Acoustic neuroma - Macmillan Cancer Support (2024)

Your treatment may depend on:

• the size of the tumour
• how the symptoms are affecting you
• your general health.

If the tumour is small and causing mild symptoms, your doctor may suggest active monitoring until treatment is needed. If treatment is needed, the main treatments for acoustic neuromas are radiotherapy or surgery.

A team of specialists will plan your treatment. Your specialist doctor and nurse will explain the aims of your treatment and what it involves. They will talk to you about the benefits and disadvantages of different treatment types. They will also explain the risks and side effects.

You may be given a choice of treatment options. You will have time to talk about this with your hospital team before you make any treatment decisions.

You will need to give permission (consent) for the hospital staff to give you the treatment. Ask any questions about anything you do not understand or feel worried about. Tell your specialist if you need more information or more time to decide on a treatment.

Active monitoring means regularly checking the tumour to find out if it is growing.

If the tumour is small and the symptoms are mild, your doctor may suggest delaying treatment until it is needed. This is because treatment can cause side effects and some of these may be permanent.

Instead of starting treatment, you may see your specialist doctor regularly to have scans to check for changes in the size of the tumour. This can help your doctor know if and when to recommend treatment. Because acoustic neuromas are often slow growing and sometimes do not grow at all, it may be a long time before your symptoms change.

Talk to your specialist doctor if you are worried about any symptoms. They will explain the benefits and risks of active monitoring.

Radiotherapyuses high-energy rays to destroy the tumour cells. You may have radiotherapy to stop a tumour growing. Sometimes it can also shrink it.

Acoustic neuromas are usually treated with a type of radiotherapy calledstereotactic radiotherapy(SRT). There are different ways of giving SRT with different radiotherapy machines. The radiotherapy machine directs radiation beams from different angles so they cross over at the tumour. This gives a high dose of radiation to the tumour and lower doses to nearby healthy areas. This lowers the risk of damage to normal cells and can sometimes reduce side effects.

You may have stereotactic radiotherapy:

• as a single treatment – this is called stereotactic radiosurgery (SRS) and it is often used to treat smaller tumours
• over 3 to 10 sessions, spread over 2 weeks.

If you do not have SRT, you may have external beam radiotherapy. This is usually given daily, from Monday to Friday, for 5 to 6 weeks.

Your specialist doctor will explain how long treatment will last and the type of radiotherapy you will have.

You may develop side effects during or after your treatment. Side effects can depend on which area of the brain has been treated and the amount of radiotherapy given.

Your radiotherapy team will explain the possible side effects of the treatment. Some side effects are mild and quite easy to cope with. Others may be managed with drugs or other treatments. It is normal to feeltiredafter treatment. This usually improves over time.

Tell your radiotherapy team straight away if your side effects get worse during or after treatment. They can give you advice on how to manage them.

Sometimes, radiotherapy for acoustic neuroma can cause long-term or permanent side effects that develop months or years later. These can include hearing loss and, rarely, damage to the nerves that affect your face.

We have more information aboutradiotherapy to the brain and possible side effects.

Surgery for acoustic neuromasinvolves removing all or part of the tumour. Sometimes the surgeon leaves a small part of the tumour to avoid damaging nearby nerves. You may have stereotactic radiosurgery (SRS) or radiotherapy after surgery.

Your surgeon will explain thesurgeryand the possible risks. They will give you information about what to expectbeforeandafter your operation. The doctors and nurses will monitor you carefullyafter your operation.

Surgeryis likely to have more immediate side effects than radiosurgery or stereotactic radiotherapy.

Surgery usually causes hearing loss in the affected ear. If you have hearing loss after your treatment, you may be able to get a hearing aid. You will usually see a hearing specialist (audiologist) or ear, nose and throat (ENT) specialist for expert help and advice.

Sometimes, surgery damages the facial nerve. This can cause drooping (palsy) of one side of the face. This is usually temporary. It can affect actions like chewing and blinking. It can take time for the facial nerve to recover.

Some people also get a dry eye. Eye drops will help with this. If needed, your doctor can refer you to an eye specialist. You may:

• have headaches
• have nausea
• feel dizzy
• notice that your balance is affected.

These usually improve in the weeks after surgery.

You may also feel very tired. It can take 2 to 3 months to start to feel better.

We have more information about help withrecovering from surgery.