Stereotactic Radiosurgery Surgery (Gamma or Cyberknife) for Meningioma

I haven't had cyber knife radiation, but I had gamma knife radiation in 2017 on 2 meningiomas that were recurrences from a meningioma I had surgically removed in 2001. My original meningioma in 2001 was 5cm, about the size of a small orange. I had the surgery in Atlanta and my neurosurgeon felt he got all of it. The recurrences were actually small tails from the original tumor that were too small to be seen during the surgery.

One of the benefits of gamma knife radiation is that it can treat multiple brain tumors in one session. One of my tumors that recurred was very elongated in shape. It went from behind my eye to behind my nose. Because it was not "round" and compact like the "typical" meningioma, I was in the gamma knife machine for 2 1/2 hours. They programmed slightly overlapping spheres of radiation to treat the elongated shape and also treated the roundish shape meningioma at the same time. I have had follow up MRI's in each year since 2017. In 2018 and 2019, the recurrences were stable. They had not gotten any larger and one was a fraction smaller. I had an MRI last week in Atlanta for my 2020 annual follow up and I've sent the CD to my doctor at Mayo in Rochester and I am waiting for his evaluation.

Jill, I really appreciated sharing your experience with all of us in this forum, was very helpful. Thanks for that.
I've been researching about the difference between gamma knife and cyber knife. If my understanding is correct, they are both like focused lasers which target the tumor. But I cannot find any articles which said that multiple tumors can all be treated at the same sessions with cyber knife.
I also hope that your annual MRI turned okay.

Hi mmbaluyut (sorry, I don't know your name),
Have you discussed with your doctor why they recommend cyber knife over gamma knife or proton beam radiation? All can be very effective at stopping tumor growth. There are pros and cons of each. There are usually very specific medical reasons for recommending one over the other. Sometimes it is simply a matter that the facility only has one of the machines. Before I self-referred myself to Mayo in Rochester, MN, I went for a consult with two neurosurgeons in Atlanta, which is where I live. One of them was the surgeon who had surgically resected my original meningioma. He recommended surgery on one of the recurrences in order to biopsy it and cyber knife on the other because it was in an area very risky area for surgery. He was very experienced with cyber knife and the facility he used for stereotactic surgery only had cyber knife. The second neurosurgeon I consulted with in Atlanta recommended gamma knife on both recurrences. He was very experienced with gamma knife. I did not feel comfortable making the decision myself as to which doctor's recommendation was the best treatment for me. I researched Mayo Clinic online. When I read that the Mayo location in Rochester had both gamma knife and proton beam machines, and that they were rated #1 in treatment for brain tumors, I called the neurosurgery dept. and I explained that my MRI showed recurrences. They arranged over the phone for me to have an appointment the very next week. I thought I would just be meeting with a neurosurgeon, but they had arranged for me to meet with the Director of Neuro Oncology. a Neurosurgeon and two Radiation Oncologists - all in the same day. After I met with each of them, they had a meeting to discuss my case. Then I had another meeting with the Neurosurgeon and he explained why they all agreed gamma knife was the best treatment for me. One big advantage gamma knife has over proton beam is that it is done in one session, whereas proton beam radiation is done 5 days a week for 28 days. Proton beam is used for larger brain tumors than my recurrences were and is preferable for certain locations of the brain. I was told that in their opinion, gamma knife radiation is preferable to cyber knife for brain tumors. I am not in anyway contradicting your doctor because I am not a doctor and I don't know any of the specifics about your tumors. Perhaps though, you would like to consider contacting the Neurosurgery Dept at Mayo or asking your doctor to do so for a second opinion. You or your doctor can send your MRI's and your doctor's notes for review at Mayo. Doctors understand, or should understand, when a patient wants a second opinion. I'm not trying to put any doubts in your mind about cyber knife. Each patient's case is unique. I was fortunate that my recurrences were fairly slow growing so I had time to meet with multiple doctors and my insurance covered each of the doctors, including Mayo Clinic. I wish you the best.
Jill

Joan, I am so happy for you that you were able to have the gamma treatment and that it's behind you now. I was out of the town for the weekend and didn't have my password with me or I would have responded sooner. I'm sorry I did not think to tell you that I had an IV for the MRI contrast. I hope you weren't taken aback when they put it in. My next mri is in August 2020 unless I experience any symptoms of another meningioma. I'm with you - I'm not going to worry about it now or even think about it until next year. I have a new problem to focus on now. I found out last week the results of a biopsy I recently had on a nodule on my thyroid. The results came back "suspicious, at risk, 50% chance of cancer'. I'm meeting with my endocrinologist tomorrow as I have a million questions. She's already told me by phone she thinks I should have all or at least part of my thyroid removed surgically. Ugh. I feel I've had enough surgery for a lifetime already. But fortunately, thyroid cancer is very treatable. Usually, a thyroidectomy is all that is needed. I'll get more info tomorrow. I hope you have a healthy and happy 2019 also! Jill

Hello, I have MS but have been symptom free for many years. I just found out that I have 2 meningiomas that the doctor wants to treat with gamma knife soon. I have double vision, from one of the tumors. I am so scared because I’ve read that any radiation even gamma knife can cause demyelination of the brain and cause a resurgence of sometimes severe MS symptoms. Has anyone else had gamma knife with a diagnosis of MS too. Thank you.

My wife was diagnosed with a brain tumour two weeks ago and had a mri last weekend with her family Dr. Telling us she has frontal lobe meningioma. She has been having memory issues for quite awhile now ,muscle weakness as well as balance issues but she hasn’t had headaches or vision problems. We see the neurosurgeon this week and was wondering what questions we should be asking. I was also wondering about the time line of things everything seems very slow and drawn out.
My wife doesn’t seem to be able to do much on her own although she had a fall that lead to the discovery of the tumour and broke her dominant arm which has also lead to the inability to do many things for herself

I have a meningioma in my left frontal lobe. I'm terrified to have the surgery to have it removed. I'm so scared I'm going to die during surgery. Please tell me what I can expect, share your stories with me. How did you calm your nerves?