This is a tough question for many reasons. First, Lorenzo mentioned CK being used in the 90's but I don't believe that to be accurate since CK was FDA approved in 2001. Mark stated that GK has been in use for forty years which is true but here's my discrepancy.
When I was seeking treatment in 2003 I was looking into GK. I desperately wanted to speak to someone that had GK 20 years ago and couldn't find one person. My guess is that the first 20-25 years of Gamma Knife use on acoustic neuromas was performed only on the elderly. Likely, the patients that had GK done in the 70's and 80's passed on due to age/health issues? This is why long term results are very important. I don't believe we've seen the true outcome in those early patients
I personally agree that the risks of malignancy is likely small but they are certainly elevated and to what extent we can only speculate. Nothing is risk free. This is why they use lead jackets for quick scans including the ones performed in the dental office. The rooms that host CK & GK have very thick concrete walls at around 10' thick. However, radiation is curing people everyday. To what extent the cure can only be seen over time and varies person to person but the immediate relief and convenience is good enough for many. CK is effectively treating tumors throughout the entire body. The only problem that AN people face is that acoustic neuromas are benign and patients with benign lesions are expected to live long healthy lives unlike many cancer patients. This is what makes treatment for acoustic neuroma so difficult and personal. I was 34 when I was diagnosed so I wanted immediate results with no long term fear of direct and non-direct malignancies even if the odds seem low. This was important to me. Also, In 2003 CK was barely around and even mentioned.
Re: Malignancy! Think about this...how difficult would it be to prove that a malignancy found 20-30 years following radiation for an acoustic neuroma was caused directly by the radiation treatment? Possible? (of course) Although, how can one be entirely sure? This is probably why we may never know the truth. The possibility can never be erased or ruled out. Radiation is it's various forms is known to be somewhat dangerous over time. Remember, some people smoke their entire lives knowing the risk and never get cancer while others smoke for a shorter time and do get cancer.
Now this leaves us with the documented cases of direct malignancies (the very site and immediate surrounding area of radiation treatment). As of today, the number is closer to 20 but this number includes and favors NF2 patients. Those tumors are known to be a bit more aggressive than the ordinary sporadic AN.
Briefly, this is my perspective and personal research on the topic.
There were a few other reasons for me to personally elect surgery and I would be glad to discuss this further. I've mentioned earlier in a previous post that CK is off to a wonderful startand should be investigated. Some older machines had some software issues but maybe they have it all figured out now. The immediate results are usually the best results so more long-term data is definately needed. Long term data for GK is still impressive 10-15 years later but that is only out of Pittsburgh. Pittsburgh highly endorses GK and is a leader in the use of GK treatment. House has impressive and published reports regarding surgery. House also has a nice little site that addresses all these issues at acousticneuroma.org ....(if I remember correctly)
May3,
There is still some mis-information out there regarding AN and treatments so the best research is your own research. Finding one of the three treatments is a very tough decision and even though surgery is initially tough to choose next to an out-patient procedure it does have advantages. For example, the relief I have knowing that it's gone is extremely comforting for me. Consequently, it cost me my hearing on one side. IMO, most people will either lose their hearing or watch it deteriorate over time anyway. It's the nature of the beast.
Maybe you've already had treatment but you raised a very good question and I had to leave my input with due respect to others (my AN friends). I hope that I have given you an accurate and unbiased perspective. My Pennsylvania friend (Mark) is always helpful should you need further CK assistance.
If you are pre-treatment feel free to contact me anytime.