Re: Suitable for Gamma Knife Treatment?

Posted By CCF Neuro MD on June 18, 1997 at 09:17:10:

In Reply to: Suitable for Gamma Knife Treatment? posted by Vaska Tumir on June 10, 1997 at 01:18:08:







: Dear Staff of the CCF Neurology Forum:
Two weeks ago, after an episode that mimicked a brain
seizure, my mother was diagnosed with a brain tumor in
the left hemisphere.  The tumor is 1.5-2 cm in size;
its type has not been determined.  It is situated very
close to the motor co-ordination center in the left
perietal lobe.  
After a brief period of hospitalization at Belgrade's
Neurosurgery Clinic, she was prescribed whole-brain
radiation therapy [there are no Gamma Knife facilities
available locally] which hasn't begun yet.  There is, at
this time, a suspicion that this may be a case of a
metastized tumor.  The primary site, if it exists,
has not been identified; my mother will be undergoing
further medical tests, examination, and a whole-body scan
in the next 10 days.    



  


At the Cleveland Clinic, we have a Brain Tumor and Neuro-Oncology Center which involves a number of neurosurgeons (Dr. Gene Barnett, director), neurologists, radiation oncologists as well as a large number of ancillary people.  In January 1997 The Norther Ohio Gamma Knife Center at the Cleveland Clinic opened.  The state-of the art facility is the first in Ohio, which is used by a number of qualified neurosurgeons and radiation oncologists in the state. Potential candidates for treatment with the Gamma Knife include tumors (primary brain tumors, metastatic brain tumors (up to 4), acoustic neuromas, schwannomas, meningiomas, pituitary tumors, skull base tumors and a number of unusual tumors such as hemangioblastomas, chordomas, chondrosarcomas and pineal region tumors), vascular malformations (arteriovenous malformations), functional neurologic disorders (chronic epilepsy, parkinson's disease), and other conditions such as cancer pain and trigeminal neuralgia.  
For brain tumor patients it provides an alternative to conventional surgery and radiation.  It may be used when the risks of general surgery and anesthesia are high or it may be used with conventional therapies.  The Gamma Knife targets an area in the brain and provides radiation to the target area that had been previously determined by MRI or CT.  The procedure takes 15-40 minutes and is performed under local anesthesia.  Patients remain in contact with their physician throughout the treatment and may listen to music during it.  There is minimal discomfort during the procedure and it is generally well tolerated.  This procedure allows the patient to go home or to a nearby hotel after a period of observation after the procedure.  After treatment the tumor or damaged brain tissue will continue to shrink over time so that improvement is gradual.  Patients need to be periodically monitored afterward to make sure the treatment was effective.  The success rate is 70-90%, depending on the patient and the type of tumor, malformation, etc.  Discussing the details of your mom's case with a neurosurgeon experienced with the gamma knife would be most appropriate, as sometimes the traditional surgical approach or radiation is more appropriate and effective.  And with any procedure, there are risks that need to be discussed.  
If you would like more information regarding this or would like to see a neurosurgeon at the Cleveland Clinic (Dr. Gene Barnett and Dr. David Miller specialize in this treatment), or would like additional information mailed to you (I have tried to summarize a recent newsletter that you may be interested in), call 1-800-223-2273 ext 56645 or 216-445-6645.  They may also be able to tell you if they recommend another facility in Europe.  If you need assistance in arranging travel over to the United States, we have an international center which is dedicated to this as well as assisting patients in their appointments with physicians, their phone number is 216-444-6404.
I hope this information has been helpful.  Please give the Cleveland Clinic a call if we may be of further assistance.  
This information is provided for general medical educationpurposes only.  Please consult you physician for diagnostic and treatment options of your specific medical condition
I and my family are currently looking for other forms of
therapy, hoping to avoid exposing my mother [who is 66 years old and
otherwise in excellent health], to any unnecessary whole-brain
radiation.  I realize that the information I have given you
is skimpy in the extreme.  I would be very grateful, however,
if you could give us any indication if, in your opinion, and going on
admittedly very little information, this may be a case
suitable for Gamma Knife treatment.
Should this type and size of tumor be a good candidate for
Gamma Knife surgery, my mother is prepared to travel abroad, either to
the nearest Gamma Knife center in Europe, or to the USA,
to have this treatment done.  We would also greatly appreciate it
if you could advise us about the viability of this course
of action.  I am seeking this information from you because
my family [my own father is a practising physician] has
not been able to get any real advice in Belgrade itself.  
Thank you so much for you time and kindness.  
Sincerely,
Vaska Tumir