Gamma Knife Surgery: What to Expect From the Patient's Perspective

Gamma Knife surgery - from the patient’s perspective This video describes Gamma Knife surgery - and what you as a patient will experience before, during and after treatment. Gamma Knife Surgery is a well-established treatment method used to treat selected neurological diseases. Leksell Gamma Knife is not a knife in the normal sense of the word. The doctor makes no incisions - instead precisely focused beams of radiation are directed to the treatment area. The treatment is painless and also allows the patient to quickly return to normal routines. More than 50,000 patients undergo Gamma Knife surgery every year. The method has been in clinical use since 1968 and there are more than 270 Leksell Gamma Knife systems in operation around the world. [How it works] Gamma Knife Surgery is a unique method that delivers extremely focused radiation beams to the target in the brain. The patient’s head is positioned inside the radiation unit. During treatment all radiation beams meet in a focal point, with sub-millimeter precision. The individual beams are too weak to damage healthy tissue on their way to the target area, but very powerful when they simultaneously merge at a single focal point. This can be compared with the principle of a magnifying glass in the sun. Through small preprogrammed movements of the head, into different positions, the shape and dose of radiation is optimized to affect only the target - without damaging the surrounding healthy tissue. [Workflow] In most cases a single treatment will be given This will involve four main steps: - Attaching the frame - Imaging - Treatment planning - and the Treatment itself A specialized team takes care of you throughout the entire procedure and the patient is, in most cases, awake at all times. Before treatment the doctor will inform you about the whole procedure. [Attaching the frame] To begin with, the lightweight frame will be placed on your head. Hair doesn’t need to be cut or shaved. Local anesthetic is applied where the frame is to be attached. Once the anesthetic has taken effect, the frame will be fixed to the head with four pins. The frame remains on your head throughout the entire procedure - to keep the head in a stable position during imaging and treatment. Attaching the frame takes about 15 minutes. A coordinate box is used during imaging – to provide reference points on the images for the treatment plan. [Imaging] After the head frame is in place, it’s time for imaging – for example MRI, CT or angiography. Although these imaging studies may have been done before, they need to be done again with the frame on – to determine the exact location, size and shape of the target. After imaging, the coordinate box is removed. [Treatment planning] The images are now transferred to the sophisticated treatment planning computer. Once the images have been taken you can rest - while the doctor, often together with another specialist, develops your treatment plan. Each treatment plan is unique and individually designed to address the particular patient’s medical condition. The specially designed treatment planning software assists the doctor in preparing the treatment. For added security the final plan is re-checked and approved. [Treatment] Once the treatment plan is complete, the actual treatment can begin. Before starting, the doctor will explain how long the treatment will take. You will lie down on the treatment couch and the head frame will be attached to the patient positioning system – which automatically moves the head during treatment. The number of small movements depends on the shape and location of the target. The treatment is silent and totally painless – and will last a few minutes to more than an hour depending on the target. During treatment you will be fully awake and able to communicate with the doctor and nurse through an audio/video connection. The team is there at all times, to assist you. [Removing frame] Once treatment is complete, the frame will be removed. Some patients may experience a mild headache or minor swelling where the frame was attached, but most report no problems. The doctor will inform you whether or not an overnight stay is needed for observation, or if you can go home immediately. Either way, a patient should be able to return to a normal routine in a day or so. [Follow-up] The doctor will stay in contact with you for periodic follow-ups and consultations. The effects of the treatment will occur over time. Radiation treatment is designed to stop the growth of tumors or lesions, which means that the result will be seen after a period of weeks or even months. [Outro] Gamma Knife surgery is a well-established, non-invasive treatment method which allows the patient to quickly return to normal routines. The guiding principles of Gamma Knife surgery are and will always be clinical effectiveness and patient comfort. Eftertext: Part of this video is based on a patient treatment at Sophiahemmet in Stockholm, Sweden.