Brain tumours are a very difficult and scary condition to come to terms with. Thanks to science though, newer and better treatments are emerging as we speak. One such treatment is the Gamma Knife Surgery (GKS) exclusively offered at Macquarie University Hospital in Sydney, New South Wales.
This is a private facility but by September 2015, Princess Alexandria Hospital in Queensland will become the first public hospital in Australia to offer Gamma Knife Surgery.
What is Gamma Knife Surgery?
Gamma knife surgery is a non-invasive dose of gamma radiation delivered directly to the target area (the tumour). Using state of the art machinery and the latest scientific technology, Gamma Knife Surgery delivers a customized treatment to every patient based on their particular condition.
A lightweight head frame is pinned to the head to restrict movement until the radiation is given. Gamma Knife Surgery can be used to treat many kinds of intercranial conditions and the fact that it does not involve any cutting into the head or brain makes it a very safe option.
After identifying the tumour or lesions accurately with brain scans, the 192 laser beams of the Gamma Knife Surgery machine converge on the target to deliver radiation to the exact location of the tumours/ lesions with high accuracy. This method also minimizes radiation scatter, which means less damage to the surrounding healthy tissue.
MDT at the Macquarie University Gamma Knife Centre
MDT is a multidisciplinary team that works to tailor make each treatment to each patient. The team includes Dr. John Fuller (neurosurgeon), Dr. Michael Izard and Dr. Annie Ho (Radiation Oncologists), Dr. Michael Grace (Medical Physicist), and Dr. Melissa Winkler (Radiation Therapist).
This group of doctors analyse MRI and CT scans of the tumour to first decide whether it can be treated by Gamma Knife Surgery. Next based on patient health etc. they design the dose that will be used for each patient. This team meets regularly to decide each patient’s plan of treatment.
What to Expect at the Macquarie University Gamma Knife Centre
1) Pre op appointment: The nurses and doctors explain all the steps to you and take you through the whole procedure, answering any questions or concerns you may have.
2) Head frame fitting: Using a local anaesthetic, and 4 pins, doctors fit a lightweight frame around the head. This frame helps to get more accurate scans of the brain and the lesions/ tumours and also helps the patient lie still throughout the procedure.
3) Target localizing: Many MRI and CT scans are taken to accurately localize the tumours. Sometimes more tests like angiograms may also be performed.
4) Planning the treatment: At this point, the MDT designs the treatment plan with the help of the scans and patient history. Each treatment is specifically designed for each patient and their condition to ensure personalized treatment.
5) Gamma Knife Surgery: The actual procedure begins. You are awake the whole time because the procedure is painless and this way the team can monitor you the entire time. The procedure can last anywhere from a few minutes to no more than a couple of hours, but it is a day procedure and depends on each case.
6) Post op: The headframe is removed and the patient generally feels quite stable and comfortable. You may feel slight pain or swelling at the point where the head frame was attached, but that is generally taken care of by low-dose pain relievers etc. Generally patients are monitored for a few hours after the procedure and then they are free to go home. Because this surgery is not invasive, patients can resume their normal life as soon as the next day, though people usually choose to wait a couple of days for rest.
7) Follow up appointment: Doctors will ask you to come in a few weeks after the treatment to assess the success. Some more scans may need to be taken to see how the radiation doe affected the lesions/ tumours.
Case Study of a Brain Tumour Patient Using Gamma Knife Surgery
Ms. Susanne Murphy was diagnosed with a triple-negative breast cancer which later spread to the brain. After initial attempts at Whole Brain Radiation Therapy (WBRT) she was referred to Macquarie University Hospital for Gamma Knife Surgery. While WBRT was the initial treatment and worked well for her, the lesions slowly progressed further, requiring more steroids and higher doses of WBRT.
Ms. Murphy came in for her surgery and was explained the procedure by the MDT in detail. She recalls “the teams of doctors [being] extremely professional: honest and knowledgeable… they made the process easy to understand, and decisions easy to make”. Then her brain scans revealed a total of 11 lesions for which the doctors prepared a GKS therapy. She was quickly administered the treatment and returned home soon after.
She said that the biggest advantage was how easy the whole process was…[and that] it’s day surgery”. There is no overnight hospitalization which makes patients very comfortable and Gamma Knife Surgery a very attractive option. Most of all, within 2 weeks after her treatment, Ms. Murphy was able to walk without aid, take care of her home and children, and even started considering going back to work. The quality of her life improved greatly and she said “[w]ithin two weeks of having the gamma knife treatment, I began to feel more myself for the first time in ages.”
Gamma Knife Surgery is still an experimental treatment, however, has a significant positive result on patient life. While it is not a cure because the lesions/ tumours will eventually come back, the quality of life for patients in increased greatly.
Later on, when conditions worsen, Gamma Knife Surgery can be considered again since it is a one-time targeted dose and does not take a toll on the body like traditional radiation therapies. For the future, with better research into the subject, by the time patients come back, there may be better more viable options to look into. For now, many brain tumour patients can look to Gamma Knife Surgery for great relief and like Ms. Murphy, who was on the path to requiring full time care, can restart their life and go back into a normal lifestyle.
2) About The Gamma Knife: http://www.muh.org.au/ServicesSpecialties/GammaKnife/AboutGammaKnife/AbouttheGammaKnife.aspx
4) Life-Changing Gamma Knife Treatment: http://www.muh.org.au/Portals/0/PDFs/life_changing_gk.pdf
5) Treatment: https://www.curebraincancer.org.au/page/9/treatment