Another interesting appointment

I saw Dr. G, the radiation oncologist, today. He explained the three options to me again (watch & wait, surgery, radiation) and briefly described the CyberKnife fractionated treatment. Basically, the goal of CK is to split up the total amount of radiation into several sessions so that the tumor gets the combined strength of radiation but the surrounding tissues get a much smaller accumulated dose. The rate of hearing preservation with CyberKnife is higher than with Gamma Knife for this reason.

GK is usually a single session of radiation directed at the tumor, and to ensure the patient doesn't move, a metal head frame is screwed into the patient's skull. CK uses a fitted mask to maintain an approximate continuity between sessions, but the machine also has an on-board CT scanner that scans the location of the patient's head during the procedure so the robotic arm can adjust if a slight recalculation needs to be made.

I didn't really feel that I learned any more about the CK option than I already knew from reading the discussion forum posts. The main thing I took away from this meeting was what Dr. G said toward the end of the appointment, which was that his recommendation for me, based on my age and the lack of long-term studies on the effects of radiation, would be to have surgery. He said that he wouldn't NOT do radiation treatment if that's what I wanted, but that it wouldn't be his preferred choice.

The thing that AN patients run into a lot of the time is a lack of unbiased sources for information. Surgeons generally want to cut, and radio-oncologists want to zap. I was surprised to hear that Dr. G, being a radiation oncologist, thought I should have microsurgery. That was when I decided for good that I needed to be focusing on surgical options.

(In the interest of full disclosure, this post was actually written on 1/29/09.)