For Patients
Gamma Knife® Surgery: What to Expect
Gamma Knife surgery is a gentle treatment with little or no pain, which is generally performed on an outpatient basis in a few hours. There are minimal side effects–some patients may experience headaches, dizziness, nausea or seizures; these effects typically subside soon after the treatment. There is usually no loss of hair. Most patients recover within a few days with no rehabilitation, and are advised to resume regular activity 24-48 hours after the procedure.
In contrast to other treatment methods which require multiple visits, Gamma Knife radiosurgery is so precise, a surgeon can deliver the full dose of radiation during a single session. And you don’t have to worry about excess radiation–the Gamma Knife system’s intelligent design keeps radiation from the rest of the body and from surrounding healthy brain tissue.
Because this technique is non-invasive, surgeons can use the Gamma Knife repeatedly to treat new brain tumors, as well as to treat the spread of cancer (metastases) in surgically inoperable tumors.
Before Your Treatment Day
If Gamma Knife radiosurgery is an appropriate option for your medical condition, you will be referred to the Image-guided Neurosurgery Center at MedStar Washington Hospital Center. Our staff will schedule all your pre-operative appointments, and send you a packet of information that should answer many of your questions about this procedure. A few weeks prior to the day of your surgery, you will:
- Complete pre-operative blood work
- Complete a consultation with a radiation oncologist and neurosurgeon
- Meet with our nurse coordinator, who will assist you throughout this process
- Take a tour of the Gamma Knife facility
Treatment Day – What to Expect and How to Prepare
Preparation
- Please arrive early in the morning to begin preparation for surgery.
- The night before your surgery, you should not eat or drink anything after midnight.
- Bring all your medications with you to the hospital, and ask the nurse or physician how and when to take your normal medications on the day of the surgery.
- You will need to remove all jewelry.
Friends and Family
Please have a family member or friend accompany you, and stay in the Gamma Knife facility during the treatment. In most instances, they will be allowed to stay with you for much of the time before surgery.
Pre-operative Procedures
An intravenous (IV) line will be inserted in your arm. The IV line will keep you hydrated, and enables us to easily administer needed medications. Patients generally receive a mild sedative to help them relax, and to minimize discomfort during the placement of the head frame.
Placement of the Head Frame
The head frame is attached to your head using sterile pins. The head frame is a lightweight structure that keeps the head from moving during the treatment, and ensures the Gamma Knife beams are directly exactly where the treatment is needed.
Imaging
Once the head frame is in place, you will undergo imaging scans of the brain. These exams may include x-rays, MRI, CT scan and/or angiogram. Information obtained from the imaging studies is entered into the Gamma Knife’s computerized treatment planning software.
Planning
At this point, you will have at least an hour or two before the next step. You will be served breakfast, and can relax with your friends and family.
During this time, your neurosurgeon and medical team are working together to plan your surgery. They will decide which areas to treat, and what the appropriate radiation dose is for each area. The cobalt-60 source of radiation in the Gamma Knife delivers radiation at a constant rate. The duration of each treatment is carefully calculated so that the proper level of radiation is delivered.
Surgery
Once the final plans have been carefully determined, your neurosurgeon will come and explain to you how many treatments will be administered, and how long each treatment will be.
To begin treatment, you will lie down on the unit’s bed, and your head frame will be attached to a helmet. The helmet has 201 holes, each delivering a beam of radiation. Individually, each “ray” of radiation is too weak to harm the brain tissue it passes through. We have helmets with different size holes for use in different areas of the brain. The team may change your helmet during treatment.
Physicians and staff will need to leave the room to begin your surgery. You can talk with your physician through a microphone in the helmet, and a video camera allows the staff to see you at all times.
To begin treatment, the bed or couch will shift backwards into the hood. During treatment, you will not feel or hear anything from the Gamma Knife unit; however, you can choose to listen to your own selection of music or our satellite Sirius-XM radio. When the treatment is completed, the bed will move back out of the unit. The total treatment time varies, depending on the size of the area to be treated and the dosages needed for effective treatment.
After Surgery
Immediately after the surgery is completed, the head frame is removed. The pin sites are cleaned and covered with gauze. A few people experience headaches or nausea once the frame is removed.
You will be given something to eat and drink at this time. The IV will remain in your arm until staff members determine that you are able to keep liquids down.
Recovery
Most patients return home the day of treatment; however, this depends on what procedures you had done and your particular condition. You will receive specific discharge instructions on how to care for the pin sites, how to monitor for side effects and when to follow up with your neurosurgeon. Usually, there are no long term side effects from Gamma Knife treatment. Some patients experience mild swelling in the brain following the procedure. If required, your neurosurgeon will prescribe a steroid to reduce this inflammation. Most patients resume normal activities within 24 to 48 hours of the procedure.
Keep in mind, you will need someone to drive you home after the procedure, and assist in care you may need.
Results
Gamma Knife surgery does not remove diseased tissue; it damages the offending cells’ ability to reproduce. Therefore, results are not immediate. Progress is monitored through follow-up diagnostic tests.