Stereotactic Radiosurgery
Stereotactic radiosurgery (SRS) is a non-invasive treatment that uses dozens of tiny radiation beams to accurately target brain tumors with a single high dose of radiation. Despite its name, SRS is not a surgical procedure and does not require an incision or anesthesia. However, the radiation beams are as small and precise as a scalpel.
A computer uses three-dimensional images from MRI and CT scans to determine the exact dimensions of the tumor. It then calculates the radiation dose to be administered by nearly 200 radiation beams. This allows radiosurgeons target the tumor without affecting delicate structures nearby. SRS can treat multiple lesions in a single procedure.
Because stereotactic radiosurgery is typically done in just one outpatient session, patients are spared from multiple radiation treatments and can return to a normal routine within a few days.
In some cases, additional SRS treatments may be ordered by your oncologist. The single dose of radiation is split into smaller doses, or fractions. This procedure is known as fractionated stereotactic radiosurgery.
Stereotactic radiosurgery is effective for treating tumors in small areas in the head and neck that cannot be reached by surgery. It also can be used on patients who cannot tolerate surgery or have had previous radiation therapy to the brain.
There are several types of SRS systems. MD Anderson uses Gamma Knife®, a photon-based radiosurgery system. Gamma Knife is used to treat:
- Cancer that has metastasized (spread) to the brain, head or neck area
- Tumors in the base of the skull
- Malignant gliomas
- Acoustic neuromas
- Pituitary tumors
- Meningiomas
I woke up one morning and noticed I was having trouble hearing in my left ear. I also had a loud ringing in that ear. I made an appointment with a local ENT, who performed an MRI.
That’s how I was diagnosed with acoustic neuroma, a benign tumor in my left ear. Once this skull base tumor was discovered in April 2019, I decided to call MD Anderson to set up an appointment. My sister-in-law works at MD Anderson, and I knew that if I was going to tackle this aggressively, I needed the best team available.
I was quickly seen by neuro-otologist Dr. Paul Gidley and neurosurgeon Dr. Franco DeMonte, both of whom specialize in acoustic neuroma. They did an amazing job of explaining my options, what to expect and how to move forward. We first decided to watch and wait for six months. However, since the tumor continued to grow, after three months my care team decided it was time for surgery.
I had multiple visits with my doctors to go through how the surgery would work. I am a visual person, so they walked through each MRI with me to make sure I knew what they were going to do.
The benefits of Gamma Knife® surgery
On Sept. 24, 2019, Drs. Gidley and DeMonte performed the surgery. They discovered the tumor would be impossible to remove without excessively increasing my risk for hearing and facial paralysis.
Since the tumor had been growing, my care team recommended I undergo Gamma Knife® stereotactic radiosurgery. This is a minimally invasive procedure that kills tumor cells with highly focused, targeted radiation. It’s performed during a single appointment. Unlike traditional surgery, it uses multiple cobalt-60 sources of gamma ray radiation to target the tumor precisely with rapid dose fall-off, so it’s less likely to kill healthy cells.
My Gamma Knife radiosurgery
I went through Gamma Knife radiosurgery on Nov. 25, 2019. My radiation oncologist, Dr. Mary Frances McAleer, made sure I understood everything and was comfortable with the plan. On the day of my Gamma Knife radiosurgery, she came to see me multiple times and explained what the team -- including medical physicists, nurses, radiation therapists and physicians -- were doing and what I should expect next.
My nurses were amazing. The thought of having a frame affixed to my head with titanium screws was scary, but they made me very comfortable. To prepare for the treatment, Dr. DeMonte numbed my head with a local anesthetic for the frame placement. Once I had the frame on my head, it felt like wearing a tight head wrap. The Gamma Knife treatment itself was simple, and I even got to listen to music during the procedure.
Although I was disappointed when I found out that my tumor was not removed during the initial surgery, I am happy my care team was experienced enough to know that it was best not to remove it. I have since recommended Gamma Knife radiosurgery to many people in the acoustic neuroma support groups in which I’m involved.
Life after my Gamma Knife radiosurgery
After my Gamma Knife radiosurgery, I went home and took a nap. I had a slight headache but nothing awful. I took one more day to rest and then returned to work.
It took a couple of months for me to regain my balance due to inflammation of my inner ear where the tumor is located, so I used a cane for a little while. I also wear a hearing aid now to help me hear on my left side. But overall, I lead a very normal life now.
I understand how difficult getting through surgeries is and how long it takes your brain to recover from the trauma. I’m happy to be here and happy that I had an amazing team of doctors. If you or a loved one is diagnosed with acoustic neuroma, look for an excellent team like I did when choosing your treatment. The staff at MD Anderson are experts for a reason. That’s why I’m glad I trusted them with my care.
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