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Gamma Knife Treatment is a safe, effective radiation therapy to shrink and prevent the growth of tumors or other lesions. It uses high-energy gamma rays to precisely target cancerous and noncancerous brain and spinal cord lesions, avoiding the normal surrounding healthy tissue.

Your doctor will review your condition and determine whether or not you are a good candidate for Gamma Knife treatment. If you are, you will be scheduled for an appointment with a neurosurgeon and a radiation oncologist. Each physician will take your medical history, perform a physical exam and obtain your consent to treat you with the Gamma Knife.

The procedure of Gamma Knife Treatment

The Gamma Knife procedure involves the attachment of a lightweight frame to your head and using local anesthesia. The frame is secured to your head at four points with pins. The anesthesia reduces any discomfort.

Building treatment plan

Following the anesthesia, you will undergo imaging studies such as magnetic resonance imaging (MRI) scans or angiography to help the doctors locate your lesion and plan the radiosurgical procedure. The data from these studies are transferred to a computer program that will guide the entire Gamma Knife treatment.

Process of treatment

Once your treatment plan is completed, you will lie down on the treatment table. A special helmet called a collimator helmet may be fitted over your head. It has 201 holes that allow the beams of radiation to pass through it in a precise pattern determined by the computer.

After the helmet is in place, the treatment table will slide into the Gamma Knife unit. The machine will then start producing radiation beams targeting your brain lesion.

You will remain awake during the procedure and be able to communicate with the Gamma Knife team through an audio and video connection. Your care team will always monitor your vital signs and provide you with pain and sedative medications as needed.

Your treatment will last a few minutes to a few hours, depending on the size and location of your brain tumor or other lesions. Most patients return home after the procedure. Some patients stay in the hospital for observation overnight, but this is rare.

Follow up after the treatment

Follow-up is essential after Gamma Knife radiosurgery because the effects of treatment occur over weeks or months. This means you must regularly see your healthcare provider for follow-up imaging.

Side effects

For some patients, side effects are mild and transient. These include a headache, numbness in the scalp, or other minor swellings around the pin sites. The numbness and swelling will gradually disappear after a few weeks.

Some patients notice temporary numbness or tingling of the scalp after Gamma Knife treatment, but this is a normal and transient sensation that will disappear in a few days. The doctor will also prescribe medication for nausea or head pain if necessary.

Recovery time

The recovery time after Gamma Knife treatment is minimal compared to surgery or other radiosurgery. This is because the beams of radiation are tightly focused on your lesion, which causes little or no damage to the surrounding tissue.

Children with brain tumors face a variety of treatment options depending on the type, grade, size, and location of the tumor. Some brain tumors are treated with surgery, while others are cured by radiation or chemotherapy. Your child’s doctor will work closely with other physicians to develop a customized plan for your child’s unique situation.

Surgery

Surgery (extirpation) is often the best option for many children with brain tumors. This is especially true for a brain tumor located in a difficult place to access. At MD Anderson’s Children’s Cancer Hospital, neurosurgeons use leading-edge equipment to help remove as much of the tumor as possible without damaging other brain parts.

Surgical extirpation is a highly effective treatment for some types of childhood brain tumors, such as low-grade glioma and high-grade glioma. For other types, such as medulloblastoma, surgery can be combined with other therapies, including radiation and chemotherapy.

Radiation therapy

Radiation therapy is a treatment that uses radioactive material to kill cancer cells, especially those that have spread to other areas of the body. The radiation dose may be delivered in one treatment, called a single fraction, or across several treatments, called multifractions.

Side effects of radiation therapy are mild, and most go away after the treatment is finished. However, some long-term side effects of radiation therapy include memory and hormonal problems and cognitive changes, such as difficulty understanding complex tasks.

Chemotherapy

Chemotherapy is the use of drugs that destroy tumor cells or slow their growth and reproduction. The drugs are given with or after radiation and surgery to decrease the chances of a tumor returning.

Immunotherapy

Other medications are used to treat a brain tumor when it has spread or is not responding to radiation and chemotherapy, such as immunotherapy. This includes drugs like ipilimumab (Yervoy), nivolumab (Opdivo), and pembrolizumab (Keytruda).

Immunotherapy is a new treatment that uses medication to stimulate the immune system’s ability to fight off tumors. It boosts the body’s natural defenses, such as T-cells and macrophages.

Stereotactic radiosurgery

Stereotactic radiosurgery is a type of radiation therapy that uses beams to target only the tumor in the brain, minimizing the risk of damage to other parts of the body. It is recommended for people with 1 to 4 brain tumors that are causing symptoms.

Whole brain radiation therapy

Whole-brain radiation therapy is a type of treatment that can be given to the entire brain, or it may be an option if other types of radiation therapy aren’t successful. It is usually used for people with up to 4 brain metastases and is more common in people in relatively good health who have had surgery to remove the tumors.

To sum it up

Your child’s doctor will talk with you about the benefits and risks of different medications, which are continually being tested. It is also essential to know that some medications can interact with other medicines, herbs, and supplements. These interactions can cause unwanted side effects or reduce the effectiveness of the drug.

Gamma knife surgery is a non-intrusive, computer-guided procedure that uses high-focused beams of radiation to eliminate masseuses and lesions in the brain. It is one of the most modern techniques to deal with arteriovenous malfunctions, acoustic neuroma, trigeminal neuralgia, and different forms of brain tumors. The procedure is popularly called stereotactic radiosurgery.

Unlike the traditional invasive procedure, this does not require surgeons to make incisions in the brain and skull but uses radiation to kill abnormal tissues and tumors in the brain.

Gamma Knife surgery definition

The procedure does not include a knife to many skulls or skin incisions despite the name. Instead, it requires high beams of radiation focused at a particular point to burn the infected cells and tissues. Approximately 192 beamlets of radiation are used under the targeted brain region, sparing the normal tissues surrounding it. As mentioned above, the procedure can cure several brain abnormalities, including the following:

• Malignant and non-malignant brain tumors like meningiomas, chondrosarcomas, glial tumors, pituitary adenomas, metastases, and craniopharyngiomas
• Acoustic neuroma is a non-cancerous growth around the hearing and balancing neurons that connect the brain with the inner ear.
• Arteriovenous malformations, which are typically tangles of blood vessels
• Tremors from Parkinson’s disease, essential tremors, and more
• Different types of epilepsy
• Trigeminal neuralgia

It is one of the best procedures when traditional brain surgery methods are not feasible for a particular condition.

The procedure of Gamma Knife surgery

The process involves the following steps:

• Frame placement: The patient is given a head frame secured to the skull using pins and scores. Keeping the head in place is essential to target the radiation in the right area.
• Imaging: MRI and CT scans are performed to get a detailed image of the brain and the affected area. This helps in treatment planning.
• Treatment planning: Depending on the condition and type of disease, the medical team uses specialized software to plan a treatment procedure. In this step, professionals also determine the exact amount of radiation that needs to be targeted to the affected area.
• Treatment: Once the procedure is drafted, the patient is positioned under the Gamma knife machine, and the radiation beams are targeted to the specific area of the brain. Depending on the size and intensity of the tumor, it can take anywhere from a few minutes to a few houses.

Gamma Knife surgery risks

Although the procured is mostly considered safe, like other medical procedures, this too carries some risks:

• Swelling and bleeding in the brain
• Vomiting and nausea
• Hair loss
• Headache
• Seizures
• Cognitive changes
• Fatigue

Gamma Knife surgery outcome

The procedure’s outcome and success factor depend on the location and type of brain disorder under study. The procedure has a high success rate, especially in treating brain tumors and AVMs. Patients also experience minimal discomfort after the procedure, and many will return to normal activities a few days after the procedure. However, it is not a cure for all types of brain disorders, and follow-up will be required in most cases.

Contrary to the term Knife in Gamma Knife Surgery, it is a non-invasive procedure that is mainly performed on patients undergoing treatment for brain cancer. The tiny beam of radiation penetrates through the brain’s cells to destroy the affected cells, keeping healthy cells intact.

According to medical reports and success stories, the procedure has a success rate of 90% in shrinking tumor cells and stopping their growth. It is the best radiosurgery for:

• Brain cancer
• Benign brain tumors
• Metastatic brain tumors
• Arteriovenous Malformation or other brain abnormalities
• Facial pain

Destroying brain tumors using gamma knife surgery

Gamma Knife surgery, also called stereotactic surgery, uses one or more 3-D positioning tools to shoot radiation doses to the affected area. This kills the affected cells in the area without causing pain or discomfort to the patient.

This is done by fixing a frame over the patient’s head to pinpoint the exact location and keep their head in position. Then, by carefully examining the patient’s condition and the intensity of treatment needed, a team of radiation oncologists, neurosurgeons, and radiation physicists plan the amount of radiation needed to treat the lesion or decrease the shape of the tumor.

Once the amount of radiation is decided, the gamma knife machine aims hundreds of tiny radiation beams at the affected spot since each beam is weak to damage the affected cell by itself. Hence, hundreds of beams meet at a spot, and their combination helps in destroying diseased cells or tissues.

Since the procedure guaranty accuracy, it is recommended for patients to receive a full radiation dose in a single session. Although the procedure lasts for a couple of hours, the results of it will unfold after many months.

What conditions does the procedure treat?

Here is a list of conditions/diseases treated by the procedure:

• Brain cancer
• Astrocytomas
• Skull base tumors
• Metastatic brain tumor
• Acoustic neuromas
• Meningiomas
• Pituitary tumors
• Brain abnormalities
• Trigeminal neuralgia
• Dyskinesia
• Essential tremor
• Parkinson’s diseases

Oncologists also recommend gamma knife procedure for patients with one or more of the following conditions:

• Patients with brain tumors where it difficult to reach the affected area through traditional surgical methods.
• When the tumors are close to critical areas like the optic nerve or the brain stem
• Patients who are not healthy to have a brain surgery
• Patients who have a history of brain tumors and traditional surgery has not worked
• Patients already undergoing chemo or radiation therapy for cancer
• Patients whose cancer has recurred after previous radiations

Over the years, there has been a massive improvement in the medical industry with different equipment made with precision to treat dangerous diseases like cancers and complicated surgeries. One such treatment is the Gamma Knife radiation therapy, mainly used to treat brain abnormalities and tumors. This painless, non-invasive procedure does not require incision or hospitalization and is used to treat acoustic tremors, neuroma, trigeminal neuralgia, arteriovenous formations, and other serious tumors.

Treatment using gamma knife therapy

This treatment method mainly focuses on targeting abnormal brain cells and gradually destroying them with the help of solid beams of radiation. The therapy uses a radiation machine equipped with 201 different beams emitting gamma rays and is directly targeted to the area of the tumor from various angles. This method is exact, delivers high accuracy, and targets the problem-causing cells without damaging the other tissues surrounding it.

The procedure is done on an outpatient basis and typically requires a few hours. Although no medication is needed during the procedure, a local anesthetic might be given to numb the pain area. It is also called stereotactic radiosurgery or Gamma knife radiosurgery. A patient usually takes a nap or listens to music during the procedure.

After gamma knife surgery

Generally, after the treatment, the area subjected to radiation is cleaned with a chemical called hydrogen peroxide, followed by the application of an antibiotic where other bandages are applied to the area. However, some patients might experience nausea, which medication can treat. After the procedure, the patient is kept under observation for 30 minutes to an hour before discharge.

Most patients might experience some swelling or pressure within the head, which can be cured by placing the head in an elevated position for up to a week.

Benefits of gamma knife procedure

Compared to invasive surgeries, this procedure is followed by many benefits.

• Does not require an incision in the brain or on the scalp
• Targets all the lesions and tumors, even the ones located deep snide the brain, that traditional surgery methods can reach.
• Targets multiple tumors at the same time
• No risk of complications from surgery
• Does not damage the surrounding tissues and muscles
• No post-operative discomfort or other problems
• Patients can return to their everyday life in a day or two.

Aside from the benefits mentioned above, the procedure’s success rate depends on various factors like the type of tumor, its location, the patient’s medical history, and so on.

One of the primary aims of the procedure is to shrink the tumor site significantly or entirely and prevent it from reappearing in the body. However, the effects of this procedure can be seen after 2 – 6 months.

A brain tumor is a mass of abnormal cells that grows in the brain or spine. Brain tumors are most often found in adults, but they can also occur in children and teens. They’re usually managed by your primary care doctor, who will refer you to a specialist if necessary.

Types of Brain Tumors

There are two types of brain tumors: benign and malignant.

• Benign tumors grow slowly, do not spread to other body parts, and rarely cause death.
• Malignant tumors grow quickly, spread from the original site to other parts of the body through the blood or lymphatic system, and can be fatal.

Symptoms and Signs

Brain tumors can cause a variety of symptoms and signs. The most common are headaches, nausea and vomiting, numbness or weakness in the face, arms, or legs; difficulty speaking, seizures; personality changes; memory loss; problems with balance and walking.

Causes of Brain Tumors

Brain tumors develop because of the following factors:

Genetic factors. The cause of brain tumors is not well understood, but some types are associated with a family history of cancer.

Radiation. High doses of radiation can increase your risk for certain types of brain tumors, especially if you’re exposed to them during childhood or adolescence when the brain is still developing and growing rapidly.

Chemicals. Certain chemicals used in manufacturing and industrial processes have been linked to an increased risk for certain types of brain tumors; these include asbestos (used in insulation), vinyl chloride (used in plastics), arsenic and chromium compounds (used in metal production).

Diagnosis of Brain Tumors

CT scan: A CT scan is a type of X-ray, or imaging test, that uses a computer to create detailed pictures of the inside of your body.

MRI: An MRI uses magnetic fields and radio waves to make pictures of the brain and spinal cord. The images show soft tissues like tumors or cysts, blood vessel abnormalities (aneurysms), and other conditions that affect the nervous system.

PET scan: A positron emission tomography (PET) scan combines a special tracer injected into your vein with a scanner that detects its location within your body by following its path inside you over time for about 45 minutes after injection until the tracer reaches its highest concentration within any one organ system (for example, brain tissue) before being eliminated from circulation through urine excretion.

The Prognosis for Brain Tumor Patients

The prognosis for a patient with a brain tumor will depend on the type of tumor, as well as its location within the brain. Tumors that are slow growing and do not spread to other parts of the body generally have a better prognosis than tumors that grow quickly or are malignant (cancerous).

The prognosis for benign tumors: Benign tumors are more likely to be successfully treated with surgery alone. Patients who have had surgery for benign tumors may experience symptoms related to their condition after treatment, such as headaches or seizures.

Prognosis for malignant tumors: Malignant (cancerous) tumors require different care depending on where they occur in your body. If you need radiation therapy or chemotherapy after surgery, these treatments will help reduce your risk of recurrence (new growth).

Patients need to understand the symptoms of this condition so they can seek medical attention as soon as possible if they suspect something might be wrong with their brain or spinal cord.

Have you heard of Brain Metastases? Do you want to know what it is? Brain Metastases occur when cancer from other parts of the body spreads to the brain which results in a brain tumor. Also called metastatic brain cancer or brain Mets, they are more common than the tumors that originate in the brain. It is found that more than 200,00 new cases of brain metastases are found every year in the U.S and their number is said to be raising rapidly.

Most common types of cancer that can cause brain metastases are lung, breast, colon, and kidney cancer. These cancers can separate from their basic tumor and reach the brain, commonly to the cerebral hemispheres or cerebellum through the bloodstream. These cancer cells form a mass in the brain causing brain metastases, and showing a variety of symptoms. But its symptoms and signs are hard to see in the initial state. Many people get diagnosed with brain metastases when doing a health check-up or while diagnosing the stage of their core cancer.

Common signs and Symptoms of brain metastases

The symptoms and signs of brain metastases depend on the position and size of your tumor. But the most common symptoms are:

Increased Intracranial pressure (ICP)

Most of the symptoms that patients who are diagnosed with brain metastases faces is due to the growing pressure inside the skull. This causes headaches, nausea, or some issue with consciousness. They can also injure the brain or spinal cord.

Headaches

One of the most common symptoms that are experienced by half of the patients in the initial stage and the majority in the advanced stages is headaches. You may experience the worse pain in the morning, but it will get reduced after a while.

Vomiting

Due to this pressure in the skull, you may experience vomiting or nausea. This symptom can be more common among children compared among adults.

Change in the level of consciousness

Brain tumor causes a lot of changes in individual mental stability. It may cause small changes like a subtle change in personality to a coma. Most of the patients will experience some sort of changes in their consciousness at some stages of brain metastases.

Seizure

When your brain develops a tumor, it will affect the traveling of electrical impulses through it, and due to this sudden change in the normal functioning of your brain, you may experience a seizure or partial seizures. Seizures can result in a change in the way you smell and taste, it can cause muscle spasms, numbness, and speech problems. With age, especially in people over 45 years the risks of epilepsy will increase.

Issues with speech and vision

Brain metastases can result in issues with speech, vision, and understanding.

So, if you are experiencing any or some of these symptoms, do a health check-up and diagnose the problem quickly.

Stereotactic Radiosurgery (SRS) is a noninvasive therapy that delivers highly focused radiation to tumors found in the brain, spine, and other body parts. It is most commonly used to treat brain tumors and cancer that spreads to the brain from other body parts.

How is SRS delivered?

SRS uses a highly sophisticated 3-D computerized image to detect the tumor’s exact location and to focus the photon beams precisely. Then, it will deliver the precise amount of radiation dose to the target in one session.

In a conventional sense, SRS cannot be considered surgery as it does not require anesthesia or incision in the case of an adult. Like other radiation therapies, SRS works by destroying the cells of tumors that will destroy or reduce the ability of the cancerous cells to reproduce. As a result, it will die eventually.

SRS effectively treats small, defined, and difficult tumors that cannot be reached through surgery. In addition, since SRS gives precise radiations, it will not affect the healthy tissues that surround the tumor.

Three SRS Technology

To deliver radiation to patients, SRS doctors use three technologies, and they are:

• Gamma knife- This is one form of radiation treatment that treats brain tumors and other dangerous conditions using surgical precision.
• Linear accelerator (LINAC)- this technology uses x-rays to deliver highly focused radiation at the cancerous tumors with high accuracy while not affecting the surrounding healthy tissues.
• Proton therapy- This advanced technology uses high-energy photon beams to deliver radiation. This technology also eliminates the chances of exposing surrounding healthy tissues to radiation.

Who can benefit from Stereotactic Radiosurgery?

SRS is one of the most used treatment methods by people with smaller tumors. Patients whose tumor is in areas not accessible by surgery or people who are advanced for neurosurgery can also use this radiation therapy. In addition, people who cannot tolerate anesthesia can benefit from SRS.

Benefits of Stereotactic Radiosurgery

Recently many people are opting for SRS as they offer many benefits, including:

• Precision- The advantage of SRS is that it delivers radiation at greater accuracy to the tumor than other radiation therapies.
• They will not affect or damage the surrounding healthy tissues.
• This radiation treatment also allows controlling the beam’s intensity so that no area gets affected by a significant dose.
• This high-dose treatment can be done in fewer sessions; at times, it can even be done in a single session.
• SRS reduces the risks posed by bleeding, infection, and anesthesia.
• They require minimal intervention from other treatments like chemotherapy, and as a result, it can be done as an outpatient treatment.

Side effects and risks of Stereotactic Radiosurgery

SRS is a noninvasive treatment and will pose less risk than surgeries. Even if they pose some side effects, they will be mostly temporary. The common side effects include:

• Fatigue
• Inflammation
• Nausea or vomiting
• Bone weakness that causes breaks.

Thus, this single-day, high-dose radiation and low-risk therapy are one of the best treatments for tumors.

When you are diagnosed with any brain injury or case, doctors will generally ask you to do some stereotactic radiosurgery (SRS). This is a treatment where they use high doses of radiation to the tumor or the area affected by cancer. Like other forms of radiation, SRS makes sure that they do not affect healthy tissues and focus only on damaging the DNA of the affected cells. By doing this treatment, the cell will lose the power to reproduce, thus reducing the tumor and killing cancer. Thus, SRS is a highly recommended treatment option if a patient is diagnosed with a brain tumor or other damage to the head.

There are many types of SRS treatments and gamma knife and cyberknife are two popular SRS treatments. Both these treatment options are quite similar but there are many differences. So, understand the difference and find the treatment that is suitable for you.

What is Gamma Knife?

This is a highly effective radiation therapy that focuses high-dosage radiation to the affected area. Since this therapy is highly focused, it will affect only cancerous cells, making sure that the healthy tissues are not affected.

This therapy has lower side effects. Since they are non-invasive, they do not have risks like traditional brain surgeries. Also, they have less pain compared to the surgeries. Their recovery period is also small.

What is CyberKnife?

This radiation treatment treats tumors by sending photons to the targeted area or tumor. One of its huge benefits is that you do not have to do it many times. Within a few radiations, you will be able to eliminate or shrink the tumor.

CyberKnife can reach out to any area of the brain and access treatment from many positions as it has a movable robotic arm. It also ensures that the healthy tissue is not affected by the treatments.

Difference between Gama Knife and CyberKnife

Even though they may sound similar, they have some difference that needs to be addressed. That includes:

Difference in specificity

Even though both these SRS treatments are highly recommended to treat cancer tumors, they differ in specificity. Both gamma Knife and cyberknife are minimally invasive. But the former treatment is more targeted and specific. Since any treatment in the brain area is critical, precision and specificity are crucial.

Treating tumors on different parts

Gamma Knife is most commonly used to treat tumors on the head and brain. But with the newer Gamma treatments, you can also treat some cervical spine tumors. But CyberKnife can be used to treat tumors on any body part.

Comfort and restrictions

When the patient is undergoing Gamma Knife treatment, they have to wear a headframe, that restricts the movement of the patient. But with cyberknife, you do not have to use a headframe, making it more flexible and comfortable. So, learn about both of these SRS treatments and find the right one for you.

A Gamma knife is a radiation therapy procedure that irradiates small targets in the brain and head with the highest precision. The treatment induces high doses of radiation on the target tissues while protecting the surrounding tissues.

A gamma knife surgery is a painless computer-guided surgical procedure that helps in focusing radiation on tumors and lesions in the brain and the head. This procedure is mainly used to treat the following:

• Brain tumors
• Arteriovenous malformations
• Acoustic Neuroma
• Trigeminal Neuralgia
• Tremors

What exactly is gamma knife surgery?

It is a radiation therapy treatment mainly used to treat all vascular malformations and other abnormalities in the brain. It involves precisely 192 beamlets of radiation focused on the target area, sparing the surrounding healthy tissues. This procedure is also called Gamma Knife Radiosurgery, Gamma Knife Radiation, or Stereotactic Radiosurgery.

The procedure of Gamma Knife Radiation

Like any other operation, this procedure involves specific steps that require the patient and the doctors to follow. The procedure involves one of the two frames – a rigid head frame or a frameless mask.

In case of a rigid head frame:

• The box-shaped head frame, made of lightweight aluminum, is placed over the patient’s head. It creates a frame of reference and holds the target aligned perfectly during the treatment.
• Once this is done, the patient receives four anesthetic injections – two on the side and two on the back of the head. At these points, the pins of the frame are used to fasten into pins. Once the face is intact, a CT or an MRI scan is performed to plan for treatment.

In the case of a frameless gamma knife:

• It is generally made of a thermoplastic mask that covers the entire face, and the mask is pinned to the table while keeping the patient’s head completely still.

Both procedures are similar except for the structure of the frame for the gamma knife procedure. Once the measurements are read, the following steps are performed:

• • An IV is inserted into the patient’s arm to induce a dye for CT or MRI scan. The dye helps determine the exact location, shape, size, and other factors about the rumor or lesion. Sometimes, a small amount of sedation is also injected to help the patient relax.
  • Once the scan is completed, a radio oncologist or a neurosurgeon will decide on the treatment procedures and prepare an accurate estimate of the treatment factors.
  • Once these are decided, the patient will again be under the gamma knife frame, and the table is slowly moved to the radiation section. The radiation procedure is performed depending on the size and location of the tumor/lesion.

Risk of Gamma knife surgery

• Brain swelling
• Headache
• Nausea or vomiting
• Numbness in the scalp
• Hair loss if the hair follicles are irradiated
• Seizures
• Brain hemorrhage
• Tiredness

Benefits of gamma knife surgery

• No incision or local anesthesia
• Target infected spots which are difficult to reach by traditional surgical methods
• Targets multiple tutors at once
• Avoids surgical complications
• Painless and no post-surgical discomfort