Saturday, November 8, 2014

"Where do You See The Future of Schwannoma Treatment and Research Going?" Three Neurosurgeons Weigh in on the Question

Hello everyone!  Today I'd like to offer our Schwannoma Survivor friends a new blogpost that features the perspectives of three neurosurgeons - as they weigh in on the question "Where do you see the future of schwannoma treatment and research going?"  It occurred to me some time ago that answering, or even trying to answer, these kinds of questions is going to be key for survivors in the future.  New approaches as well as new understandings of schwannomas will be integral in hopefully creating new treatment options that will lead to the best possible results.  In any event, I asked three neurosurgeons, who have very generously offered their assistance to the Schwannoma Survivors page, what their perspectives may be on this issue, and below are their answers...I hope you find them helpful!

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Co-director, USC Spine Center
Professor of Neurosurgery, Keck School of Medicine of USC

Keck Medicine of USC

Dr Liu writes:

Developments in the diagnosis and treatment of schwannomas continue to evolve and include different diagnostic MRI modalities to differentiate schwannoma from other types of tumors that may present in a similar fashion.   Continued research into the genetic make up of schwannomas may help our understanding in the etiology and why certain tumors may progress to malignancy.  

New techniques in minimally invasive access to the spine as well as intra-operative navigation can make removal of spinal schwannomas safer with faster surgical recoveries.  Focused radiation treatment as opposed to surgical resection may offer additional options in treatment.  
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Columbia University Medical Center
Department of Neurosurgery

Dr Ogden writes:

The future in the treatment of spinal schwannomas lies in defining the correct applications and limitations of minimally invasive approaches.  The vast majority of spinal schwannomas are effectively treated with open surgical approaches.  The experience of numerous clinicians has shown that these tumors can be removed with minimally invasive approaches.  What we have yet to define is what the comparative outcomes are between minimally invasive approaches and open approaches in terms of postoperative recovery and neurological outcome.  Just because something can be removed through a smaller opening doesn’t necessarily mean that it should. 

The other modality whose role is well defined for intracranial schwannoma, but not for spinal schwannoma is radiosurgery.  Although most would consider the indications for radiosurgery for spinal schwannoma very limited at present, I would expect this to change significantly over the next ten years.

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Stanford University School of Medicine
Clinical associate professor, Neurosurgery

Dr Chopko writes:

 I believe that understanding the genetic issues underlying  Schwannomas has some exciting promise for new therapies. If a specific gene mutation or overexpression can be targeted, then it would be theoretically feasible to develop a pharmacologic treatment for these tumors, perhaps avoiding surgery in some cases. On a more immediate topic, advances in minimally invasive and endoscopic surgery are reaching a broader use. These techniques allow surgeons to make much smaller incisions and allow patients to hopefully return to more active lives in a more rapid fashion.
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Disclaimer: The contributing physicians and their associated medical facilities assume no liability whatsoever for the comments or advice offered in the content of this blog.   The consulting physicians have offered their advice generally on the issues relating to treatment of Schwannomas.  Consulting physicians and the Schwannoma Survivors & Schwannoma Fighters group always insist that a person should make all major medical decisions in consultation with one's own physician.