FREQUENTLY ASKED QUESTIONS

  • 1
    Why is it called a Gamma Knife?

    The original Stereotactic Gamma Unit made a "knife-like" lesion in the brain leading to it being called the "Gamma Knife".

  • 2
    How long has Gamma Knife Radiosurgery been available?

    The first unit became operational in Sweden in 1968. The first unit in the United States was installed at the University of Pittsburgh in 1987.

  • 3
    Can Gamma Knife Radiosurgery be used for other body areas?

    No. Gamma Knife Radiosurgery was invented by a Neurosurgeon for non-invasive brain surgery. They physical design of the unit prevents using it for lesions in other areas of the body. It can only treat lesions in the brain and head.

  • 4
    What are the side effects of Gamma Knife Radiosurgery?

    Side effects are limited and uncommon. Since there is no incision, there is no risk of infection, blood loss or spinal fluid leak. Brain or other tissue adjacent to the lesion treated can be injured but the risk of that is usually small. The neurosurgeon will discuss specific risks associated with lesions to be treated with patients in the initial consultation, prior to treatment.

  • 5
    Is Gamma Knife Radiosurgery painful?

    The actual procedure is painless. Head frame attachment is done with local anesthetic and mild sedative and is usually not uncomfortable.

  • 6
    What are the advantages of Gamma Knife Radiosurgery versus traditional brain surgery?

    When it is possible to do Gamma Knife Radiosurgery as an alternative to traditional "open skull" neurosurgery, the risks are lower, it is pain-less, there is no hospitalization and the costs are usually lower.

  • 7
    Is it cost effective?

    Costs associated with Gamma Knife treatment are usually considerably less than for traditional neurosurgical treatment of the same lesion. The most obvious cost saving, to the patient, is from the lack of recovery after Gamma Knife Radiosurgery. The procedure is typically done in a single, outpatient visit, so the cost of hospital stays is reduced. Since there is little convalescence needed after Gamma Knife Radiosurgery, there is no prolonged absence from work or other activities as there often is after more traditional "open skull" brain surgery.

  • 8
    Is it cost effective?

    • Medical and Surgical History • Clinical Examinations • Imaging studies, such as MRI, CT and/or PET scans

  • 9
    What happens during Gamma Knife treatment?

    Once a patient’s condition is reviewed by our multidisciplinary team and Gamma Knife treatment is deemed an appropriate, the patient will be scheduled for a treatment day. On the day of treatment, there are several steps that take place. First, a lightweight frame is attached to the patient’s head. Local anesthesia and a light sedative is used before the frame is secured in place. This frame will remain in place throughout the treatment process, and ensures no movement occurs during the process. This frame allows Gamma Knife treatment to be extremely accurate. Next, the patient has an MRI or CT imaging study or, in the case of an arteriovenous malformation, angiography, may be needed in order to precisely locate the diseased area. Data from the imaging study is transferred into the treatment planning computer. While the patient rests, the treatment team (a neurosurgeon, radiation oncologist and physicist) uses advanced software to determine the treatment plan. This takes one or two hours to complete, depending on the complexity and location of the disease. When the individual treatment plan is completed, the patient is placed on the Gamma Knife couch and precisely positioned. The patient is then moved automatically, head first into the machine, and treatment begins. Treatment typically lasts from 15 minutes to an hour or more, during which time the patient feels nothing unusual. The radiation treatment cannot be seen or felt. Actual treatment time varies based on the condition being treated and its location. When treatment is completed, the patient is automatically moved out of the machine, and the head frame is removed. Gamma Knife treatment is usually an outpatient procedure, but some cases may require an overnight stay. If a patient is treated on an outpatient basis, he or she will be observed for a period of time and released. If the procedure has been designated as inpatient, then the patient will be admitted to the hospital.

  • 10
    Will I be awake during the procedure?

    Yes, patients remain conscious throughout the entire procedure and may communicate with the treatment team.

  • 11
    Will my head be shaved?

    No, Gamma Knife treatment does not require a patient’s head is be shaved.

  • 12
    What can I expect after the treatment?

    When the treatment is finished, the head frame will be removed. Sometimes there is a little bleeding from where the pins were attached to the head. In this case, gauze and pressure will be applied to stop the bleeding and keep the area clean. A temporary head dressing is placed to keep the pin sites clean. It is recommended that the patient take it easy over the next 12 to 24 hours. Pre-Gamma Knife activities can be resumed within a few days.

  • 13
    Is Gamma Knife treatment safe?

    The Gamma Knife allows non-invasive brain ‘surgery’ to be performed with extreme precision while sparing healthy tissues surrounding the targeted treatment area. The risks usually involved with open brain surgery such as hemorrhage or infection, are greatly reduced. Hospitalization is rarely required and recovery time is minimal. While individual patient outcomes may vary, patients may resume their normal pre-treatment lifestyle within a few days. Gamma Knife treatment has been in use for over 40 years. Over 600,000 people worldwide have been treated with Gamma Knife, and more than 3,000 peer-reviewed clinical papers have been written about Gamma Knife treatment.

  • 14
    What if I am older or have other medical conditions?

    Gamma Knife radiosurgery is especially valuable for patients whose neurological disorders require a difficult surgical approach or may be impossible to treat using conventional neurosurgical techniques like open brain surgery. Patients of advanced age or in poor medical condition can be at an unacceptably high risk for general anesthesia and conventional surgery, making Gamma Knife treatment an ideal solution. Gamma Knife technology also is highly beneficial for patients whose lesions are situated in an inaccessible or functionally critical area within the brain. In addition, the treatment can be used as an adjunct to the care of a patient who has undergone conventional brain surgery, interventional neuroradiology, conventional radiation therapy, or chemotherapy.

  • 15
    When can I return to my normal pretreatment activities?

    Most patients can typically return to pre-treatment activities within a few days. The only restrictions you will have are the same you had prior to your treatment.

  • 16
    How does treatment with the Gamma Knife differ from other forms of radiation therapy?

    Treatment with the Gamma Knife differs from other forms radiation therapy in a couple of ways. The Gamma Knife is a form of stereotactic radiosurgery which only directs treatment to targeted areas and spares adjacent, normal brain tissue. Other forms of radiation therapy do not provide such a ‘fitted’ treatment, and may not deliver as high of a treatment dose as Gamma Knife. Treatment with the Gamma Knife is performed in a single (one) day treatment session versus other forms of radiation therapy which may require three to thirty or more treatments over several weeks. Gamma Knife treatment can often be repeated if necessary where other forms may not. Gamma Knife treatment also does not typically interrupt or impede ongoing chemotherapy for a primary cancer, and may not require patients to hold other medications for treatment.

  • 17
    What are the tell-tale signs of brain tumors?

    Generally speaking, brain tumors manifest their presence in two ways: symptoms that reflect increased intracranial pressure and secondly, destruction or dysfunction of a particular area of the brain. Thus, one may have headaches, nausea or vomiting, and changes in alertness which are all pressure-related or one may exhibit language problems, hearing loss, paralysis or seizures which on the other hand be speak of structural problems in a particular area of the brain.

  • 18
    Do all brain tumors or brain blood vessel problems require an operation?

    Generally speaking, brain tumors manifest their presence in two ways: symptoms that reflect increased intracranial pressure and secondly, destruction or dysfunction of a particular area of the brain. Thus, one may have headaches, nausea or vomiting, and changes in alertness which are all pressure-related or one may exhibit language problems, hearing loss, paralysis or seizures which on the other hand be speak of structural problems in a particular area of the brain.

  • 19
    What are the important factors that a doctor and his patient consider when one designs the best treatment option?

    Common sense tells us that among many, the two more important considerations are the size and the location of the lesion. A competent doctor will help you in discussing other important factors such as the biologic behavior of the tumor (benign or malignant), the overall health status of the patient (e.g. age, medical condition), the pros and cons of the various treatment modalities and the overall ideal goal of treatment. No patient is an exact replica of another.

  • 20
    I heard that surgery for brain tumors and certain brain vessel diseases is now obsolete and one does not need to be operated on. Is this true?

    Because the premise of the question is obviously sweeping, the answer is NO. Surgery remains as the hallmark for treatment for most cases. I can understand the desire and need for an ideal treatment that does not require surgery and yet cures or controls the problem. Despite all advances we still do not have the panacea of miracle cure. However, there's a new development in neurosurgery called Stereotactic Radiosurgery (SRS) which allows a non-invasive approach in treating brain tumors. No skin incision is done and the neurosurgeon does not have to actually handle the brain to obliterate tumors and vascular malformations. I want to emphasize however that this is limited to certain specific brain tumors and brain vessel disease that has to comply with the strictest criteria to enhance the treatment effectively. This is a wonderful development but this is certainly not the miracle cure we want it to be.

  • 21
    How the Gamma Knife Procedure done?

    On the day of treatment, a head frame is placed on the patient under local anesthesia with mild sedation. The head frame is needed to develop a precise treatment plan and keeps the head in a fixed position to maximize accuracy during treatment.

    After the head frame is attached, the patient undergoes diagnostic imaging (MRI, CT or Angiogram). Information from the imaging study is transferred into the state-of-the-art treatment planning system and the Gamma Knife team will then develop a treatment plan tailored to fit each patient’s case.

    When the treatment plan is completed, the patient is positioned in the Gamma Knife. The focused radiation targets the lesion, leaving the surrounding brain tissue virtually unharmed. Treatment times vary depending on the condition treated.

    When the treatment is over, the patient is taken out of the machine and the head frame is removed. Most patients will be observed for a period of time and are released. However, some patient may be required to stay overnight in the hospital. Most individuals return to normal pre-treatment activities within two or three days.

What Our Client Says

Almost every day, we receive warm, wonderful letters of thanks from former patients, their families and friends. We thank them for taking the time to praise the excellent care they received, for telling us about their recovery and for sharing their “Rancan Gamma Knife Centre Experience” with us.

I wanted to let all of you know that my family and I appreciated the wonderful care on my 'day' at the Rancan gamma knife center. Your kindness and the pleasant attitude made it much easier to deal with it all. Thanks for the pictures - my kids loved them! Mom is a space alien!

Abdin Wilson

Really I feeling like a home and all doctors and staff were execellent. Your thoughtfulness, professionalism, caring and gentle ways took this terrified person through the procedure with success! I appreciate what you've done and who you are. Thank You! God Bless.

Mohammed Belal Uddin

Treatment Procedure

A step-by-step description of the Gamma Knife process and what to expect on treatment day follows: