What Are the Treatments for Schwannoma?

Schwannomas are tumors that grow within a nerve. These neural tumors arise from the fibers inside the nerve called schwann cells, rather than from the nerve sheath where other neural tumors arise. Schwannomas are extremely slow-growing, taking years to become large enough to feel or see. Schwannomas usually occur randomly. However, there is a condition called von Recklinghausen's disease that can cause schwannomas to grow throughout the body. Doctors can diagnose von Recklinghausen's disease by physical examination combined with body scans. Often, schwannomas become very large before a patient notices any ill effects from them. Treatments for schwannoma depend on tumor location, the symptoms it causes, its size, signs of malignancy and the patient's overall health.

Identification

• In most cases, schwannomas are benign tumors. However, there are rare occasions where a schwannoma is malignant. Schwannomas can occur anywhere in the body, but tend to favor the brain, trunk and the nerves where appendage flexion occurs.

Surgery

• The most common treatment for schwannomas is surgical removal of the tumor by a neurosurgeon. Finding an experienced neurosurgeon is imperative for the best long-term prognosis. Neurosurgeons often have subspecialties regarding tumor location where they have the most experience. In cases of cancerous schwannoma tumors, neurosurgeon-oncologists are the optimal resource for treatment and therapy. Nerve surgery commonly causes temporary nerve dysfunction, causing feelings of pins and needles, shock sensations and tingling along the nerve that the surgeon manipulated to get the tumor out. Sometimes nerve trauma causes these symptoms for longer periods. The patient can also have hypersensitivity and pain. If a surgeon has to sever a nerve fiber to remove the tumor, numbness can be permanent.

Radiation Therapy

• Sometimes doctors use radiation as a treatment for schwannomas. If the tumor is large, the surgeon may wish to shrink it before surgery. Larger tumors carry a higher risk of nerve damage from surgery, and are harder to remove from the nerve fibers. In some cases, radiation is the primary treatment for schwannomas. The goal of radiation as a primary treatment is to shrink the tumor enough to minimize or eliminate symptoms it causes. The two most common forms of radiation therapy used for schwannomas are Gamma Knife and reflected solar radiation (FSR).

Close Monitoring

• In cases where the tumor is not causing any symptoms and there are no signs of malignancy, the doctor may recommend close supervision. This involves regular appointments and magnetic resonance imaging (MRI) scans to assess any problems. The scans allow the doctor to check the schwannoma's growth. The doctor and patient decide whether to do surgery or to continue the active monitoring.

Considerations

• In some cases, medical issues may make surgery a poor choice. In cases of benign tumors combined with serious medical problems, doctors may recommend avoiding surgery due to the risks. If the tumor is causing symptoms, the doctor may recommend radiotherapy to shrink the schwannoma. The doctor can continue close supervision in order to determine if and when surgery is the best option.