I'm not so sure if I should be writing here judging by some of the major surgery stories but here goes.
As a result of a 'swollen optic nerve' examination which was spotted in my annual 'retinopathy scans'(I'm type 2 diabetic), I then had an MRI scan. This revealed a meningioma bt followed by an invite to see a consultant for 'a chat'. Apparently it is very small and a-symptomatic, but as the surgeon said: it's there and it should'nt be, and nothing to do with the swollen nerve in one eye problem. Go away, he said, and think about an operation to remove it while you are young(61) - better now than later".
That's exactly what I have been doing for 12 months. Saw the consultant recently and it's the same story, he wants me on his list, he seems very keen to open Pandora's box. But, as I told him, it's not giving me any problems and I've got some overseas travelling to do. So let's look at an MRI scan later this year to see if it's 'moving' with a view to having it out in June 2010.
QUESTION: Is this the right decision to wait and see or should I open the box! Advice sought
Frankly, I am not a fan of your doc...first of all, er, you ARE symptomatic as that is why you went to the doc and you are having eye issues. The optic nerve is very fussy and the last thing you want to lose is your sight. Is your eye doc a neuro-opthomologist? If not, get one, and get a better one if the doc lets you wait.
I would get another opinion.
The tumor itself is benign, but it may be in a bad place - depending on where it is - and could mess with other things liek hormones. Do you have copies of the reports, films and all - to go somewhere else?
It may not be a box to open BTW... but I would get another opinion.
A very close relative of mine has a meningioma between her eyes. They watched it for a while with MRIs as it slowly grew bigger. They almost waited until it was too big to do gamma knife surgery (called bloodless surgery, using gamma rays and a helmet they screw on to make sure the head is absolutely still during the procedure). The meningioma was extremely close to the optic nerve where they almost couldn't do gamma knife as well. But thanks be to God, they were able to and it wasn't quite too big to do gamma knife surgery.
The neurosurgeon had wanted to shave hair, open the skull and manually remove it but my relative said it's gamma knife or nothing. She did not want to take that risks of open surgery like that. Her dad died of a tumor (probably the same variety) that was discovered too late. My relative had her gamma knife surgery at Good Samaratin Hospital and one of the surgeons she had was one of the pioneers of the procedure. That was back in Feb. 2002 and I'm so thankful that the tumor did some shrinking and recently has stayed the same reduced size (followed up by serial MRIs). Open brain surgery, if it can be avoided, I think should be. It is not without significant risk. You might also look into cyber knife.
Yes, the ol' watch and see method is pretty poor in general.
I would investigate methods of treatment. I myself think surgery is just fine as radiation has a different set of risks (necrosis of healthy tissue, and takes longer to work) so it really depends on the location of the lesion, and all sorts of things.
Yes, I think perhaps it is better when you are talking the very small pituitary gland and all its important hormones to excise rather than risk even gamma knife.
But with meningioma, that means it is a tumor growing on the meninges, or the outer lining of the brain. It can, however, start to press inward as it gets bigger and cause trouble.
The double dye MRI they do before gamma knife (only done alone on up to a 3 cm tumor) helps them map the brain so the precision of the gamma rays should be excellent in targetting the tumor, with power of the rays going through the other brain tissue to get to the tumor not highly concentrated enough to do any significant damage to other parts, according to what is said about it, but all the highest intensity focused right on the tumor.
Gamma knife kills the DNA of the tumor. The only new necrosis shown in my relative's MRIs subsequent to the 2002 surgery mentioned by the doctor(s), was in the tumor.
When you factor in the higher morbidity rate for open brain versus gamma knife, and the higher risk of surgeon's error, which, if close to the optic nerve, can even potentially result in blindness, it was her best option in the opinion of my close relative back when she made the decision.
There is also proton therapy you might look into besides cyber knife and you might see what else is out there too. So I encourage you, Lenhan, to research all the options.
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