questions

10 Jul, 2025

i met with six surgeons and two radiation oncologists when deciding whether to pursue surgery or radiation. you probably don't need that many opinions, but the first two surgeons i met with gave me very different advice (basically one told me confidently to pursue surgery, and the other told me to avoid surgery at all costs), which made me spiral a bit and go hard with seeking "second" opinions.

when meeting your surgeon, they should always start by showing you your mri images and describing the type, size, and location of your tumor. afterwards, they'll probably go over your options moving forward, the advantages and disadvantages of each option, and finally their recommendation.

here is a list of follow-up questions i found helpful to ask my surgeon:

1. what is the best case scenario if i were to pursue surgery? what is the likelihood that surgery can achieve this result?
2. what is the chance of total resection?
3. if total resection is not possible (or highly unlikely), what percentage of the tumor do you expect you'll be able to remove?
4. if only partial resection is achieved, what are the chances i'll need radiation down the road, and in how many years after surgery?
5. if the tumor is encasing or affecting a nerve or artery, will you optimize for saving the nerve or getting rid of as much tumor as possible?
6. what are the risks i should be aware of in my case, and what is the likelihood of occurrence for each of those risks?
7. which surgical approach would you take and why? what are the advantages and disadvantages to this approach?
8. how many times have you performed this type of surgery on a meningioma similar to mine? what have your outcomes been?
9. how soon would you recommend getting surgery? is time of the essence?
10. are there any benefits or harms to pursuing radiation first and saving surgery as a last resort?

here is a list of follow-up questions i found helpful to ask my radiation oncologist:

1. what is the best case scenario if i were to pursue radiation? what is the likelihood that radiation will achieve this result?
2. which type of radiation would be most appropriate for me? what are the advantages and disadvantages of this method?
3. what are the risks of damage to healthy cells near my tumor? specifically, which nerves, arteries, or other elements might be damaged?
4. what are the side effects to radiation? what is the likelihood of occurrence for each?
5. if radiation fails and i need surgery down the road, will it be more difficult to operate on me after i've undergone radiation?
6. would you recommend pursuing surgery or radiation in my case?