What is Gamma Knife Surgery?
The Gamma Knife is a revolutionary piece of technology that treats neurological conditions, such as brain tumours, without the need for invasive surgery.
Gamma Knife is a form of stereotactic radiosurgery that uses computer planning software to locate and treat brain tumours with radiation therapy. It delivers intense radiation with extreme precision to the tumour location without needing to touch the surrounding tissue.
With the ability to treat many other brain conditions that may have previously required invasive surgery, Gamma Knife surgery is an integral part of brain tumour management.
Reasons for Gamma Knife Surgery
Our experts use Gamma Knife radiosurgery in the treatment of the following conditions:
- Metastases – secondary brain tumours.
- Acoustic neuromas – benign tumours which arise on the hearing nerve inside the ear.
- Complicated meningiomas – benign tumours from the lining inside the skull that are difficult to remove with surgical operations due to the proximity of critical nerves.
- Arteriovenous malformations – developmental tangles of blood vessels which have a propensity for bleeding resulting in neurological deficits or death.
- Trigeminal neuralgia – lancinating facial pain in one or more trigeminal nerve distributions.
- Pituitary Adenoma – a growth or tumour on the pituitary.
- Glomus Jugulare Tumours – often benign tumour, located within the skull cavity.
Gamma Knife surgery can also treat certain other rare forms of cerebral disease.
Benefits of Gamma Knife treatment
Designed specifically for and dedicated to the brain, Gamma Knife surgery is widely recognised as the gold standard in stereotactic radiosurgery.
Advantages of Gamma Knife surgery include:
- Non-invasive and highly targeted with minimal dose to surrounding normal brain.
- Avoiding complications associated with surgery and Whole Brain Radiation Therapy (WBRT) including white matter changes and neurocognitive decline.
- Less dose to normal brain and body compared to other radiosurgery devices.
- Clear clinical advantages and superior outcomes for certain indications (for example, SRS with Gamma Knife low dose to cochlear preserves serviceable hearing in most patients with an acoustic neuroma).
- Offers clinician new possibilities to treat cancerous and non-cancerous brain conditions.
- Single-session treatment.
- No cessation of systemic treatment, and ability to maintain drug dosing parameters.
- Permits the clinician to scan, plan and treat in a single session – optimal efficiency at low cost.
- Fewer side effects than standard radiotherapy (less fatigue, no hair loss).
- Single session treatment completed generally in one day means less burden on patient and carers.
- Most extensive clinical evidence base with over 2,500 peer-reviewed publications including numerous papers describing the utility of the Gamma Knife surgery for multiple metastases.
What to expect when undergoing Gamma Knife treatment
Prior to the treatment the doctor will explain the entire process and answer any questions the patient may have. Gamma Knife “surgery” does not require any cutting or shaving of the patient’s hair. The nurse will contact the patient prior to treatment to discuss any further questions or concerns.
An essential component to the Gamma Knife treatment procedure is the use of a specialised precision head frame. The head frame performs two important functions. First, it allows the doctors to pinpoint the target area requiring treatment very precisely and accurately. Secondly, the frame ensures the patient remains completely still throughout the procedure. The head frame is attached to the head via four pins using local anaesthetic.
Once the head frame has been fitted, a series of tests will be performed to determine the exact size and location of the target area. This includes imaging techniques such as MRI, CT, or angiography.
The information gained from the imaging in step 3 is used by the doctors with the assistance of highly trained medical physicists to develop an accurate and customised treatment plan. Every plan is unique and tailored to the specific requirements of each patient.
Once the treatment plan has been completed by the team of professionals the treatment can begin. With the head frame attached the patient will be positioned on the treatment couch. The procedure is completely painless (indeed it can be considered boring) and the patient will remain awake throughout the procedure with the treatment team monitoring them the whole time.
The length of the treatment will vary from patient to patient and depends on the size and shape of the target area. The treatment time can be from one to three hours. The entire Gamma Knife procedure — frame on to frame off — therefore takes approximately two to eight hours.
Following treatment, the head frame and pins will be removed. Generally, the patient will feel no treatment effects; however, some may experience a mild headache or minor swelling from where the frame was attached.
An appointment will be made for the patient to see either their treating or referring doctor. Should there be any queries following treatment, please contact the consultant or the nursing staff at Radiation Oncology.
The effectiveness of the Gamma Knife treatment will be evaluated over time. The radiation treatment is designed to stop the growth of tumours or dysfunctional tissue; therefore, it may take weeks or even months before the full benefit of the treatment may be realised.
A multi-disciplinary approach
Macquarie Neurosurgery & Spine works closely with MQ Health to adopt a multidisciplinary team (MDT) approach to care for patients needing Gamma Knife surgery.
Our team meets regularly to discuss individual cases and determine the best treatment approach for all patients being treated with the Gamma Knife.
The team includes clinicians from different specialist areas including neurosurgeons, radiation oncologists, medical physicists, radiation therapists and nurses.
At the team meetings, we discuss every case referred and explore all possible treatment options before Gamma Knife treatment is approved.
As the first Gamma Knife and one of now only 3 units in Australia, Macquarie Neurosurgery & Spine is proud to partner with MQ Health and an expert radiation oncology team at Genesis Cancer Care to offer Gamma Knife surgery to all suitable patients.
We have combined our expertise in neurosurgery and radiation oncology to provide a high quality, cost-effective radio-surgical service for patients.