How To Prepare For Gamma Knife Surgery

The advances that Gamma Knife Treatment represents have been very well documented. Its capacity to tackle brain cancer tumours, save lives and avoid the long-term rehab involved with invasive surgery is well-established. 

All that is extremely good news if you are a cancer patient. It may mean at the very least that time is added to your life, or even that the treatment will ensure you are still here many years from now. The question is, how should you prepare for such an operation?

The first thing to note is the fact that this is a safe form of surgery. It’s not one of those dreaded operations where its touch and go that you’ll wake up from it, which can happen in other cases. 

This means you won’t have to make the kind of provisional preparations some will have to undertake, such as writing various ‘goodbye’ letters in case it doesn’t work out or making other practical arrangements. While it always makes sense to have a will anyway, the urgency of doing things – and the fear involved – need not be there. 

A second element of the operation is the fact that, because it is non-invasive but uses radio waves, it is rare that you will even need to stay in hospital overnight. The reason for this lies in the design of a gamma knife. It focuses the beams of gamma radiation with such precision that any spot on the brain outside the area being operated on receives very little radiation. 

The best aspect of it all is that this means you can plan ahead for the days beyond. Because it is unlikely you will be in hospital for long, you can make your plans for a post-op meal or family gathering, with hope and optimism that the future will be so much brighter.

What is a Gamma Knife

Gamma knife surgery: About the operation | Private Healthcare UK

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A Century of Radiotherapy

Radiotherapy has long been an invaluable tool in the battle against various cancers, particularly brain tumours. Today, visiting a radiotherapy centre is a highly recommended course of treatment the world over. It is possible to chart the evolution of this area of medicine throughout the 20th century, and a fascinating journey it has certainly been.

In 1895 X-rays were first discovered by German-Dutch physicist and mechanical engineer Wilhelm Conrad Röntgen, a breakthrough for which he was later awarded the first ever Nobel prize for physics in 1901. Not long after this achievement the fields of radiation oncology and radiotherapy were born.

Before the negative effects of prolonged exposure to radiation became more widely understood, radiotherapy was used in the treatment of many conditions. In the early 20th century it was a standard treatment for tuberculosis. 

Around this time some of the most brilliant and pioneering work in the field of radiation was being undertaken by married physicists Marie and Pierre Curie. The former would become the first woman to win a Nobel prize, alongside her husband and colleague Henri Becquerel, in 1903 for the development of the theory of radioactivity.

There followed throughout the century several phases and eras in the development of radiotherapy. The Orthovoltage era, generally regarded as spanning from 1930 to 1950, saw advances in brachytherapy. This term denotes radium based interstitial radiation, and it allowed physicians to specifically target tumours more effectively than ever before.

After this came the Megavoltage era from 1950 to 1980. During this time advanced studies were undertaken in order to further the evolution of treatment for deep tissue cancers. Innovative therapeutic devices and approaches such as Cobalt teletherapy were discovered here, and significant progress was made in the development of proton beam therapy.

Today physicists and their colleagues are looking closely at what the next step in radiotherapy will be. That very question was posed at the recent ESTRO 2022 conference held in Copenhagen, Denmark.

Several experts from across the globe stepped up to argue for different approaches for the future. These included automation and robotics, inter-fraction adaptation and faster delivery of radiotherapy in shorter periods of time.

Meanwhile, in the United States, guidelines for the treatment of brain metastases by radiotherapy have recently been updated by the American Society for Radiation Oncology. Vinai Gondi, M.D., from the Northwestern Medicine Cancer Center and Proton Center in Warrenville, Illinois was one of the main participants in updating evidence-based recommendations.

“With the emergence of novel radiotherapy techniques and technologies, brain-penetrating drug therapies and neurosurgical interventions, modern management of brain metastases has become increasingly personalized, complex, and multidisciplinary,” Gondi was quoted as saying.

In terms of medical science, the practice of radiotherapy is quite young. Throughout the 20th century many advances have been made, and looking ahead to the future one can only imagine where the technology will go and how the practice will evolve. No doubt it will be a fascinating second century for what has become one of the most widely practised forms of care in the world.

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Language Test Could Detect Brain Tumour

There could be another way to identify brain tumour sufferers, as researchers have found a language test could help GPs determine whether people with common symptoms, such as headaches, might, in fact, have something far more sinister. 

The Brain Tumour Charity funded a study of 270 people, which tested those with brain tumours and those with headaches who did not have brain tumours. 

The findings showed that those with brain tumours had significantly lower ‘verbal fluency task’ than the control group. 

The first symptom of a brain tumour is often a headache. However, for every 1,000 people who go to the GP with a headache, just a couple will have a tumour. Therefore, this could be a helpful triage test to help identify who would be in urgent need of a brain scan or not.

According to the study, published in BMC Neuroscience, 87.5 per cent of those who had a poor score in the test, which involves naming as many animals as possible in a minute, had a brain tumour. 

It also revealed almost half (48.1 per cent) of those with a good score did not have a brain tumour. 

In conclusion, people who got a score of 14 or above were nearly eight times more likely to be brain tumour-free. On the other hand, a poor rating increased the likelihood of a brain tumour by more than three times. 

Ben Wilson is one such patient who went to see his GP when he was having severe headaches and dizzy spells. He said he only booked an appointment as he was furloughed from his job as an area manager for a brewery in 2020 and had more time on his hands. 

The 34-year-old was subsequently diagnosed with a low-grade Pilocytic Astrocytoma and underwent treatment just seven days after the initial GP appointment. Find out more about Gamma Knife Surgery in the UK for brain tumour recovery.

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Trials Hint At Major Progress In Brain Cancer Treatment

The results of new trials for treating brain cancer in children have shown very promising results, suggesting this may soon be added to the options for helping fight the disease.

Swiss pharmaceuticals firm Novartis has revealed the trial, using a combination of two drugs called Tafinlar and Mekinist, saw tumour shrinkage in 47 per cent of the patients, compared with 11 per cent in a comparative group that was being treated with chemotherapy. Moreover, the time without disease progression nearly trebled to 20 months.

The tests were being carried out on youngsters aged between one and 17 with low grade gliomas (LGGs), which are the most common childhood brain cancer. The drugs were administered orally.

However, the treatment itself was limited to a certain category of patients; they all had a genetic condition called BRAF V600, which is a factor in between 15 and 20 per cent of LGG occurrences in children. 

The drug combination itself has already been approved to treat some other cancer conditions, including skin, lung and thyroid cancer, but again this is focused on those with the BRAF V600 mutation.

While these results have been presented to the American Society of Clinical Oncology (ASCO) at its annual meeting and will now be passed on to regulators in an application for approval, it is therefore clear that they are only applicable to a minority of cases for one particular condition, based on a genetic mutation that accounts for no more than a fifth of LGG cases.

While that is not to understate the benefits of the treatment for those who can benefit from it, it is clear that this is not a catch-all miracle drug. Nor does it provide a permanent cure. This is why using radiotherapy for brain tumour conditions remains for many the most viable and effective form of treatment.

Novartis is far from alone in seeking to develop new pharmaceutical treatments for brain cancer. Oncology drugs maker Kazia Therapeutics has just presented the latest findings of research into paxalisib, a drug designed to tackle brain metastases. 

Phase II trials have shown that patients enjoyed longer survival times, a median of 15.7 months compared with 12.7 months for those using another drug, temozolomide, which the patients in the trial had a genetic resistance to. Progression free survival was also longer, at 8.6 months compared with 5.3 months in the temozolomide cohort. Side effects were few and mostly mild.

This was significant because at present, temozolomide is the only drug approved for this type of condition in the US. 

Kazia CEO Dr James Garner said: “The directionality of these analyses gives us greater confidence in the efficacy signals observed and appear encouraging for future development.”

Like the Novartis results for its combination therapy, the results were presented at the annual ASCO event and will have provided plenty of reasons for optimism going forward. 

One again, however, they are limited results that may offer less of a solution for brain tumour patients than radiosurgery, which as well as being non-invasive will not require continual treatment. These drug developments may be good news, but the possibilities offer by a Gamma Knife may remain far greater.

Novartis says drug combination outperformed chemo in children with brain cancer (NYSE:NVS) | Seeking Alpha

Novartis drug combo shows promise in childhood brain cancer (yahoo.com)

KaziapresentsfinalPIIdataatASCO (kaziatherapeutics.com)

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Amethyst UK, first to use new frame to transform patient experience

Amethyst UK, first to use new frame to transform patient experience at its London treatment centre Queen Square Radiotherapy Centre.

Read the full article from htworld.co.uk here.

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Ian Paddick, Amethyst Physicist, to receive Fabrikant Award

We’re delighted to announce that Amethyst Physicist, Ian Paddick, recently received the esteemed Fabrikant Award in Milan at the ISRS Congress 2022.  The Award is given every two years to an individual or individuals who are members of the International Stereotactic Radiosurgery Society (ISRS), and have made longstanding and significant contributions to the field of radiosurgery.

On receiving the Award, Ian Paddick said, “I’m truly humbled to receive this award. It’s the first time a physicist has received the prize on their own and I’m also the first recipient from the UK. The award is usually given to radiation oncologists or neurosurgeons, but this year’s award demonstrates that physicists are valued by clinicians and make a significant contribution to shaping clinical practice”.

He went on to add, “I’ve published over 50 articles on stereotactic radiosurgery (SRS), and have been lucky to have my work on indices incorporated into all the major treatment planning systems. I’ve also been fortunate to visit and teach at over 100 Gamma Knife centres around the world, so my work really has a global reach. My current and future research is in radiobiology where I believe we can make significant improvements in the efficacy and consistency of treatments.”

Importantly, the winner of the Fabrikant Award is invited to give a ‘Fabrikant lecture’, which is then published as a paper in the ISRS Journal – the Journal of Radiosurgery and Stereotactic Body Radiation Therapy . The winner also receives a grant of $5,000 and a commemorative certificate. During his lecture, Ian discussed ways to improve clinical research, encouraged attendees to question dogma which holds back the discipline of SRS, and highlighted aspects of work published such as the Paddick Conformity Index, Gradient Index and Efficiency Index and the importance of being able to standardise treatments so that centres can compare their data.

Ian was the first physicist to serve as president of the ISRS (2017-2019), and today he serves as an Ex-officio member of the board where he chairs the Certification Service. This Service provides the only in-person quality audit for SRS centres that is offered by a device agnostic organisation. This is an exciting initiative, which Ian hopes will raise the standard of SRS around the world. Two centres have been audited so far with the first, Koç University in Istanbul, receiving their certificate of quality in radiosurgery at the meeting in Milan.

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Patient Hails Survival 20 Years After Gamma Knife Op

June 28, 2022

To some people with brain tumours, the idea of undergoing a gamma knife procedure may sound very novel and scary. But in fact the procedure is so well established that people have had having their lives transformed for many years.

Speaking to the Richmond-Times Dispatch in the US, Tina Holloway, a patient who had been diagnosed with a stage 4 metastatic melanoma in 2015 – by which point the cancer had also spread to her breasts, abdomen, legs and pelvis as well as her brain – explained her story.

The prognosis looked terminal, with doctors giving her six months to live, but Gamma Knife surgery saved her life. After three hours of surgery, she was sent home and within 30 days she was declared in remission. “It’s scary when you’re told you have six months to live,” Ms Holloman said, “and here I am in 2022.”

Private radiotherapy centres in the UK like ours have been using Gamma Knife surgery for years. The fact that the procedure has been used so often, for so long and with so much success should be seen as highly encouraging to anyone needing treatment.

There should be no surprise that this extraordinary technology should be seeing more and more use. Indeed, the latest research has revealed that the technique continues to grow in use all over the world and will go on doing so.

A market research study by Future Market Insights titled ‘Gamma Knife Market: Global Industry Analysis and Opportunity Assessment 2015-2025’ has predicted that there will be ongoing rapid growth in the use of the technology.

It predicted the market will see compound annual growth of 5.90 per cent between 2021 and 2031, taking its global value from US$287.3 million to US$507 million, with North America being the leading regional market, the Asia-Pacific region second and Europe third.

The UK will be a part of Europe’s growth, although the prediction is for Germany to be the leading user of Gamma Knife surgery in Europe with a 20 per cent share of procedures.

Dealing with brain metastasis will be the most common use of the technique, although others will include conditions such as arteriovenous malformation and trigeminal neuralgia.

Behind these numbers lie thousands of real-life stories of patents for whom it seemed all hope was lost and who, without Gamma Knife surgery, the rest of their lives would have been very short. Not only is the hugely treatment effective, but it is painless, people can go straight home afterwards without a long convalescence, and there is none of the physical scarring involved in invasive surgery.

For so many the reality is now very different as they live cancer free lives way beyond their diagnoses and often with many more years ahead of them.

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Designer Hat Auction To Raise Funds For Brain Tumour Research

June 3, 2022

The Derby, taking place on June 4th, will be taking centre stage for a reason other than horse racing this year, with a special auction going on to raise money for charity Brain Tumour Research.

As part of the Platinum Jubilee Celebrations and in tribute to Queen Elizabeth, some of the biggest milliners in the UK have come up with designs for a one-off collection of hats inspired by the Queen’s 70-year reign, with the hats going under the hammer online on June 12th.

The Hats Fit For a Queen collection features pieces designed by Royal milliners Rachel Trevor-Morgan and Stephen Jones. The hats will be on display in the Queen’s Stand at Epsom Downs on both the Friday and Saturday.

Charity supporter Lisa Connell, who was diagnosed with an inoperable meningioma at the age of 26 and had Gamma Knife surgery to treat the tumour, has been pictured modelling the hats on behalf of Brain Tumour Research.

She also recently set up a fundraising group called Officially Lisa Connell to help find a cure for brain tumours and improve outcomes for patients.

Anne McEntee has also modelled some of the hats for the charity. Her husband Tom passed away two years after he was diagnosed with a glioblastoma. Since then, Anne has gone on to raise nearly £25,000 for charity.

Gamma Knife surgery itself is a well-established way to treat some brain tumours or lesions, although it’s not actually a knife in the traditional sense, since no incisions in the head are made at all.

The procedure is simple and painless, with precise and focused beams of radiation directed to the treatment area, meaning that only the target is hit, leaving the surrounding tissue intact.

To find out more about this type of radiosurgery, get in touch with us today.

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Queen Square Centre Included In Best Specialised Hospitals List

May 18, 2022

The world’s best specialised hospitals for 2022 have been ranked by Newsweek, in partnership with global research firm Statista – and the Queen Square Gamma Knife centre has been named as the third best for specialist treatment (neurology) in the world.

The best facilities across six specialities were reviewed in 2021 – cardiology, neurology, oncology, endocrinology, gastroenterology and orthopaedics.

But for 2022, the list was expanded to ten specialities, with the ranking now featuring the top 250 hospitals in oncology and cardiology, the top 150 for cardiac surgery and paediatrics, and the top 125 in neurology, neurosurgery, gastroenterology, orthopaedics and pulmonology.

The list itself is based on a global survey of medical professionals, with scores based on primary and secondary recommendations. More than 40,000 medical experts were invited to take the online survey in over 20 countries, asked to recommend and rank hospitals based on expertise in one primary medical field.

The Queen Square Radiosurgery Centre is a leading internationally recognised clinical centre of excellence. It was established in 2021 and went on to join the Amethyst Group in 2020.

It can be found within the University College London Hospitals’ National Hospital for Neurology and Neurosurgery in Queen Square in London. It is, in fact, the oldest neurosciences hospital in the world.

Clinical director Neil Kitchen commented on the news, saying: “The Queen Square Gamma Knife centre has been at the cutting edge of neurosurgery treatment for the past ten years.”

Together with the UCL Queen Square Institute of Neurology, the Queen Square site forms a major centre of excellence for teaching, training and research in neuroscience. In all, four of the world’s top 12 most cited authors in neurosciences and behaviour are now based at Queen’s Square.

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Precision Accuracy With Gamma Knife

May 16, 2022

Gamma Knife radiosurgery is a very well-established way to treat certain brain tumours or lesions in the brain – but it’s not a knife in the strictest sense, since no incisions at all are made in the head.

Instead, the simple and painless procedure involves directing incredibly precise and focused beams of radiation to the specified treatment area, which means that only the target is hit and none of the surrounding healthy tissue is damaged.

It is a safe and effective way to treat brain tumours and lesions, helping over 80,000 patients around the world each year.

The radiation source used for Gamma Knife is cobalt-60 and 192 physical pieces of this are loaded into the unit. This means that the radiation beams generated are delivered incredibly accurately and, when they intersect at the desired target point, the combined radiation is strong enough to deliver treatment.

Over the years, the treatment has been successful in shrinking tumours in the brain, effective at treating acoustic neuroma, meningioma, and pituitary adenoma, as well as other non-cancerous conditions and trigeminal neuralgia (sudden and severe facial pain).

There are a range of benefits associated with Gamma Knife treatment, not least the fact that no surgical incisions are necessary in order to access the right part of the brain. The accuracy of the treatment is one of its biggest unique selling points and it also means that there’s less downtime, with a full dose of treatment typically delivered in just one session.

There’s also no need for the head to be shaved because no incision is required, and the risk of associated complications is low. Patients should be able to go home the same day and start following their typical daily routine in just a couple of days’ time.

For more information relating to Gamma Knife surgery in the UK, get in touch with us today.

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