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Spring 2013

What to Expect

Contrary to its name, there is no knife in Gamma Knife®. No incisions are involved in this safe, painless and effective procedure used for more than 30,000 patients every year.

While the Gamma Knife treatment is a relatively quick outpatient procedure, because of preparation and treatment planning time, you should expect to spend most of the day at our facility. The treatment process includes:

  • attaching the Gamma Knife head frame
  • imaging: MRI, CT or angiography
  • treatment planning, and treatment

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

Referring physician Referring physician
If a referring physician suspects that a patient has a brain tumor, or other form of neurological malformation or functional disorder, he or she will refer the patient to a neurosurgeon or radiation oncologist.

Neurosurgeon or radiation oncologist
If the neurosurgeon or radiation oncologist confirms the referring physician’s diagnosis through examination and testing, he or she will recommend the appropriate treatment procedure. If Gamma Knife is recommended, the doctor will discuss the benefits, risks, and recovery process with the patient, and explain what the patient should expect on the day of the procedure.
 

Treatment Day

Attaching the headframe

Attaching the headframe
Upon arrival at the facility at St. Joseph Medical Center in Tacoma, the patient will be met by a specially trained nurse who will help the patient check-in and get ready for the placement of the headframe, diagnostic imaging, and the procedure itself. The patient will then go to St. Joseph Day Surgery Center where the neurosurgeon will fit the patient with the special lightweight “stereotactic headframe.” Under local anesthesia, this unique device will be temporarily affixed to the skull by four shallow screws so that the patient’s head will not move during diagnostic imaging, or the actual Gamma Knife procedure.

Diagnostic imaging

Diagnostic imaging
After the headframe is in place, the patient will be taken downstairs for diagnostic imaging, which may involve MRI (magnetic resonance imaging), CT scan (computed tomography) or angiography. Three-dimensional imaging is required to determining the exact size, shape and position of the radiation’s “target abnormality” in the brain. During the process, a special “coordinate box” is temporarily placed atop the headframe to provide the precise map-like reference points (coordinates) of the target your team will be treating. The coordinate box will be removed before the actual Gamma Knife process begins.

Building the customized treatment plan

Building the customized treatment plan
Once the images have been taken, the patient can rest and listen to music or watch a TV while the Gamma Knife team (neurosurgeon, radiation oncologist and physicist) analyzes the diagnostic images and designs the specific treatment plan. Every patient’s plan is different, individually crafted to address their specific needs. Creating the complex plan takes approximately two hours.

The treatment

The treatment
After the plan is completed, the patient’s treatment can begin. The patient will lay down on the treatment couch and the headframe will be attached to the special “Helmet” inside the Gamma Knife unit. During the whole procedure the patient is awake and can communicate with the team via audio and video. The treatment is totally silent and painless, and lasts anywhere from a few minutes, to an hour, depending on the size and shape of the target.

After the treatment

After the treatment
When the treatment has been completed, the stereotactic headframe will be removed. Some patients will experience a mild headache, or minor swelling, where the headframe was attached, but most experience no problems. Patients typically can go home an hour after the headframe is removed, and most return to normal activities in just a day or two. In cases where the patient had an angiogram, they will be required to lay quietly for several hours before leaving.

Treatment results take time

Treatment results take time
The effects of Gamma Knife treatment will occur over time. Radiation treatments are designed to slow or stop the growth of lesions or tumors over a period of weeks or months. The Gamma Knife team stays in contact with each patient to assess progress, which may include follow-up MRI, CT or angiography images.

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