Gamma Knife Radiosurgery Archive Questions

Below are Dr. Kwok’s answers to Gamma Knife Radiosurgery questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.



Now displaying records 1 to 15 of 29.

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Q : 1 11/08/2009	My 38-yo sister-in-law has metastatic breast cancer with 5 lesions in the brain. Total of 7 years since onset of original diagnosis, with this being the second metastatic occurrence. MRI shows 2x1cm in left frontal lobe, 2.7x3cm in parietal lobe, 1.7cm in the posterior fossa, and small lesion in cerebellum. She is receiving oral chemo and completed multiple radiation treatments. Doctors said inoperable. Would she benefit from the Gamma Knife procedure, especially in the posterior fossa? Possibly. Typically when there are 5 lesions, we do not operate (craniotomy). However, if she is in good shape, she may potentially benefit from Gamma Knife stereotactic radiosurgery. The decision can only be made after a thorough consultation and examination and a review of the the MRI scans before and after whole brain radiation.
Q : 2 10/09/2009	I have an benign ependymoma. I had surgery in 1998 and localized radiation in 2006. It has now been recommended that I have surgery again. Do you have any recommendations for post-op experimentatal ways to deal with it? Gamma Knife has been discussed. This is a very complicated case and all depends on the location of your ependymoma and the amount of radiation you received. Whenever safe and possible, a maximal safe surgery should be performed before a decision is made regarding repeat radiation in the form of Gamma Knife radiosurgery or fractionated repeat radiation. So much of this depends on the location of the tumor in relation to critical structures like the brain stem and the optic apparatus. I strongly recommend a second opinion from an experienced hospital with a strong foundation in multi-disciplinary (Radiation Oncology and Neurosurgery) teamwork. It is critical you do so before a decision is made. Good luck.
Q : 3 06/27/2009	I am scheduled to have radiotherapy after having surgery to remove a craniopharyngioma which is located close to the optic nerve. Is it safe to have radiotherapy? Could it cause me to lose my vision? Blindness, pituitary problems and brain damage are all problems associated with receiving radiation to these tumors. However, the tumor can also cause these problems (and is more likely to do so if untreated). In the balance, I would not expect fractionated radiotherapy to cause you to lose your vision. The Gamma Knife is usually not an option, as it is more likely to cause blindness.
Q : 4 06/17/2009	My mother recently finished treatment for lung cancer. Her doctors are now telling her that she will need radiation to decrease the chance of the cancer spreading to the brain. However, they have said that there are no tumors and no cancer present in the brain at this point. Is this a common practice? Yes, it is what is called prophylactic craniospinal radiation and it is a common practice for lung cancer. A radiation oncologist could give you a more informed opinion.
Q : 5 06/08/2009	I was diagnosed with a large left lateral ventricular tumor (5.3cm x 5.4ml x 9.3cm AP diameter). I presented with symptoms of a lasting mild headache and some numbness of the right arm and right leg prior to performing the MRI, and NO dysphasia, hearing or vision problems, or any other neuro deficits. My doctor thinks this is most probably a benign tumor (possibly Epindymoma) and suggested the use of Gamma Knife as a possible treatment option. Others suggested that the size of the tumor was too big to use Gamma Knife. We would appreciate it if you could comment on whether or not it is applicable and the possible benefits of its use. The size, if the dimensions you give are indeed correct, is too large to even consider gamma knife. A definitive diagnosis needs to be made requiring at least a biopsy. Finally, I would not consider an ependymoma to be a benign diagnosis. These situations often require radiation, chemotherapy and have a worrisome recurrence risk.
Q : 6 05/17/2009	I have multiple sclerosis and trigeminal neuralgia. I have had 3 rhizotomys and a MVD to no avail. I am on Neurontin, but it has broken through. I can't talk, brush my teeth, eat, drink, or smile. I would like to know if you think the Gamma Knife could help me. Thank you so much for your time. The Gamma Knfe could help you, but it might not. The odds are not in your favor, but it may still be worth a try.
Q : 7 04/12/2009	My great nephew, age 5, has a brain stem glioma. He is currently receiving radiation therapy and chemotherapy. Is the gamma knife procedure a possibility for a 5 year old with this condition? Not usually, but the gamma knife procedure is sometimes considered in unusual situations. However, it should only be considered if it will become a part of an overall treatment plan.
Q : 8 03/27/2009	My young daughter had an ependymoma brain tumor removed. She will also take chemotherapy. Our family has had many deaths from cancer. Is there enough data to make educated guesses on the extension of lifespan with and without treatment for this cancer? Yes, we do have some data with ependymomas. The more complete the surgical removal, the longer the survival should be. Chemo and radiation improve the outcome in incompletely removed tumors. With young children, they may withhold radiation because of long-term side effects, and use radiation for recurrence.
Q : 9 03/03/2009	I suffer from left temporal lobe epilepsy and have all my life. Medication will never control my seizures, so I am looking into Gamma Knife surgery. Could you tell me if Gamma Knife surgery is at all possible for my condition? The use of the Gamma Knife for epilepsy is controversial. There are some studies in process to look at the potential of Gamma Knife to help with epilepsy. The indications for Gamma Knife are similar to those for standard epilepsy surgery.
Q : 10 12/08/2008	Can a symptomatic pineal cyst be treated with the Gamma Knife and if so, how dangerous is the surgery and what would recovery be like? Usually not, unless the cyst is associated with a tumor. The danger is in proportion to the size of the pineal tumor. If everything goes well, recovery is a matter of hours.
Q : 11 10/26/2008	I am a 40-year-old male who had 2 ependymomas removed 20 years ago, 1 at l4/l5 and a year later at s1 s2 nerve root. The tumor at s1/s2 nerve could not be completely resected, so I had the maximum does of radiotherapy. I have just had an MRI showing a 1cm x 0.5cm enhancing mass on the s2 and s3 nerve. Can the Gamma Knife be used for this scenario? No. The Gammma Knife is only designed for intracranial targets. However, other radiosurgical techniques may be considered, such as Trilogy (which is the newest generation of linear accelerator based radiosurgery systems http://www.umgcc.org/trilogy/what_is_trilogy.htm). Trilogy is used in the spine as well as the brain. I would recommend consultation with a physician who uses Trilogy. Usually this is a radiation oncologist.
Q : 12 09/03/2008	I have been seeing an oval in the center of my vision, in both eyes, for several months. It blocks my vision partially, consists of a flashing pattern of light and dark, and increases or changes when I'm in the sunlight, especially when trying to drive. It's there all the time, eyes open or closed. I have been seeing a retina specialist who has no idea what is wrong. Is it possible that this is being caused by my brain? Should I seek another type of specialist? I have had a variety of other symptoms start at the same time including extreme fatigue, migraines, memory loss and confusion. Yes, this could be a neurologic problem. I would recommend consulting with a neurologist.
Q : 13 08/29/2008	I am 63 years old and just found out I have a tumor of the pituitary gland. I had a CT scan because of my left cheek bone being enlarged. Is this a symptom of the tumor? No, this is not a symptom of a pituitary tumor; however, other tumors in this region could cause an enlargement of your cheek bone.
Q : 14 07/11/2008	I am a 40-year-old with an acoustic neuroma, 1.5cm in canal and attached to the acoustic nerve. Everything I am reading opts towards surgery. Would Gamma Knife be an option? Any thoughts would be greatly appreciated. This is an area where there is a choice between surgery and Gamma Knife. The younger the patient, the more the doctor would be inclined toward surgery. It is important that you seek consultation at a center that can offer you both options and the surgeon can discuss both with you.
Q : 15 05/03/2008	My husband will undergo a Gamma Knife treatment for an arteriovenous malformation. How long do we have to wait to have an intercourse after the treatment? If I get pregnant after his treatment, will it effect the baby in any way? I am assuming that his physician has not placed your husband on any restrictions pertaining to intercourse prior to the gamma knife treatment. If that is the case, there should be no restrictions relative to the Gamma Knife treatment. There should be no effect of your husband's Gamma Knife treatment on the baby conceived after the treatment.

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