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ask the doc
miparent
Posted: Wednesday, March 13, 2013 10:46 AM
Joined: 3/13/2013
Posts: 1


stupid question but where is the "Ask the Doc" section????
radsrus
Posted: Wednesday, March 13, 2013 5:16 PM
Joined: 10/10/2008
Posts: 4435


RIght here

 

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

 


Derek
Posted: Tuesday, October 29, 2013 10:50 AM
Joined: 10/10/2008
Posts: 18


Hi Docs... A person diagnosed with an acoustic neuroma and who has no medical qualifications, insists that if the conservative management (watch & wait) option is chosen then even though the size of the tumour remains static, the tumour continually 'eats away' at the acoustic nerve resulting in eventual hearing loss on the affected side. Whilst accepting that all forms of AN treatment including conservative management are not without respective risks, I am doubtful that an untreated AN continually 'eats away' at the acoustic nerve. Your professional opinion would be greatly appreciated. Regards Derek
radsrus
Posted: Tuesday, October 29, 2013 10:58 AM
Joined: 10/10/2008
Posts: 4435


Not true. But you can get hearing loss from tumor enlargement that is too small to see on scans

 

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

 


Derek
Posted: Tuesday, October 29, 2013 11:03 AM
Joined: 10/10/2008
Posts: 18


Dr M... Many thanks for your rapid and succinct response. Regards Derek
Derek
Posted: Sunday, November 24, 2013 2:04 AM
Joined: 10/10/2008
Posts: 18


Dr M... I refer to my previous post on October 29 2013 in the 'Ask the Doc' section re my query as to whether a stable AN which shows no sign of enlargement eventually (as per the theory of a third party) 'eats away' at the acoustic nerve and can result in eventual hearing loss. Your response that same day indicated that the theory referred to was incorrect and that enlargement of the tumour was the cause of hearing loss albeit such an increase may be too small to be visible on a scan. Another party has indicated that many AN patients who choose conservative management (watch & wait) will lose their hearing without the tumour enlarging and has put forward some research findings in support of that claim which I herewith attach for your information and would be most appreciative for your views. http://www.ncbi.nlm.nih.gov/pubmed/19730147 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3302957/ http://www.ncbi.nlm.nih.gov/pubmed/21150682 Regards Derek
radsrus
Posted: Sunday, November 24, 2013 4:35 AM
Joined: 10/10/2008
Posts: 4435


http://www.ncbi.nlm.nih.gov/pubmed/19730147 This study abstract oes not delineate which patients lost hearing versus which patients did not have tumor re-growth. In fact, the way it is worded is ambiguous as to whether the patients who lost hearing were in the conservatively treated group, although I think that is what they meant. What it does show (in a small group of patients really) is that hearing loss is about as frequent with no treatment as with treatment, so why not get treated? I don't have access to the full paper. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3302957/ This paper is very interesting and I had not seen it before. It does seem to indicate a correlation between cochlear problems and AN. However, what it does not do is say whether those change progress over time with untreated tumors. And it does not answer the question of causality. Are the cochlear change due to the tumor, or are they both due to some underlying problem (such as the chemical that causes both hyperthyroidism and thyroid ophthalmopathy). Nor does it answer the question as to whether treatment of the tumor would have made a difference. http://www.ncbi.nlm.nih.gov/pubmed/21150682 This paper simply says that tumor growth and hearing loss are not necessarily related. It does not offer any evidence that the tumor somehow "eats away" at the nerve. I think it is fair to say the following: 1. AN and hearing loss are related, but degree and method of causality are undetermined. 2. Tumor treatment will usually control the tumor, but may or may not prevent further hearing loss 3. Treated and non-treated patients are about equally likely to have hearing loss 4. If the tumor os definitely growing, you can throw out 1-3 and be reasonably sure that continued growth is going to cause hearing loss, which may be preventable in over half of cases by treatment with radiosurgery

 

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

 


Derek
Posted: Sunday, November 24, 2013 4:58 AM
Joined: 10/10/2008
Posts: 18


Doc M... Once again I am most grateful for your valuable time and very swift, concise and informative response. Your review of the data in question is both logical and easily assimilated to those with no medical background. Many thanks. Regards Derek
Derek
Posted: Saturday, August 09, 2014 8:40 AM
Joined: 10/10/2008
Posts: 18



Derek
Posted: Saturday, January 02, 2016 3:13 AM
Joined: 10/10/2008
Posts: 18


Doc. CA Medbery Hi Doc... A fellow patient was diagnosed in June 2015 with an acoustic neuroma measuring 14mm x 7mm x 3mm. A further MRI scan in December 2015 indicated the AN now measured 18mm x 8mm x 8mm and is allegedly considered 'ineligible' for CK or Gammaknikfe treatment because of the 'aggressive' growth rate. Is that usual in the circumstances albeit the size of the tumor would appear to be still within the dimensions suitable for radiation treatment? Regards Derek
radsrus
Posted: Saturday, January 02, 2016 3:35 AM
Joined: 10/10/2008
Posts: 4435


It could be treated with GK or CK. I see no reason why that growth rate should change things.

Clinton A. Medbery, III, M.D. Southwest Radiation Oncology buddy@swrads.org
Derek
Posted: Saturday, January 02, 2016 5:09 AM
Joined: 10/10/2008
Posts: 18


Doc CA Medbery Many thanks for your swift response. I shall pass on your conclusion to the relevant party. Regards Derek
Derek
Posted: Saturday, November 05, 2016 11:55 AM
Joined: 10/10/2008
Posts: 18


Hi Doc... I now have almost 15 years in 'watch & wait' since my initial diagnosis with an acoustic neuroma and have had annual MRI scans until 2013 since when they are now biennial. Just wondered whether as a matter of routine, any other brain related medical disorders are also simultaneously searched for during the scan such as early onset Alzheimer's disease? Regards Derek
radsrus
Posted: Saturday, November 05, 2016 12:47 PM
Joined: 10/10/2008
Posts: 4435


They look at everything, but I don't think Alzheimer's can be diagnosed by standard MRI's. I am not a radiologist so don't hold me to that

Clinton A. Medbery, III, M.D. Southwest Radiation Oncology buddy@swrads.org
Derek
Posted: Sunday, November 06, 2016 6:01 AM
Joined: 10/10/2008
Posts: 18


Doc Medbery... Many thanks for your response. Regards Derek
 

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