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Radiosurgery


MSWKitty

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My dad's scheduled for radiosurgery for tumor in his brain this Thursday (tomorrow- yikes!). Just wondering if anyone here could tell my about their experiences (or their loved ones experiences) with it. He's on 4 mg of decadron, every six hours. I don't know how long this will be for-- probably for some time after the surgery... :?::?: ...

Thanks :!:

Kitty

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Kitty,

There are several different names/type of radiosurgery. It's not "surgery" like you might be thinking. It is totally noninvasive, it's just a more powerful radiation treatment focused specifically on the tumors. Because they can pinpoint radiate each tumor, they can circle it (at least they can with Novalis) and hit the tumor from several angles and hit only the tumor and not the other cells. Other than the "halo" they have to screw on their heads, it is truly painless. My husband had Novalis, some have Gamma Knife, some stereotactic radiosurgery (although I don't know if that one means the same as gamma knife). My husband's Novalis treatment was very successful. It took ALL day, though (from 6:00 a.m. until about 6:30 p.m.). They had to treat 6 brain mets, and by the time they put on the halo, did the computer workup and had to reset the machine for 6 views, plus there were several 20-30 minute delays because they kept having to hunt down the doctor to check each set up before they could do the "zap" (grrrr), it was a very long and very tiring day. The next day - no problems, no side effects - everything was just the same as the day before except for a mild headache. The results were two mets disappeared and the other four shrunk about 30%.

Good luck tomorrow.

Peggy

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I don't know about the surgery, but the decadron for the swelling is pretty standard. Be aware that it wrecks havvock with your blood sugars and for some people it gives them mood swings and makes them mean. So if suddenly Dad is not so nice, be patient with him, its not his fault.

Good luck to him on the surgery!

Blessings

Betty

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Hi Kitty,

I had a brain met and it was removed surgically on April 6, 2004. The tumor was in the Ceribelim (sp?) area. It was approximately 1cm. It incapsulated itself upon removal. I did have stereotactic radiation treatment June 4, 2004. It is a different treatment than the Novalis that Peggy's husband had. This is a one shot radiation tretment and it takes about 45 minutes. It is a heavy dose of radiation. The only side effect I had was fatigue and a tiny bit of nausea, no vomiting. I live in California also and had the treatment at the City of Hope. It has been 3 months since the treatment and I am almost back to normal as far as no nausea and getting my strength back. I had an MRI last week and according to my onc. it looks good. I meet with radiation onc. at the City of Hope on the 9th of September. I was on the Decadron for 5 months. As Betty said, it does raise your blood sugar, makes you very hungry and it does alter your mood. Sometimes happy and sometimes anxious and angry. I was only on 2mg total per day. This worked for me. The doctors say normal protocol is 18-20mg per day. I said no I don't need that much, I knew what my body needed. It worked for me. It is to reduce the swelling and inflamation in the brain. This is my experience, if I can help any further you can PM me. Praying for your dad and family...

God Bless,

Karen

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I had the gamma knife procedure twice (11/02 and 5/04). From admission to completion of the procedure, it took about half a day. When the frame came off, I felt alot of pressure in my head for which they gave me a pain shot. I took a nap and was good to go in the afternoon. Where I have it done, they require you to stay overnight in the hospital which in my opinion is totally unnecessary. The next day, on both occassions, I went shopping and away for a long weekend.

For the first treatment, I was on decadron for about 2 months because there was some edema around the lesion. The second time, I did not take any decadron. I absolutely hate this drug. It caused sleeplessness, constipation, increased appetite, and mood swings in a bad direction.

If you have any other questions, please do not hesitate to email me.

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Peggy,

The following is a response to your request to describe the types and advantage of radiosurgery devices.

Gamma Knife - Gamma Knife is the gold standard for radiosurgery. The GK was developed in Sweden in the 1970's. The Gamma Knife is still undesputedly the most precise radiosurgery device. It has no moving parts which enables the high degree of precision

Linear accelerator based systems - novalis is an example of Linac based systems. They are generally not as precise as the Gamma Knife because they have a heavy head that rotates on a gantry. Moving parts always lead to some decrease in precion. The heavy head cause some bending leading to some decreased precision. Novalis has been able to effectively market there device on radio ads. I know that there have been a lot of ads on the radio in Indianapolis and I really think that they are unfortunately misleading. Novalis is a good tool but offers no advantage over Gamma Knife and one could argue that Gamma knife is better because of its increased precision. In fact there is one controversial study demonstrating better results for the gamma knife compared to linear accelerator systems.

Cyberknife - the Cyberknife is a robot that has a linac attached to it. The cyberknife claims to be able to perform radiosurgery without an invasive head frame due to its sophisticated imaging/tracking system. The ability to not use a head frame is certainly an advantage. However, there has to be a loss of precision with this method. Also, there is some loss of precision secondary to moving parts and weight as seen in linacs.

Now, having critiqued the devices, I must say that the precision that I am talking about probably makes no difference for brain metastasis. The Gamma Knife is accurate to withing 0.1 mm. The linacs are probably accurate to within 1.0 mm. However, the Gamma Knife precision is important when there is a tumor a few mm away from the optic nerves or other critical structures.

Hope this helps.

Robert Woodburn M.D.

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The ironic part is my dad is having G. Knife today as well. He has the hallo on right now and they are in a holding patter because they have to go back and take more pictures. Why would they need more pictures when they just took some (with the frame on) this morning. Wondering at my desk if they found some new mets this morning.......... They were scheduled to do it earlier but now won't start until after 4:30 pm......long day.

Is it standard to get the steriod after surgury?

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