Expert: Claes-Gustaf Nordquist, M.D. - 9/10/2007

Question
QUESTION: Doc, My husband has an "AN" it is I believe 2 & 1/2 cm by 2. He has done radiation 28 days , here @ Baylor in the Medical Center in Houston.  It has been 18mo.  At the beginning we saw necrosis, now we don't see that, we actually see some solidifying and some slight growth again.  My question is from that point do they ever see it begin to " necrosis" again?  And I know we can't do radiation again.  He just turned 44.  And his neurosurgeon just retired after 30 yrs. so we are waiting to go in again.  Thanks for your help.  Newton Coker was his doctor's name.

ANSWER: How was this radiation done? Proton beams? GammaKnife? Anything else. AN can basically only be treated with radiation with the 2 methods I first mentioned - or something very similar - but what you describe do not seem to fit any of those. So how was it done? I need to know that in order to answer. The size of his AN fits those therapies.


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QUESTION:  I believe it was called the "cyberknife" I hope I'm right.
It is pressing on his brainstem and we were told he basically bought himself 9mo. of time because they are slow growing tumors. And it's a wait and see game.  They took his case before a whole South Conference a the general concenses was for him to go the radiation route b/c of his job. It involves public speaking and the risks w/ surgery of facial paralysis were high. I hope this helps.

Answer
Cyberknife I think is very similar to GammaKnife. Actually an AN of this size should be possible to CURE with the right radiation treatment (proton beams, GammaKnife etc.). However if his lesion was/is located right by his brain stem the treatment may have been compromised due to its nearness to sensitive brain structures so that the necessary radiation dose for a cure could not be given. Lacking all necessary background information this is as far as I can come at present.