Acoustic Neuromas: Gamma Knife vs Surgery
Following a diagnosis of an acoustic neuroma, your doctor will begin to discuss potential treatment options with you. For some patients, monitoring will be sufficient. However, others will require some form of active intervention, which can include traditional surgery, Gamma Knife radiosurgery or a combination approach.
While your doctor will discuss the treatment plan they feel will be most appropriate for your case, it can be helpful to understand your condition and the treatment options before you discuss your case together. Familiarizing yourself with your diagnosis will enable you to play a more active role in the conversation and development of your treatment plan.
About Acoustic Neuroma
An acoustic neuroma (also known as vestibular schwannoma) is a benign brain tumor that arises from the nerve responsible for balance, the vestibular nerve. Benign means the cancer will not spread to another site of the body. However, it can still cause unpleasant effects and require treatment if it impinges on nearby tissues.
Acoustic neuromas usually form in people 30 to 60 years old. Because they tend to grow slowly, they may go undetected for several years, and a doctor may discover one when doing imaging for another condition. Most patients have a vestibular schwannoma on only one side of the brain (there is a vestibular nerve on both the right and left side), except for those who have a rare hereditary disorder called Neurofibromatosis Type 2.
Treating Acoustic Neuroma: Gamma Knife vs. Surgery
If your doctor has recommended treatment for your acoustic neuroma, there are generally two optionsto reduce your tumor’s size as much as possible. The first approach is traditional surgery, and the second is Gamma Knife radiosurgery, a specialized form of radiation therapy. Each can be used individually or in a combination approach, and your doctor will recommend the approach they feel will be most appropriate in your case.
Gamma Knife radiosurgery is not a surgical procedure and involves no incisions. Instead, it is an advanced form of radiation surgery that uses multiple focused beams to target treatment directly at your tumor, sparing the healthy surrounding brain tissue. There is no hospital stay and fewer unpleasant side effects than with traditional radiation therapy.
On the other hand, in traditional surgery, the neurosurgeon will access your tumor and remove as much as possible, which may be all or only a portion of the cancer. The surgery is performed while you are asleep in a hospital setting and does require a hospital stay. Sometimes surgery is followed up with Gamma Knife radiotherapy in a combination approach to eliminate any remaining tumor cells.
When to Choose Gamma Knife, When to Choose Surgery
Your doctor will recommend the treatment option they feel will be most appropriate for you based on the size and location of your acoustic neuroma, as well as your specific health factors. However, there are some instances in which doctors commonly favor one approach over the other.
If your tumor is very large, surgical resection may be the preferred approach, as Gamma Knife alone may not eradicate the tumor cells. Likewise, surgery is sometimes the preferred approach for younger patients. On the other hand, some patients are not good candidates for surgery due to age, complicating health conditions or other factors, in which case minimally invasive Gamma Knife will likely be the initial treatment approach.
Benefits & Risks of Each Treatment Option
As your doctor develops your treatment plan, they will consider the risks and benefits of each option relative to your individual condition to determine the most appropriate treatment path for you.
Gamma Knife Radiosurgery
- Minimally invasive procedure, with no incisions
- Less pain and shorter recovery time than traditional surgery
- No hospital stay required
- No risks are commonly associated with surgery, including anesthesia reactions and infection
- Available when a patient cannot undergo traditional surgery
- Side effects associated with radiation therapy, including headache, nausea and fatigue
- Risk of delayed swelling months later (treatable with medications)
- Once surgeons remove a tumor, recurrence is unlikely
- If complete resection is not possible, can combine with Gamma Knife radiosurgery
- Risks associated with any surgical procedure, including anesthesia reactions and infection
- Risk of damage to the facial nerve, resulting in temporary or permanent muscle weakness
- Risk of damage to the vestibulocochlear nerve, affecting hearing
- Hospital stay required
- Longer healing time with more discomfort than Gamma Knife radiosurgery
The Treatment Path Right for You: Acoustic Neuroma Gamma Knife vs. Surgery
Whether you already have your procedure scheduled or were only recently diagnosed, learning more about your acoustic neuroma treatment options can improve your discussions with your doctor and set your mind at ease about your treatment.
Take the information you’ve learned into your next appointment, including any questions you may still have, to carry on the discussion with your personal doctor. They will be able to best explain the factors taken into consideration when recommending one treatment over another. Because you’ve taken the time to learn more on your own, you will likely find that your conversation is even more meaningful, giving you peace of mind about your treatment choices.