Unveiling the invisible scalpel: Gamma Knife surgery
Dr Sylvia Rodrigues explores the power of Gamma Knife stereotactic radiosurgery (SRS) and why it’s becoming an increasingly preferred choice for patients with various brain conditions.
You can listen to this article below, or by using your favourite podcast player at pod.link/oncologybuddies
Gamma Knife SRS is a cutting-edge medical procedure that offers precise, non-invasive treatment for various brain conditions.
Despite its name, it doesn’t involve actual surgery; instead, it utilises highly-focused radiation beams to target specific areas of the brain with remarkable accuracy. The first Gamma Knife was developed, in 1967, by Lars Leksell, a Swedish physician and professor of neurosurgery. South Africa’s first and only Gamma Knife was launched, in 2017, at Netcare Milpark Hospital in Johannesburg.
How does Gamma Knife SRS work?
Unlike traditional surgery, which requires incisions and the removal of tissue, Gamma Knife SRS delivers a concentrated dose of radiation to the targeted area of the brain while minimising exposure to surrounding healthy tissue. This is achieved through a combination of advanced imaging technology and computer-guided precision.
The procedure begins with the patient wearing a specialised headframe or mask to ensure their head remains perfectly still during treatment. Next, high-resolution imaging, such as MRI and CT scans, are performed to precisely map the location and size of the target area within the brain. This information is then inputted into a sophisticated computer system that calculates the optimal treatment plan.
Once the treatment plan is finalised, the patient is comfortably positioned within the Gamma Knife machine. This machine contains multiple radiation sources that converge on the target area from different angles, delivering a powerful dose of radiation with pinpoint accuracy.
Applications of Gamma Knife SRS
Gamma Knife SRS is highly versatile and can be used to treat a wide range of brain conditions, including:
- Brain tumours: Gamma Knife SRS is particularly effective for treating benign and malignant brain tumours, including metastatic tumours that have spread to the brain from other parts of the body. By precisely targeting the tumour while sparing healthy brain tissue, Gamma Knife SRS offers an effective treatment option with minimal side effects. Meningiomas, pituitary adenomas, acoustic neuromas, glomus jugulare, craniopharyngiomas and even ocular melanomas are being treated with Gamma Knife SRS.
- Arteriovenous malformations (AVMs): These are abnormal tangles of blood vessels in the brain that can cause symptoms such as seizures and headaches. Gamma Knife SRS can be used to target and shrink them, reducing the risk of bleeding and alleviating associated symptoms.
- Trigeminal neuralgia: This painful condition affects the trigeminal nerve, causing severe facial pain. Gamma Knife SRS can effectively alleviate pain by targeting the nerve responsible for transmitting pain signals, providing long-lasting relief for patients who may not respond well to medication.
- Movement disorders: Gamma Knife SRS can also be used to treat movement disorders, such as essential tremor and Parkinson’s disease. By targeting specific areas of the brain involved in controlling movement, Gamma Knife SRS can help reduce symptoms and improve quality of life for patients.
Advantages
- Non-invasive: Unlike traditional surgery, Gamma Knife SRS doesn’t require incisions or general anaesthesia, resulting in shorter recovery times and fewer complications.
- Precise: The highly-focused nature minimises damage to surrounding healthy tissue, reducing the risk of side effects.
- Outpatient procedure: In many cases, Gamma Knife SRS can be performed on an outpatient basis, allowing patients to return home the same day.
- High success rate: Clinical studies have demonstrated high success rates and long-term tumour control, making it a highly-effective treatment option for many patients.
- Safety: Safer alternative to traditional brain surgery in many cases.
Potential side effects
However, like any medical procedure, it can have potential side effects. These can include:
Fatigue is experienced in some patients following the procedure, which can last for a few days.
Headaches are common after treatment, though they are usually mild and temporary.
Nausea may be experienced in some patients, typically in the first few days following the procedure.
Hair loss can occur at the site where the radiation beams are focused, though it’s typically temporary.
Radiation necrosis can develop in rare cases. This is damage to healthy brain tissue caused by radiation and can lead to weakness, seizures, or changes in cognitive function.
Radiation-induced tumours are rare but there is a small risk of development in the treated area years after the procedure.
Vision loss may occur if the optic nerves are near the treatment area which has a small risk of damage to these nerves, which can lead to vision problems.
Hearing loss may occur if the treatment area is near the auditory nerves.
Important to note
The likelihood and severity of these side effects can vary depending on factors such as the size and location of the treated area, the dose of radiation used, and the patient’s health status. Patients should discuss potential risks and benefits with their healthcare provider before undergoing Gamma Knife treatment.
In conclusion, Gamma Knife SRS represents a remarkable advancement in the treatment of various brain conditions. By harnessing the power of focused radiation beams, Gamma Knife SRS offers patients precise and effective treatment with minimal risk and downtime.
MEET THE EXPERT – Dr Sylvia Rodrigues
Dr Sylvia Rodrigues is a clinical oncologist who works in Alberton, Gauteng. She participates in weekly oncology multi-disciplinary meetings and is a member of the Alberton breast cancer multi-disciplinary team.
Header image by Freepik
