GammaKnife is a unique radiosurgical treatment method for malignant and cancer tumours. The device delivers high-precision irradiation and is commonly prescribed for brain masses. Radiosurgery is sufficient for tumour destruction - a benign or malignant tumour, an arterial or venous malformation. Usually, it does not cause side effects on the surrounding tissues.
Gamma Knife is one of the radiation therapy devices. The technic delivers a high dose of radiation to the tumour and destroys it like a regular surgery. Most often, it is used to perform radiosurgery of brain masses. However, the technique can be used for various locations.
The nature of the machine is irradiating a brain tumour pointwise through a special helmet with the help of thin gamma beams. The dose is so high that it leads to damage in one or, less commonly, several tumours.
At the same time, healthy tissues around the tumour receive a mild dose of radiation that is tolerable without adverse effects. As a result, it is easy to save organs' function and reduce harmful effects.
Thus, the radiologist, without the use of surgical methods, gets access to the tumour and immediately begins the treatment of the neoplasm.
Details of gamma knife radiosurgery
Gamma Knife procedure begins with diagnosis: the patient undergoes CT and MRI. Then, if it is needed, a doctor can additionally prescribe angiography.
The head of the patient is fixed with a unique stereotaxic frame to avoid movements. The doctor administers anaesthetics to prevent the patient from feeling pain at this time. Medications exclude any unpleasant sensations, except for slight squeezing. Then the patient is placed in the desired position in the Gamma Knife device. The specialists leave the room and maintain a voice connection with the patient.
The machine rotates over the patient for accurate radiation to the targeted points. The timing depends on the tumour's size, location, and the presence of metastases. The procedure can last from half an hour to 4 hours, and the doctor informs about it in advance.
Candidates for GammaKnife
The device treats very small neoplasms (5-10mm) and large tumours (up to 6cm). As a result, it can easily access areas where it is impossible to penetrate using traditional surgical methods. Also, Gamma Knife is essential when the formation is close to critical areas such as the brain stem or optic nerve. The accuracy of the machine is around 0,15 mm.
Gamma beams can reach many tumours. However, patients with the following conditions are ideal candidates:
- Benign brain tumours;
- Neuromas of cranial nerves (in particular, auditory);
- Meningiomas - any localisation of neoplasm;
- Pituitary tumour;
- Trigeminal neuralgia;
- Primary intracerebral tumours (from the first to the last stage of malignancy);
- Cancer metastases to the brain (up to 10);
- Cavernous angiomas;
- Arterio-venous malformations.
That is not a complete list of radiosurgery-targeted conditions. Doctors consider each tumour for possible application, comparing it with other methods.
Advantages of GammaKnife for benign and malignant tumours
Among all radiosurgical methods, Gamma Knife is recognised as the gold standard for oncology treatment. And this is no coincidence. The technique has many specific advantages:
- No trepanation of the skull is required, as in a surgical operation;
- Less damage to healthy tissues surrounding the tumour;
- The painless technique is performed under local anaesthesia;
- Fast recovery - the operation does not require hospitalisation, and the patient returns home the same day.
- The desired result, in most cases, is achieved after a single exposure.
- A reliable alternative to surgical methods - it destroys tumours that are not accessible to a neurosurgeon's scalpel. First of all, this applies to tumours located near the vital structures of the brain.
Additionally, the method is highly effective and has predictable results. In most cases, the procedure allows doctors to kill the mass or take control of its development.
Undesirable side effects
The drawbacks of the method are low accuracy in some cases and limit to wide application - only brain tumours and some metastases. The technique can cause common side effects like headaches, vomiting, nausea, vision deterioration and fatigue. Doctors nowadays well manage general complications after the treatment.
There are certain conditions and contraindications to the operation performed using a GammaKnife. Due to irradiation of a large tumour, there is a risk of local post-radiation complications. Therefore, the neoplasm cannot be more than 5-6 cm. Symptoms related to brain compression may develop quickly (the doctor always limits the tumours that can have radiosurgery).
Individual features and contraindications to surgery can be determined only by a qualified radiologist with training or a neurosurgeon.
Recovery after radiosurgery
The procedure takes place in an outpatient setting - hospitalisation, in this case, is not required. GammaKnife is entirely painless. During and after the treatment doctor prescribe symptomatic treatment to prevent or treat any symptom.
Usually, it takes one day, after which the patient receives a conclusion and recommendations for further monitoring. Then, you can return to daily activities the very next day. Most patients are recommended to have a control MRI scan in several weeks to track tumour size.
Who is suitable for GammaKnife surgery?
The Gamma Knife is an alternative to surgery for patients who cannot be operated on for the following reasons: the tumour is located in a hard-to-reach place, near vital structures or organs, the operation carries the risk of developing significant functional disorders, the patient cannot undergo surgery due to comorbidities. Each case is individual, and only a doctor can prescribe this treatment based on diagnostic studies.
What is the success rate of the GammaKnife procedure?
GammaKnife radiosurgery is almost 90% successful in destroying or shrinking brain tumours or stopping their growth. And it does not hurt and does not require anaesthesia. In most cases, one session is enough for patients to return to normal activities immediately.
Is GammaKnife designed only for brain tumours?
Gamma Knife has low topographical accuracy and is usually prescribed only for the brain. But the device is effective not only for destroying malignant tumours. Pituitary adenomas, Parkinson's disease, trigeminal neuralgia, arteriovenous malformations and cavernomas are also indications for radiosurgery.
What is the maximum size of the tumour for GammaKnife?
The device is highly accurate and targets hard-to-reach and often numerous brain tumours. However, there are certain limitations in the size of the neoplasm. A radiosurgery operation is possible only if its size does not exceed 6 cm. The tumour's large size can complicate the operation's course and cause brain damage due to a large area of irradiation.
How many tumours can be treated with Gamma Knife?
While many conditions have only one target, the Gamma Knife was designed to treat multiple neoplasms. It is not uncommon for patients with brain metastases to treat 15-20 tumours in one day.
Where can I get GammaKnife?
What are the best clinics for GammaKnife?
Who are the best doctors for GammaKnife?
Prof. Dr. med. Alexander Muacevic from European Radiosurgery Centre Munich
Prof. Dr. med. Philipp M. Paprottka from University Hospital Rechts der Isar Munich
Prof. Dr. med. Claus Rodel from University Hospital Frankfurt am Main of Goethe-University
Prof. Dr. med. Robert Krempien from Helios Hospital Berlin-Buch
Dr. med. Otto Bundschuh from Radiotherapy and Gamma Knife Centre Hanover
GammaKnife procedure cost
To understand how much the Gamma Knife operation costs, you need to get a preliminary consultation with a specialist who will draw conclusions based on the diagnostics passed. The cost of Gamma Knife treatment for each patient is calculated individually. It depends on several factors:
- The stage of the oncological process;
- The presence or absence of metastases;
- General health.
Therefore, experts can only name the exact price after a complete examination. In addition, the price of the procedure depends on the country where the treatment takes place. In general, approximate cost of therapy: 6,000 $ - 15,500 $.