Gamma Knife radiotherapy offers non-invasive treatment for brain tumours. Understand the process, preparation, and what to expect before, during, and after.
Here at Amethyst Radiotherapy, we’ve been working closely with Radiotherapy UK to develop a new video series, which aims to help prepare brain tumour patients for Gamma Knife treatment, a type of radiotherapy.
This can be a daunting prospect at what is already a difficult time and the videos will take you through each step of the process to help demystify it and ease your natural apprehension.
The video shows a step-by-step guide to the Gamma Knife treatment and is supported by four additional videos from the medical team including the therapeutic radiographer, neurosurgeon, clinical oncologist and medical director.
A brain tumour diagnosis can cause major upheaval in the life of a patient and their loved ones. There is a lot of new information to take in, at a time when emotions can be running high and there are also practical issues to deal with, such as arranging time off work for treatment and dealing with paperwork and finances.
This can make the prospect of discussing and starting your treatment feel overwhelming. Every patient will have a dedicated medical team who will be able to guide them through their treatment options, based on the type and size of brain tumour they have and its location in the brain, and also their general state of health and personal wishes.
Patients with a certain type of brain tumour may be a suitable candidate for Gamma Knife radiotherapy. This is a highly focused form of radiotherapy that delivers tightly targeted high doses of radiation to the brain tumour. The radiation beams cause deliberate damage to the DNA of the tumour tissue, while leaving the surrounding healthy tissue largely untouched.
Brain tumours can affect people of all ages, and research is ongoing to understand more about what causes them. There are many different types of brain tumours, and they can cause different symptoms depending on the size and location in the brain. They are broadly categorised into two main groups: malignant and benign.
Malignant brain tumours are cancerous and fast growing, and benign brain tumours are usually slow growing and non-cancerous. However, the term benign can be misleading, because even non-cancerous tumours can cause serious symptoms and the tumour may need to be carefully monitored or removed if possible.
Some specific types of brain tumour are best suited to Gamma Knife radiotherapy, including metastases, acoustic neuroma, and meningioma, because they are well contained within one area of the brain. Other types of tumour such as gliomas may be less suitable for the treatment, because they tend to spread further through the brain.
Your medical team will provide you with expert advice and guidance on the treatment options open to you, based on the results of your biopsy and MRI scans. This will be a two-way process, and you will have the opportunity to ask questions and be given time to think over your decision.
In some cases, a combination of traditional surgery, chemotherapy, and Gamma Knife radiotherapy may be the agreed way forward. Gamma Knife does not involve any incisions despite its name; it is delivered externally from a special machine designed to accurately focus high doses of radiation at a precisely targeted area.
This eliminates the immediate risks of traditional surgery such as infections and bleeding, and recovery times are much quicker. Typically the treatment is delivered in one dose and can take between ten minutes and several hours, depending on the nature and extent of the tumour. Occasionally, a second or third dose may be required.
Gamma Knife treatment is generally tolerated well with few side effects, and usually results in the tumour being well-controlled. Sometimes, patients may experience a delayed reaction, which might include headaches or occasionally seizures. Your medical team will fully explain all the risks and potential side-effects before your treatment starts.
If you make the decision to go ahead with Gamma Knife treatment, it can be helpful to know what to expect on the day. In most cases, the treatment will be delivered as a day case and you will not need to stay overnight in the hospital. Your medical team will discuss in advance if you do need to stay overnight.
Before the treatment begins, you will have an MRI scan that will be examined by the radiologist and consultant. This process can take up to an hour or two, so bring some entertainment with you. The medics will use the information from the scan to locate the exact position of the tumour in your brain.
On the day of the treatment, it’s important that you wear comfortable clothing with no metal attachments or jewellery. If you wear a headscarf, you will have to remove it while the frame is fitted, but it can then be placed back on. You will be fitted with a lightweight frame (or in some cases a mask) to make sure that your head is kept still during the treatment process.
You can eat and drink as normal beforehand, and you will be invited to use the bathroom directly before the process starts to ensure your comfort. However, you can also have toilet or water breaks during the treatment.
During the treatment, you will lie on a couch and your head and chest will be positioned in a large horizontal bucket-shaped device. You will not feel anything, and can leave your eyes open and listen to music or podcasts if you wish. There will be no one in the room with you, but you will be able to communicate with your medical team via an intercom system.
You will be automatically repositioned during the procedure so that the gamma rays can target slightly different areas of the tumour each time. Each exposure will take several minutes, and the whole procedure may take several hours.
When the treatment is over, you will be taken to a preparation room where the frame will be removed from your head. You may feel slightly sore and sensitive in this area for a few days after the procedure. Your medical team will discuss all the potential side effects with you, such as nausea, headache, or dizziness.
The treatment is non-invasive and you will not be radioactive afterwards, so you can resume normal procedures as soon as you feel able to do so. After the procedure, you will have follow up appointments and may have further scans if necessary to monitor your progress.
If you have any issues or concerns after your treatment, contact a member of your medical team and they will be able to discuss these with you.
Centres of Excellence for Stereotactic Radiosurgery treatment of complex Brain Tumours
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