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. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. 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.

  • You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.

  • 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 is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • 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 is medicine used to numb an area of your body that will have surgery or a procedure. The medicine may be given in an injection, cream, gel, or patch.

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: You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • 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 healthcare provider. Do not stop taking your medicine unless directed by your healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.

    • Anticonvulsant medicine: This medicine is given to control seizures. Take this medicine exactly as directed.

    • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.

    • 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.

      • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

    • 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.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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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