June 2000 Meeting of BANA (British ANA)

Contributed by Chris and Sheila Ottewell.  Chris is a member of the AN Archive patient advisory board.

The June 2000 Annual General Meeting of BANA (British ANA) was the most exciting and informative meeting I have ever attended...

1. Talk by Dr. Lindquist

The first talk was by Christer Lindquist. He is a world leading GK surgeon and Microsurgeon with a unique view of the world.  He has spent 25 years with Karolinska, Sweden, where he performed all the microsurgeries in the last five years of his time there, as well as GK. He is now Director of the Gamma Knife Centre at the Cromwell Hospital in London, one of only three GK centres in England. He has worked for a long time with Georg Noren, currently well known as the GK expert in Providence, Rhode Island.

He showed a video where he was conducting a surgical operation on a patient whom he had previously treated by GK! So, despite advocating GK for most AN's under 2.5 cms, he was not afraid to say it doesn't always work (only a couple of % failure though according to him). The audience questioned him on this and he took the opportunity to say that microsurgery after GK (in his experience) wasn't any harder than a second surgical procedure after surgical failure.

He also said a number of other notable things:

Whilst, as a rule of thumb, GK is his preferred option for tumours under 2.5 cm, he similarly advises surgery for those over 4 cm; those in-between always need more assessment on their individual merits.  However, he said he always wants his patients to make their own decisions which he implements as long as he feels it isn't dangerous. He gave a couple of examples including a Portugese woman with a large tumour which he had treated with GK despite his advice that surgery was preferable -- she had a perfect outcome! And the person whose operation he had featured in the presentation:  they had demanded surgery second time around, after the GK failure, despite his advice that a GK repeat was the best option for her. 

He is the only person I know of who has done repeat GK. He also gave a figure of "more than 10,000" for the total number of AN's now treated by GK worldwide since 1969 (out of more than 100,000 brain tumours of all types). So, it seems to have a considerable track record!!!

The next part of Dr. Lindquist's talk was unexpected.  He showed a screenshot slide of the AN Archive Do Not Panic! page and said:  

"I refer all my patients to this web site - It is the best place in the world to get full and unbiased advice - This is a very important message - (do not panic) - as it's what most newly diagnosed patients do".

He went on to commend and discuss all the good advice on that page...  He also showed a screenshot of the Myths page and said:

"All of these are myths which we must do away with".

He then discussed many of them and explained why they are myths and the harm people are doing to patient well being by perpetuating them... So, 10/10 for www.ANarchive.org!

2. Talk by Dr. Walsh

The second speaker was Dr. A.R. Walsh, a leading neurosurgeon from the hospital hosting our meeting. He used a model skull with a removable "lid" and a model AN inside to demonstrate the difficulties presented by the three surgical techniques in common use. This was very interesting as it beomes quickly very clear why one procedure swaps one advantage for another disadvantage and why there is no single ideal approach to an AN.

He answered detailed and probing questions from the audience clearly and fully. He also made it clear that since patients often end up more damaged by the cure than the disease (statistically speaking), he liked to observe tumours before deciding to operate, asuming that they were small enough to do this safely. He felt (as do many who write to the AN Archive) that for older patients with small tumours, it is often possible to go without treatment as long as a sensible observation regime is put in place.

He also said that it's vital that patients choose a surgeon who is experienced in the approach they want, not an experienced (for example) translab surgeon to perform some other procedure.

Some surgical patients in the audience asked about nerve grafts. He said that he always tried to do them as part of the AN removal procedure if they were obviously needed. Otherwise, they should be done as soon as possible (e.g. if it only becomes clear after the op that a graft is needed). In any event, they should be done within 12 months, as after 18 months the muscle will have withered so much that even if the graft succeeds, there will be no muscle to react to the signal.

Best wishes,

Chris and Sheila Ottewell

Last Edited: Wednesday, October 30, 2002