.

Mary



Hi,

I am 59 female and was diagnosed in March with a right side 1.1cm acoustic neuroma. I am having hearing problems on right side at high frequencies and in particular with word recognition. I have tested all over the map for this. Some saying 28%, some saying up to 80% word recognition. Real life, I feel it does vacillate but tends to be around 50-60% and has gotten greatly worse in the last few months. My balance is 78% damaged on right side, if I understand that correctly. I feel very dizzy at times and have been given exercises I am doing. Recently I occasionally have minor twitching in my lip or chin on that side. All my symptoms have appeared within the last year and most within the last 3-4 months.

I have decided AGAINST watch and wait as well as microsurgery. I will be seeing the CK and GK Dr. here in Phoenix in a week. I have been so very impressed so far with Barrows. I have had a face-to-face 2nd opinion as well as a few phone calls and emails with other specialists in the field, sending my MRI and medical info. I plan to stay with the Barrows team.

I am just wanting to cover my bases before that appointment so I feel prepared and knowledgeable.

Does size of tumor dictate how many days the CK will be done?

Does the new GK Perfexion improve the GK experience or outcome over the older model? How long does treatment take as an average for a smaller tumor? Do patients complain much about the screwed on frame?

How do statistics compare between CK and GK in reference to hearing preservation, permanent facial nerve damage, chronic headaches or other long term debilitating side effects?

I am concerned about claustrophobia. I feel ridiculous having this concern, but alas, I do. Unless I am in really tight spaces (like the MRI) I do not have it. However, I really have it in small spaces. Can a strong medication be given to alleviate any claustrophobia. One woman I met here in Phoenix said she wasn't claustrophobic, but the mask making really bothered her. The CK mask looks like it goes down to the neck and have heard it is tight. Is this correct? Does it feel tight on the neck or can the under chin part of mask not go as far as the neck? Can eye holes be cut in the mesh? Can you get breaks? Do people complain of claustrophobia afterwards with either treatment? How long are treatment sessions?

What are the statistics of long term tumor control with both CK and GK? How does it compare with microsurgery and watch and wait?

Do you have suggestions for questions I should ask him?

Oh this ended up being a longer list than I expected. Thank you in advance for any and all that care to address this list.

Mary

Briefly, the new GK machine (Perfexion) may speed things up some and offers greater versatility but it is still basically the same machine. The decision to fractionate with CK is based upon the concept that there will potentially be greater preservation of hearing, taking advantage of the ability of CK to be used that way. It also depends upon the location of the tumor with respect to critical structures such as the brainstem. You can take breaks with the mask, but it is best to get it done as quickly as possible, usually in an hour or less per session. You can and should take medication to relax you if you are claustrophobic, and the mask should be reasonably comfortable while holding you relatively still.

Overall, the results seem to be equivalent comparing the two systems, although we believe that CK offers the advantage as mentioned of preservation of hearing. Facial nerve damage is uncommon with either approach. From the standpoint of comfort, there is no comparison. GK takes hours when you take into account the placement and removal of the frame, the scanning with the frame in place, and the actual treatment itself. Perfexion does decrease treatment time somewhat over previous systems.
Jerome J. Spunberg, M.D., FACR, FACRO
Cyberknife Center Of Palm Beach
jspunberg@radiationoncologyinstitute.com
(561) 799-2828

Radiation Oncology Institute
10335 N. Military Trail, Suite C
Palm Beach Gardens, FL 33410
(561) 624-1717


Eye holes can be cut in the mask, and we don't usually bring it all the way down the neck (although some do), but we have not found claustrophobia to be a problem other than for the MRI scan. I can think of only a single patient for whom it was really problematic,

Most patients would prefer not to have a frame. since there is no advantage to it, why do it?

Most 1.1 cm AN's will be treated with 3 fractions on the CK, on the principle that fractionation will help preserve hearing (and data suggests it has a moderate effect in that manner). Long-term debilitating effects are uncommon, the most common two being hearing loss on the affected side and balance issues. Hearing preservation is related to the amount of hearing you already have, probably the fractionation scheme, and probably to factors we cannot yet quantify. We have begun to think that reducing the dose to the cochlea is important. THe balance problem also appears to be at least partly related to he degree of difficulty before treatment. It can be helped with vestibular therapy. Dr. Daspit at Barrows is an expert at that if you have that problem.

About 95-98% of tumors will be controlled with any of the more common methods of treatment, usually around 98% for most radiosurgery series. That is the same for CK and GK. The advantage of CK is no frame and possibly greater hearing preservation. That is about the same for most good surgical series. There is of course no control for watch and wait. I personally don't think you are a candidate for that approach give your current symptoms.

See Dr. Kresl at Barrows, and tell him I am watching him.
Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102
Diagnosed March 24, 2008, 1.1cm, right side, "Goldie" - small but mighty!! :-(
Hearing, lottsa balance problems and a few facial twitches before CK
CK June 2, 2008, BNI in PHX, Drs Daspit/Kresl, side effects,steroids helped. Getting "sea legs".
Apr 2012 - Still glad I chose CK

1golfnut

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Re: Some questions about GK versus CK answered
« Reply #1 on: April 29, 2008, 05:54:34 pm »
Mary,

Having just had a GK procedure two weeks ago, the initial fitting of the frame isn't as bad as as one would think. After the Novocaine was injected, I really didn't experience much pain. I wore the frame for approximately 10 hours and even managed to put on my glasses. The removal of the frame is where you will experience some discomfort. One of the after effects of having the frame is that I have experienced some numbness on the left side of my skull where they placed the screws. After talking to the nurse today (04/29/2008), I was told that the screw had cut through the nerve and eventually this will heal. It may take up to 4 months before the numbness goes away.

The whole procedure lasted for 4 hours in the afternoon. Most of the time went to setting up for the procedure. The actual time under the machine was about 1 hour.

I too was claustrophobic and was placed under sedation only for the MRI. The frame will not cover any portion of you eye so you can have an unobstructed view of what is going on.

I hope this answers some of you questions.

Please keep me posted and good luck!



Rich Bialeck
1golfnut

MaryBKAriz

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Re: Some questions about GK versus CK answered
« Reply #2 on: April 29, 2008, 07:09:50 pm »
Hi Rich,

Thank you for your input. It helps to get answers from different perspective. Not everyone has claustrophobia and it is hard to understand for those who don't. I am not afraid of getting shots, snakes or spiders, but some are. It was good to hear that you could see out well. Lots to consider....

Hope you continue to do better and the nerve rejuvenates quickly.

Take care,

Mary
Diagnosed March 24, 2008, 1.1cm, right side, "Goldie" - small but mighty!! :-(
Hearing, lottsa balance problems and a few facial twitches before CK
CK June 2, 2008, BNI in PHX, Drs Daspit/Kresl, side effects,steroids helped. Getting "sea legs".
Apr 2012 - Still glad I chose CK

MaryBKAriz

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Re: Some questions about GK versus CK answered
« Reply #3 on: May 01, 2008, 10:22:30 am »
Here is a very interesting addition to the thread I had on the CK site. I thought the data was importanat t note.

Take care all,

Mary

Also from Pubmed (but less data published thus far than for CK):

Neurosurgery. 2005 Jun;56(6):1254-61; discussion 1261-3. Links
Staged stereotactic irradiation for acoustic neuroma.

Chang SD, Gibbs IC, Sakamoto GT, Lee E, Oyelese A, Adler JR Jr.
Department of Neurosurgery, Stanford University School of Medicine, Stanford, California 94305, USA. sdchang@stanford.edu
OBJECTIVE: Stereotactic radiosurgery has proven effective in the treatment of acoustic neuromas. Prior reports using single-stage radiosurgery consistently have shown excellent tumor control, but only up to a 50 to 73% likelihood of maintaining hearing at pretreatment levels. Staged, frame-based radiosurgery using 12-hour interfraction intervals previously has been shown by our group to achieve excellent tumor control while increasing the rate of hearing preservation at 2 years to 77%. The arrival of CyberKnife (Accuray, Inc., Sunnyvale, CA) image-guided radiosurgery now makes it more practical to treat acoustic neuroma with a staged approach. We hypothesize that such factors may further minimize injury of adjacent cranial nerves. In this retrospective study, we report our experience with staged radiosurgery for managing acoustic neuromas. METHODS: Since 1999, the CyberKnife has been used to treat more than 270 patients with acoustic neuroma at Stanford University. Sixty-one of these patients have now been followed up for a minimum of 36 months and form the basis for the present clinical investigation. Among the treated patients, the mean transverse tumor diameter was 18.5 mm, whereas the total marginal dose was either 18 or 21 Gy using three 6- or 7-Gy fractions. Audiograms and magnetic resonance imaging were obtained at 6-months intervals after treatment for the first 2 years and then annually thereafter. RESULTS: Of the 61 patients with a minimum of 36 months of follow-up (mean, 48 mo), 74% of patients with serviceable hearing (Gardner-Robinson Class 1-2) maintained serviceable hearing at the last follow-up, and no patient with at least some hearing before treatment lost all hearing on the treated side. Only one treated tumor (2%) progressed after radiosurgery; 29 (48%) of 61 decreased in size and 31 (50%) of the 61 tumors were stable. In no patients did new trigeminal dysfunction develop, nor did any patient experience permanent injury to their facial nerve; two patients experienced transient facial twitching that resolved in 3 to 5 months. CONCLUSION: Although still preliminary, these results indicate that improved tumor dose homogeneity and a staged treatment regimen may improve hearing preservation in acoustic neuroma patients undergoing stereotactic radiosurgery.

Minim Invasive Neurosurg. 2004 Oct;47(5):290-3. Links
CyberKnife radiosurgery for vestibular schwannoma.

Ishihara H, Saito K, Nishizaki T, Kajiwara K, Nomura S, Yoshikawa K, Harada K, Suzuki M.
Department of Neurosurgery, Clinical Neuroscience, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan. hishi@po.cc.yamaguchi-u.ac.jp
OBJECTIVE: The CyberKnife is newly developed equipment for radiosurgery and fractionated radiosurgery. The authors report on their experience using the CyberKnife in 38 patients with vestibular schwannoma who were treated between 1998 to 2002. METHODS: During this period, 38 patients with vestibular schwannoma were treated using CyberKnife fractionated radiosurgery. Before undergoing fractionated radiosurgery, 14 patients had Gardner Robertson classes I or II hearing (the serviceable hearing group), and 24 patients had classes III to V hearing (the non-serviceable hearing group). The treatment volumes of these two groups were 0.5 to 24.0 cm (3) (mean 4.7 cm (3)), and 0.5 to 41.6 cm (3) (mean 8.2 cm (3)). Target irradiation was administered in 1 - 3 fractions (mean 2.5 fractions). The total marginal radiation doses were 15.0 to 20.5 Gy (mean 17.0 Gy), and 11.9 to 20.1 Gy (mean 16.9 Gy), respectively. RESULTS: After a mean follow-up period of 31.9 months (range 12 to 59 months, median 27 months), 94 % of the tumors were controlled. Only one patient in the group with non-serviceable hearing underwent additional surgical resection for a presumed increase in tumor size. The hearing preservation rate was 93 %. Facial weakness did not develop in any of the patients in the serviceable hearing group. New trigeminal symptoms did not develop in any patients in either group. CONCLUSION: Although a longer and more extensive follow-up is needed, CyberKnife fractionated radiosurgery is considered to be safe and effective, even in patients with large tumors.
Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102
Diagnosed March 24, 2008, 1.1cm, right side, "Goldie" - small but mighty!! :-(
Hearing, lottsa balance problems and a few facial twitches before CK
CK June 2, 2008, BNI in PHX, Drs Daspit/Kresl, side effects,steroids helped. Getting "sea legs".
Apr 2012 - Still glad I chose CK

Elizabeth Roberts

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Re: Some questions about GK versus CK answered
« Reply #4 on: May 01, 2008, 02:09:05 pm »
Hi Mary,

You're doing some great research. I had LINAC radiosurgery at UF-Gainesville 4 years ago and thought I'd throw a few things your way. I, too, get claustrophobic, especially in those darn MRI machines. That said, I was told by numerous Drs. and techs. that the original tube MRIs are superior to the newer flare MRIs. At this point in my AN history I've had at least 6 MRIs and have used various techniques to deal with it. I used to take 1 valium before having an MRI done but in the past two years have been able to do it on my own my using a sort of meditation - the key for me is to close my eyes before they move me into the machine and to NOT open them at any point during the testing while I'm still in the tube. I ask them to give me the panic button, just in case, I bring a meditation CD for them to play for me, and I also ask them to give me the time for each scan - 1 min., 3 mins., etc. Then, I use that timing as part of my meditation - first, I get a picture in my mind of a relaxing, calming happy place - the beach, usually - then I count down the time of each scan in my head, which keeps my brain focused on something other than freaking out.

And I did have a headframe for the LINAC - nowhere near as bad as you think. Don't be fooled when people say they 'screw' the frame into your head. There are plastic screws, yes, but they do not break the skin, nor do they penetrate the bone. The previous writer was correct that the worst part is after they remove the frame and release the tension on your nerves and skin. I had a slight headache for a few hours afterwards and some short term numbness at one attachment site that went away in a couple of weeks.

When you find the treatment and the doctor that's right for you you'll just know it. I did.

Good luck,
Elizabeth   
1 cm. right-sided AN
Onset symptom - constant dizziness
Treatment: 2004, UF-Gainesville, LINAC, no side effects
2009 MRI shows tumor is shrinking

sgerrard

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Re: Some questions about GK versus CK answered
« Reply #5 on: May 01, 2008, 08:13:10 pm »
Hi Mary,

Yup, the data is out there if you are willing to look for it, and wade through it when you find it. The exact numbers fluctuate with each study, of course, but I think they add up to a good body of evidence supporting the use of CK for AN's. The studies Medbery listed are for patients treated before 2003; there have been many more treated since, with a notable lack of reports of adverse effects.

When you see Dr. Kresl at Barrows, if you do tell him Medbery is watching him, I'd love to know his response. :)

Steve
8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.

MaryBKAriz

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Re: Some questions about GK versus CK answered
« Reply #6 on: May 01, 2008, 09:45:05 pm »
Steve,

Yes, I want to make sure to do that! It will be interesting.  :D

I received a call today from a great lady who will meet me before my appointment with Kresl to give me info and support. I was so surprised to get the call and have someone reach out that way. We figured out we had met at the AN support group meeting. Gotta love Barrows! I am so glad I live fairly close.

Sunday, I meet again with my new friend, Annette, who I met here on the ANA site. She is such a great source of support, an a terrific person.

Take care,

Mary
Diagnosed March 24, 2008, 1.1cm, right side, "Goldie" - small but mighty!! :-(
Hearing, lottsa balance problems and a few facial twitches before CK
CK June 2, 2008, BNI in PHX, Drs Daspit/Kresl, side effects,steroids helped. Getting "sea legs".
Apr 2012 - Still glad I chose CK

Mark

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Re: Some questions about GK versus CK answered
« Reply #7 on: May 01, 2008, 10:51:36 pm »
Mary,

another Postie who had CK with Dr. Kresel who you might want to chat with is named Suzanne. She goes by "shoegirl" on this forum and while I haven't seen her post in a long time I'm sure you could send her a PM. She is actually now a patient story on the Accuray web site

http://www.accuray.com/uploadedFiles/Suzanne_Patient_Story.pdf

For those who have been here for awhile and remember her, I'll try to paste her story and picture, hopefully she won't mind

Well, The picture won't copy so you'll have to follow the link for that  :)

Mark


Suzanne’s Story – Brain Tumor
For 34-year-old Suzanne, nothing is more important than being the best mother possible to her young children. But in the fall of 2005, a discovery during a routine brain scan threatened to hinder the Phoenix, Ariz., mom’s ability to care for her children.
Several years before, doctors had discovered that Suzanne had a pineal cyst, a benign lesion in her brain that was causing no adverse symptoms. To ensure that the cyst did not grow or change, Suzanne had regular brain scans. However, as she was going in for an MRI in October 2005, Suzanne had a feeling that something was wrong, even though she was not experiencing any specific problems. She was right – the scan showed a growth in her brain, but it wasn’t the pineal cyst.
Suzanne had an acoustic neuroma, a typically slow-growing benign tumor that can cause hearing loss, facial numbness and/or paralysis and effect ones balance. “I was happy to know that it wasn’t cancer,� Suzanne said. “But when my doctor told me that the most common treatment was microsurgery, all I could think about was my kids – who were then three and one – and how their lives would be affected by my long recovery and the possibility that something could go permanently wrong.�
During the week between her diagnosis and the first appointment with a specialist, Suzanne spent many hours online learning more about acoustic neuromas. “I became more and more anxious,� she said. “I went from just wanting [the tumor] out of my head, to being terrified about having surgery.�
She knew that recovery from surgery could take several months, and that most likely she would lose hearing in her left ear. And there was great risk that she would have permanent facial paralysis and balance issues. “I wasn’t willing to take those risks because my children would have had to deal with a different mom,� she added.
As she began researching potential treatment options, she discovered that radiation was a possible alternative and that a new technology – the Accuray CyberKnife® Robotic Radiosurgery System – was being used to treat brain tumors. When Suzanne visited the neurologist, he said that she was a candidate for either radiation or surgery and referred her to a radiation oncologist. When Suzanne met with the first radiation oncologist a week later, he could offer her no information on the CyberKnife System. “He could only talk to me about the technology he had, and that I would have to undergo weeks of radiation treatment,� Suzanne said. “I was disappointed because when it came to the radiation treatment, I wanted the most accurate treatment available, so the cells surrounding the tumor wouldn’t be harmed.�
In the meantime, Suzanne sought more information from patients undergoing CyberKnife treatments for acoustic neuromas through the internet and patient support group website. And she learned that there was one in use in her hometown at St. Joseph’s Hospital’s Barrow Neurological Institute (BNI). “I knew I wanted the best technology out there,� she said. “When I came across CyberKnife one of the things I liked the most was that it’s noninvasive, it has amazing accuracy and it would be something that wouldn’t have an impact on my quality of life.�
She made an appointment with Dr. John J. Kresl, a radiation oncologist, and his team who were using the CyberKnife System and other radiosurgery systems at BNI. They all agreed with her decision in that the CyberKnife System was the best course of treatment for Suzanne.
By the time she began her CyberKnife treatments a month later, Suzanne knew exactly what to expect. Suzanne was impressed that Dr. Kresl’s team showed her the CyberKnife System and the computers that run it. They explained in great detail how it worked – that it detects the slightest motion of the patient or tumor and would readjust immediately so it could continue targeting the tumor with extreme accuracy. And they made sure she knew what to expect during her treatment sessions.
Prior to her treatment, Suzanne contacted the CyberKnife Patient Support Group, a community of patients who have been treated by the CyberKnife® System. “I was able to ask them detailed questions, such as how they felt afterward, and even something as silly as what to wear to my treatment,� Suzanne said. “There was a woman from Australia undergoing the treatment at Stanford during that time, and through the support group, I was able to follow her progress every day and discuss with her how she was feeling. It really prepared me.�
On a Friday in mid-December 2005, Suzanne had a CT scan and MRI to help doctors pinpoint the location of her tumor and plan her course of treatment. The next Monday she went in for the first treatment, which lasted one-and-a-half hours. She had two more treatments, lasting an hour each, on Tuesday and Wednesday.
Though she was a little tired after each treatment, she was still able to go home each day and interact with her children as usual. “I didn’t feel a thing,� Suzanne recalled. “You almost wonder if it’s really doing anything because it’s completely painless.�
But, in fact, the CyberKnife treatment was doing its job. In September 2006, her nine-month check-up showed signs that the tumor was dying. And, thankfully, Suzanne said, she has had none of the complications that are common when patients undergo microsurgery. She didn’t lose her hearing, her balance remains the same and she has no facial paralysis.
“The entire CyberKnife journey was very easy,� Suzanne said. “My quality of life never changed, and for me, that was a big deal because I didn’t want my children’s lives to be different. There are others I know, who have had the same type of tumor and opted for microsurgery. But they have had completely different outcomes, and every day is hard for them. I feel almost guilty that the whole process has been so easy for me.�
Suzanne added that she now knows she can not take anything for granted. “You just never know when your life may change. I had no reason to believe that anything was wrong with me,� she said. “Now I try to make the most out of my time with my family and my kids.�


CK for a 2 cm AN with Dr. Chang/ Dr. Gibbs at Stanford
November 2001

leapyrtwins

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Re: Some questions about GK versus CK answered
« Reply #8 on: May 01, 2008, 11:31:50 pm »
Mark -

Suzanne's story is a great testament to CK, but as one who had surgery, I have to say that I feel it is somewhat misleading.

Not to knock CK at all - it's definitely a wonderful choice for some - but there are lots of us who had surgery who have had very positive outcomes and I feel I need to point this out.

I am not pro surgery, nor am I against radiation - CK or GK.  I also realize that this subject is titled "Some questions about GK versus CK" but I wouldn't want those who are still undecided about their treatment to read Suzanne's story and think that surgery will leave them with a life full of insurmountable complications.

I, personally, didn't have several months of recovery, nor is every day hard for me.  I don't have permanent facial paralysis, significant balance issues, and my surgery has in no way hindered my ability to care for my children!  Yes, I am SSD, but so are lots of people who never had AN surgery.  In short, I don't feel like I am an exception to the rule.

Respectfully,

Jan



Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

Mark

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Re: Some questions about GK versus CK answered
« Reply #9 on: May 02, 2008, 12:09:23 am »
Jan,

I appreciate your perspective, and certainly have read enough of your posts to know you have a very balanced and fair view of both treatment options.

However, I would ask you to consider the context of both why I posted it as well as the content

1) Mary in AZ is going to see Dr. Kresel at barrows about CK and I was offering her another point of Contact in Suzanne
2) Many long time posters here know Suzanne as Shoegirl and I thought they would like to see her story and picture
3) The only aspect of her story that I would take exception to is the one sentence where it says "common complications associated with microsurgery". Clearly that is misleading and inaccurate as there are a lot of great surgical outcomes. It is fair to take exception to that as a statement of fact, but it is also important to remember that this is offered as a patient story and it is based on her perspective of what she has seen and been exposed to. It is not meant to be a clinical study, and in that context, it is as valid as yours, mine or anyone else's in my view. So, while I would agree with you that the one comment is misleading re: surgical outcomes,  I don't feel it would be correct on my part to edit it out either. Heck, I would be a rich man if I had a quarter ( ok, maybe a dollar) for every inaccuracy or flat out nonsense I've seen people put in their posts or stories  ::)  ;D.

As a wise lady once told me, "all feelings are true and all facts need to be proven" and I guess I take patient stories in that vein.

Hope that explains my thinking in posting it.

Best,

Mark
CK for a 2 cm AN with Dr. Chang/ Dr. Gibbs at Stanford
November 2001

leapyrtwins

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Re: Some questions about GK versus CK answered
« Reply #10 on: May 02, 2008, 06:11:24 am »
Mark -

I agree with you 100%.

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

sgerrard

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Re: Some questions about GK versus CK answered
« Reply #11 on: May 02, 2008, 09:21:38 am »
I would have picked out the line "there was great risk that she would have permanent facial paralysis and balance issues." That has to be the Accuray marketing department putting a little spin on the situation. In this day and age, with hype going around about everything, I guess it is forgivable to have that in a "my story" article on the Accuray site. They are promoting their system, after all.

So Jan, you are quite right to call them on it, and Mark is quite right to say he was just quoting, and is not at liberty to edit it. Since you agree 100%, there is was no need for me to say anything, but I felt like it, so I did.  :)

Steve
8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.

MaryBKAriz

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Re: Some questions about GK versus CK answered
« Reply #12 on: May 02, 2008, 09:22:37 am »
Mark and Jan,

Thank you for the posts. Suzanne's story is a reassuring one. I agree a lot of people do well with microsurgery and it is the right choice for them. I hope every newly diagnosed person really researches all options because there are no written in stone choices. I believe people have to choose what is best for their own lives and those of their family.

I am actually excited to see Dr. Kresl on Monday. I feel very comfortable with where I am. I have done mega research and done lots of Specialists opinions on my tumor and health. I am ready to get the ball rolling. I will keep you wonderful people posted.

Thank you, again,

Mary
Diagnosed March 24, 2008, 1.1cm, right side, "Goldie" - small but mighty!! :-(
Hearing, lottsa balance problems and a few facial twitches before CK
CK June 2, 2008, BNI in PHX, Drs Daspit/Kresl, side effects,steroids helped. Getting "sea legs".
Apr 2012 - Still glad I chose CK

MaryBKAriz

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Re: Some questions about GK versus CK answered
« Reply #13 on: May 02, 2008, 09:25:42 am »
Good point,  Steve. Accuray obviously is biased to their product. It would be frightening if they were not. I am sure Gamma Knife feels the same about their process. I tried to read between lines of hype and get to the meat of what was said. I still do not know if it is CK or GK but I am leaning to CK.

Mary
Diagnosed March 24, 2008, 1.1cm, right side, "Goldie" - small but mighty!! :-(
Hearing, lottsa balance problems and a few facial twitches before CK
CK June 2, 2008, BNI in PHX, Drs Daspit/Kresl, side effects,steroids helped. Getting "sea legs".
Apr 2012 - Still glad I chose CK

MaryBKAriz

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Re: Some questions about GK versus CK answered
« Reply #14 on: May 03, 2008, 04:11:14 pm »
Okay,

I am very sad today. I went to my audiologist and had a hearing test. I have had 4 - 5 tests in the past year. The first one was 100% functional hearing, with only very high frequency lost. Today it was 20% functional.

I hear the sounds except high frequency, but - no kidding - I heard static come into the right ear and wondered what we were doing, so I looked at her and she was talking and I realized she was doing word recognition!!! I did hear a few of the words down the line, therefore I got up to 20%. She said no hearing aids can help with this because it is the distortion. If the volume increases, I will just have loud distortion. (She tested at various settings, and go the same results.) Anyway, she is a friend, and she said, "it is good you have a good left ear, because your right one is pretty much useless). She thought I might be a good candidate for BAHA. Anyway, my hearing has dropped dramatically in the last few months. So now she is the second audiologist to record less than 30% in the last 5 weeks.

I guess now that in the CK vs GK question, keeping my functional hearing is now a moot point. I guess the realization is hitting me. I am basically deaf in my right ear. I always took care of my hearing and up to a year ago had such good hearing. To have it go away this fast....well, I know you all understand. I know many of you have had to deal with this. I know it isn't the worst thing to happen to someone but I feel like my horse is trying to buck me again. Seeing Dr Kresl on Monday, I am not sure which he will recommend since hearing is off the table.

Thank you for letting me vent. I feel better already.

Mary
Diagnosed March 24, 2008, 1.1cm, right side, "Goldie" - small but mighty!! :-(
Hearing, lottsa balance problems and a few facial twitches before CK
CK June 2, 2008, BNI in PHX, Drs Daspit/Kresl, side effects,steroids helped. Getting "sea legs".
Apr 2012 - Still glad I chose CK