Dizziness and gait disturbances

Observation (Watch and wait / monitoring only). In a lot of cases, the growth rate can be lessthan one millimeter per year.

Microsurgery – surgery aims to reduce the size of the tumour and to preserve hearing. Surgery will also be determined by the type of tumour. There are risks associated with anysurgery including infection, hearing loss, headaches and bleeding.

Surgeons try to preserve other cranial nerves (especially the trigeminal), but the facial nervecan be damaged in 10-40% of cases.

Radiotherapy - gamma knife / LINAC (linear accelerator – single dose of radiotherapy)

Fractionated Radiotherapy – several doses given in a course of treatment.

High frequency hearing loss or afeeling of congestion in the ear

Tinnitus (ringing in the ear)

Vestibular Schwannomas (formally known as acoustic neuromas) are two different termsfor the same tumour. They occur in the general population (people without a diagnosis ofNF2) and have an incidence of 1:100,000. They are made up of Schwann cells and 95% areunilateral (one side only).

The incidence of NF2 is approximately 1:25,000-40,000.

GAMMA KNIFE SURGERY

AgeSize of tumourPatient expectationsGeneral healthQuality of life factorsLocation of tumour – if bilateral, then hearing is considered.

WHAT DETERMINES TREATMENT OPTIONS?

WHAT MIGHT BE SIGNS AND SYMPTOMS OF VESTIBULAR SCHWANNOMAS?

WHAT ARE THE CURRENT TREATMENT OPTIONS?

Webinar SummaryPresented by Dr Annie Ho, Radiation Oncologist at Macquarie University Hospital

HOW COMMON ARE VESTIBULAR SCHWANNOMAS?

Tingling or facial numbness

Disorientation

Headaches

Side Effects: the day of treatment can cause soreness, numbness or bruising. The tumourmay continue to swell for the next three months, which may exacerbate symptoms (but canusually be treated with steroids).

Nasty side effects such as malignant transformation in NF2 (another tumour formingbecause of treatment) are rare at only 0.3% risk.

Availability: there are two Gamma Knife machines in Australia. One at Macquarie UniversityHospital (Private) in Sydney and one at the Princess Alexandra Hospital in Brisbane (Public,but for Queensland residents only).

Cost: Treatment is approximately $26,000, but Medicare rebate 80% of this (out of pocketexpenses are approx. $4,000). A foundation has been established to assist in costs fortreatment at Macquarie University Hospital.

IT SOUNDS TOO GOOD TO BE TRUE, WHAT ARE THE DOWN SIDES?

FOR MORE INFORMATION CONTACTMacquarie Neurosurgery Suite 2012 Technology Place NSW 2109T: +61 (2) 9812 3900T: +61 (2) 9812 3220 E: admin@mqneurosurgery.com

WHAT IS A GAMMA KNIFE?

Macquarie University Hospital, NSW Princess Alexandra Hospital, QLD

Watch the clips here:

Gamma Knife is a form of stereotactic radio-surgerythat uses computer planning software to treat braintumours with radiation therapy,

It delivers 192 cobalt sources of intense radiationwhich all converge onto the precise location of thetumour without impacting the surrounding tissue.

A frame is fixed to the patient’s head to ensurestability and pinpoint accuracy.

Patients can be treated in a single day and it reducethe need for invasive surgery.

HOW EFFECTIVE IS THE TREATMENT?As stated, it can be some time untilresults are obvious; however,studies show that the tumours arecontrolled in 89-99% of cases after5 years.

Most (50-80%) of these people hadpreserved hearing depending onthe tumour location. Only half hadpreserved hearing if the tumourwas located close to the cochlear,but people had an 80% chance ofpreserving hearing if the tumourwas further away as the cochlear issensitive to radiation.

Over 90% had undamaged facialand trigeminal nerves.

WHAT DOES IT REALLY DO?

Radiotherapy hits the tumour cells and damages theDNA so that these cells can no longer multiply orreproduce.

Benign tumour cells have a very long life cycle, sochanges to the tumour size may not be evident for 1-2years after treatment.

Royal Princess Alexandra HospitalGamma Knife Care Coordinator P: +61 (7) 3176 1908

Radiation Oncology DepartmentReception Phone: +61 (7) 3176 6586Outpatients Phone: +61 (7) 3176 1961