Vestibular Schwannoma
Vestibular schwannomas (Acoustic Neuroma) are non-cancerous growths along the nerve that joins the inner ear to the brain.
This nerve controls hearing and balance. They are also sometimes called acoustic neuromas. Vestibular schwannomas can cause hearing loss and problems with balance.
Radiation Therapy and Vestibular Schwannomas
The best person to talk to about radiation therapy for vestibular schwannomas is a radiation oncologist. A radiation oncologist is a specialist doctor who is part of the team that takes care of people having radiation therapy.
You can ask your doctor for a referral to a radiation oncologist to learn if radiation therapy is an option for you.
The Treatment Team
Doctors make a treatment plan for each person based on the:
- size and location of schwannoma
- what treatment has been tried before
- the person’s health.
The type of treatment a person gets is worked out by a team of doctors and health professionals often called a Multidisciplinary Team.
A highly trained radiation oncology team takes care of people having radiation therapy. This includes radiation oncologists, radiation therapists, medical physicists and radiation oncology nurses.
Treatments for Vestibular Schwannomas
There are a few ways to treat vestibular schwannomas. These include observation, surgery, or radiation therapy.
Observation
Most vestibular schwannomas grow slowly and may not cause problems.
If the schwannoma is small, the doctor may recommend a “watch and wait” approach. This means scans every 6-12 months and regular hearing tests.
If the schwannoma grows quickly, or if a person’s hearing gets worse or they get new symptoms the doctor will offer other treatments.
Surgery
For larger schwannomas and younger people, surgery is preferred. This is when the doctor removes the schwannoma through the inner ear or a cut in the skull.
If the schwannoma is completely removed it is unlikely to grow back. However, during surgery there is a small risk of nerve damage. This can cause further hearing loss or damage to the nerve that controls muscles in the face.
Some people also get headaches after surgery.
If the schwannoma is close to important nerves or blood vessels the doctor may not be able to remove the whole thing. In this case the tumour may grow back after surgery.
Radiation therapy can be used to treat vestibular schwannoma. The aim of treatment is to stop the tumour growing and protect the nerve.
Types of Radiation Therapy Used for Vestibular Schwannomas
Stereotactic Radiosurgery (SRS)
Stereotactic radiosurgery is when high-energy x-ray beams are focused precisely on the tumour.
This treatment is painless and usually done in one session.
People must stay very still when they get SRS. Doctors use special equipment to make sure this happens, such as a face mask or head ring.
Stereotactic Radiation Therapy
Stereotactic radiation therapy is like SRS, but treatment is done over 3 to 5 sessions, rather than one.
Fractionated Stereotactic Radiation Therapy
Fractionated stereotactic radiation therapy is the same as stereotactic radiation therapy but doctors deliver small doses of radiation (fractions) each day over 5-6 weeks.
How effective is radiation therapy?
Radiation therapy is very effective for treating vestibular schwannomas.
Stereotactic treatments have success rates of between 91 to 100% 10 years after treatment.
General Side Effects of Radiation Therapy
Radiation therapy is more effective with fewer side effects than ever before.
Recent advances mean radiation oncologists can effectively treat the cancer while getting less radiation on healthy body parts. This means much fewer side effects.
Side effects from radiation therapy vary between people, even for those having the same treatment.
While some people feel no side effects, some feel mild side effects, such as tiredness or skin redness during and/or just after treatment. These usually get better within a few weeks.
The treatment team will offer advice and medicine to help with side effects.
Serious side effects that start later (months to years after the radiation therapy) are rare.
Before starting treatment, your radiation oncologist will talk to you about side effects and answer your questions.
The side effects of radiation treatment can be split into 2 groups:
- Early side effects which occur during and shortly after radiation treatment.
- Late side effects which can occur months to years after radiation treatment.
For more information, go to the Potential Side Effects page.
The side effects of radiation treatment for Vestibular Schwannomas can be split into 2 groups:
- Early side effects which occur during and shortly after radiation treatment. Most patients do not notice any side effects of stereotactic radiation therapy during or just after treatment, although some people do have headaches and nausea.
- Late side effects which can occur months to years after radiation treatment. The long-term side effects of radiation therapy for vestibular schwannoma can happen months or years after treatment and may include:
- Damage to cranial nerve The risk of this is very low but it can cause pain, hearing loss and vertigo.
- Tumour growth Sometimes the tumour grows a little 6-12 months after treatment.
- Hearing loss This is common but depends on hearing before treatment and varies. Hearing tends to get worse slowly over years, and is more likely in older people, those with larger tumours, or people with greater hearing loss before treatment.
- Second cancer Cancers caused by radiation therapy are a very rare side effect.
Other Useful Resources for Vestibular Schwannomas
Find additional information about cancer types, research groups, and support groups.
Radiation Oncologist
The best person to talk to is a radiation oncologist. You can ask your doctor for a referral to find out if radiation treatment is right for you.
GPs and Health Professionals
Information for any health professional involved in a patient's cancer care with a particular focus on primary care providers.
Talking to Your Doctor
Your GP or other doctors in the cancer team can organise a referral to a radiation oncologist.
Treatment Centres
Search and find your closest Radiation Oncology Treatment Centre.
