Gamma Knife Surgery For Malignant Glioma

WHAT YOU SHOULD KNOW:

• Gamma knife surgery for malignant (mah-LIG-nant) glioma (gli-O-mah) is done to remove and treat a tumor (lump) in the brain. The brain is made up of neurons, which transmit and receive nerve signals, and glial cells, which support and nourish neurons. A malignant glioma forms when glial cells become cancerous. The glial cancer cells grow and divide without control or order. These cancer cells often make too much tissue and affect other nearby structures in the brain.
  
  
• A head frame, special helmet and computer are used during surgery. Stereotaxy shows three-dimensional pictures of your brain on a TV monitor. Beams of radiation will be targeted through the many holes in the helmet. These beams pass through your skull and brain until they meet at the tumor. You and your caregiver will decide if this type of surgery for your malignant glioma is right for you. With gamma knife surgery, your malignant glioma may disappear. Your signs and symptoms caused by the glioma will also go away.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

• Problems may happen during surgery that may make open brain surgery necessary. Your brain, eyes, other bones and organs, blood vessels, or nerves may get injured while having the surgery. This radiation may cause nausea (upset stomach), vomiting (throwing up), skin or blood problems, or seizures (convulsions). Even after having surgery, there is a chance that your tumor may come back or not be completely removed.
  
  
• Without treatment, a malignant glioma may grow and push other structures near it. If this happens, there is a danger that the blood or nerve supply to the other structures will be cut off. If this happens, you may have problems seeing, moving, speaking, breathing, or thinking clearly. This may lead to other serious medical problems, such as blindness, seizure (convulsion), or stroke. Ask your caregiver if you are worried or have questions about your surgery, medicine, or care.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.
  
  
• IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
  
  
• Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.
  
  
• Local anesthesia: This is medicine to make you more comfortable during your procedure or surgery. It is a shot of medicine put into the skin. It is used to numb the area and dull your pain. You may still feel pressure or pushing during the procedure or surgery after you get this medicine.

During your surgery: Before your surgery starts, pins will be used to attach the head frame to your head. This is done to hold your head in place during surgery. Your head frame is attached to a helmet and computer. During your surgery, the special bed or couch you are lying on will be moved inside the treatment hood. Using stereotaxy, beams of radiation will be targeted through the many holes in the helmet. These beams pass through your skull and brain until they reach the target tumor. After the surgery is complete, your bed will be moved out of the hood and the head frame and helmet will be removed.

After your surgery: You may be taken to a recovery room where caregivers will watch you closely for any problems. Later, a caregiver will take you back to your hospital room.

• Activity: Caregivers may help you get out of bed to walk on the same day of surgery, or the day after. Ask caregivers if there are exercises that you may do while in bed. Exercise helps blood move through your body and may help prevent blood clots from forming. Your caregiver will tell you when it is OK to get out of bed. Call your caregiver before getting up for the first time. If you feel weak or dizzy while standing up, sit or lie down right away and call your caregiver.
  
  
• Diet: You may be able to eat when bowel sounds are heard. Your caregiver will listen to your stomach for bowel sounds using a stethoscope. You may be given ice chips at first, and then liquids such as water, broth, juice, or soda pop. If you do not have problems after drinking liquids, caregivers may then give you soft foods. Some examples of soft foods are ice cream, applesauce, or custard. Once you can eat soft food easily, you may begin eating your usual diet.
  
  
• Medicines: You may need any of the following:
  
  
  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your caregiver. Keep taking this medicine until it is completely gone, even if you feel better. Stopping antibiotics without your caregiver's OK may make the medicine unable to kill all of the germs. Never "save" antibiotics or take leftover antibiotics that were given to you for another illness.
    
    
  • Anticonvulsant medicine: Anticonvulsants are given to control seizures.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and control vomiting (throwing up). Pain medicine may upset your stomach and make you feel like vomiting. Because of this, pain medicine and anti-nausea medicine are often given at the same time.
    
    
  • Diuretics: You may get diuretic medicine to help decrease swelling in your brain. This may help your brain get better blood flow.
    
    
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain. Medicine may be given regularly, or may only be given if you ask caregivers for it. Tell caregivers if your pain does not decrease enough for you to feel better. Do not wait to ask for your pain medicine until the pain is very bad. The medicine may not work as well at controlling your pain if you wait too long to take it. Ask your caregiver for help getting out of bed if you feel tired or dizzy.
    
    
  • Prednisone: This steroid is often given with other chemotherapy medicines. Prednisone may help shrink lymph nodes back to their normal size. It can also help control the number of leukocytes, which are a type of white blood cell. Do not stop taking this medicine without your caregiver's OK. Stopping on your own can cause problems.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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