Scared about Gamma Knife Surgery? Let's talk about it simply!

When you hear the word 'Gamma Knife Surgery', you might think of a major operation performed using a knife. In fact, even though the word "Knife" is in the name, no knife is used, and no skin is cut. So what is this Gamma Knife? Is it really surgery?

Simply put, what is this Gamma Knife?

Gamma Knife surgery is a non-surgical , highly advanced form of radiation therapy. Specifically, it is a computer-controlled method of treating tumors and other conditions in the brain and upper spine.

This involves combining very high-energy gamma rays into a fine beam and directing them only at the targeted diseased tissue. This results in minimal damage to surrounding healthy tissue.

What diseases is Gamma Knife treatment used for?

The main goal of Gamma Knife therapy is to stop the growth of, shrink, or completely destroy a tumor or other abnormal tissue in the brain. This treatment is usually used for small abnormalities in the brain.

The table below can explain this further.

Sometimes, the Gamma Knife method is also very useful for treating tumors that are deep in the brain and cannot be reached by conventional surgery. It is also a good option if, for some reason, you cannot have surgery under anesthesia .

How do you prepare for this treatment?

Before treatment, you will need to see a neurosurgeon and/or radiation oncologist. They will examine you and give you any necessary advice.

Things to tell your doctor:

• In your bodyIf you have a device installed, such as a pacemaker, cochlear implant, medication pump, or nerve stimulator, you should definitely mention it.
• Tell us about your allergies.
• If you have difficulty remaining upright for 30-60 minutes at a time due to conditions such as lung disease or esophageal reflux, please let us know in advance.

Common advice:

• Do not eat or drink anything after midnight the day before treatment.
• Take your morning medication with a little water. Bring all your medications, including inhalers, to the hospital.
• Wash hair thoroughly the night before treatment.
• Do not put clips, pins, or bands in your hair on the day of treatment.
• Wear shoes that are easy to take off and loose clothing. Avoid clothing that can be pulled over your head and removed.
• Be sure to arrange for someone to take you to the hospital and back home .

The frame that you put on your head, the mask... what is this?

During Gamma Knife treatment, a special device is used to keep your head still. This comes in two forms.

1. Frame: In this method, a lightweight metal frame is attached to your head. This helps keep your head still and directs the gamma rays precisely to the target.

2. Frameless: In this, a custom-made thermoplastic mask or mesh is worn over your face.

You might be a little scared when you hear about this frame being fitted to your head. But don't worry. The medical team does it like this:

• First, a local anesthetic is injected into the front, sides, and back of your head to numb it . So you won't feel any pain.
• Then, the frame is fixed to the skull using four small pins placed in the numb areas. You may feel a slight pressure, but there is no pain.
• There's no need to worry about this.

With the Frameless method, there is no such stinging sensation. The doctors will give you medication if necessary to keep you calm during the treatment.

What happens during treatment?

There are several steps before treatment actually begins.

• IV insertion: An IV cannula will be placed in a vein in your arm. This will be used to give you medication to help you relax, if needed, and to give you contrast dye for scans .
• Imaging tests: A CT scan and/or MRI scan will be performed to see exactly where and how much of your brain disease is present.
• Treatment planning : After reviewing the scan reports, your medical team (neurosurgeon, radiation therapist, medical physicist) will use a computer to plan your treatment. This is where they will decide exactly how much radiation to give and where to give it.

Then the treatment begins. You will lie down on a table that goes into the machine. You will not feel any pain, heat or noise during the treatment. Most people will sleep during this time. The medical team will constantly monitor you from outside. There is a microphone for you if you want to talk.

When the treatment is complete, the frame or mask is removed and the IV is removed. The entire treatment can take anywhere from 30 minutes to two hours.

What happens after treatment? Benefits and side effects

You may feel a little sleepy after the treatment. In most cases, you can go home the same day and resume your normal activities the next day.

When should you see a doctor?

After treatment, if you experience the following symptoms, call your doctor .

• If you feel heat when you touch the areas where the frame is attached.
• If a foul-smelling pus-like fluid comes out of those areas.
• If you have a fever.

If the following serious symptoms occur, go to the nearest hospital Emergency Department (ETU) immediately:

• Severe nausea or vomiting
• Very severe headache
• Vision changes
• Difficulty speaking
• Having a seizure