Stereotactic Gamma Ray Surgery For Malignant Intracranial Tumors

What you should know

• Stereotactic gamma ray surgery is used to treat intracranial tumors. Your brain is made up of glial cells and neurons which transmit and receive nerve signals. Malignant intracranial tumors are lumps of cancer cells that can grow anywhere inside your head. They include tumors inside the eye, such as a uveal melanoma, and tumors in your sinuses. Cancer cells can break off from the tumor and travel through blood or lymph vessels. They can spread to other parts of your body, and grow into new tumors. Cancer cells from other parts of your body can also spread to your head and grow into a tumor. These cells may come from tumors in your lungs, skin, breast, or kidneys.
  
  
• During gamma ray surgery, x-ray beams cross at a single point to kill the tumor cells. Normal tissues near the tumor get little or no radiation. A head frame may be used to keep your head very still. You may need one or more treatment sessions. Gamma ray surgery can stop your tumors from growing bigger, and help prevent cancer cells from spreading. With this treatment, your tumors may get smaller or go away, and relieve your symptoms such as seizures and headaches.

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

• Radiation kills tumor cells but can also damage other normal cells in your head. Your brain, eyes, blood vessels, or nerves may get damaged while having gamma ray treatments. You may have headaches, nausea (upset stomach), vomiting (throwing up), seizures, or problems seeing. You may have trouble remembering things. You can have alopecia, a condition where your hair thins and falls out. If the pituitary gland in your brain is damaged, it may stop working correctly. Because of this you may need to take more medicines. There is a chance that your tumor may come back, or may not be completely removed. In some cases, a new tumor may grow after this treatment.
  
  
• Without treatment, malignant intracranial tumors may grow bigger and damage other tissues around them. The blood or nerve supply to nearby structures may 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, seizures, or stroke. Cancer cells can spread and grow into new tumors in other parts of your body. Ask your caregiver if you are worried or have questions about your treatment, medicine, or care.

Getting Ready

The week before your treatment:

• Ask a family member or friend to drive you home after your treatment. Do not drive yourself home.
  
  
• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• Tests: You may need x-rays, a computerized tomography (CT) scan, or magnetic resonance imaging (MRI). These tests will help your caregiver check the location, shape, and size of your tumor. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your treatment:

• Ask caregivers about directions for eating and drinking.
  
  

The day of your treatment:

• Write down the correct date, time, and location of your procedure.
  
  
• Ask your caregiver before taking any medicine on the day of your treatment. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the treatment. It also explains the problems that may happen, and your choices. Be sure all your questions have been answered before you sign this form.

Treatment

What will happen:

• You will be taken to the room where the treatment will be done. You will get treatment on a special table that can be moved to different positions. Shields to block radiation from going to other parts of your body may be put over you. A head frame may be used to hold your head very still during the treatment. You may get medicine to numb the area where the frame will be placed. The head frame may be secured using pins.
  
  
• When your treatment starts, the special bed you are lying on will be moved inside the treatment hood. MRI or CT scans are used to help point the beams directly at your tumor. Your caregiver will set the shape of the beams, and how much radiation your tumor will get. When the machine is turned on, the beams will pass through your skull and brain and reach your tumor. You will need to lie still and relax during the treatment. The treatment should not be painful, and you may not feel any pain or discomfort. After the treatment, your bed will be moved out of the hood. The head frame and helmet will be removed.

After your treatment:

You will be taken to a room where caregivers will watch you closely for problems. Do not try to get out of bed until your caregiver says it is OK. Later, you will be taken to your hospital room or you may be able to go home.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You have a fever.
  
  
• You cannot make it to your treatment on time.

Seek Care Immediately if

• You had a seizure.
  
  
• You suddenly have problems thinking about, and remembering things.
  
  
• You have sudden trouble breathing or chest pain.
  
  
• Your arms or legs suddenly get weak, or you lose feeling in them.
  
  
• Your headaches, seizures, or other symptoms get worse.

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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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