Gamma knife surgery - Radiosurgery word cloud

When Is Gamma Knife Surgery The Best Option For You?

All over the world, millions of people who have contracted brain cancer will have soon learned there is more hope for extended survival today than ever before, because of the wide range of treatments available.

For those learning about gamma knife surgery, there may be a lot of interest in this option and the circumstances in which it might be used as the best available means of treating a tumour.

Brain tumour surgery has certainly been in the news a lot recently, with news that the former US Open golf champion Gary Woodland has had surgery to remove most of a tumour.

The 39-year-old, who won his major title in 2019, revealed on his X (Twitter) account that he would have the operation on September 18th, having been diagnosed just over three months earlier. He had been seeking to use medication to treat the lesion but had agreed after consultation to undergo the operation.

A subsequent statement on his social media accounts revealed: “After a long surgery, the majority of the tumor has been removed and he is currently resting.” 

No further details of the nature of the operation were provided, but the use of the phrase ‘long surgery’ may be a strong indicator that this was a matter of invasive surgery in which the brain was physically accessed and most of the tumour excised.

A gamma knife operation would not be quite like this. Firstly, it does not actually involve any invasive surgery at all as it involves the focused direction of radiotherapy beams on the specific affected area of the brain.

Secondly, the time taken does not particularly fit the description ‘lengthy’. Although the duration of the procedure can vary, a period of less than one hour is perfectly normal.

Also, while Gary Woodland is ‘resting’ from his surgery and it required someone else to make the social media posts on his behalf – suggesting he may have been under general anaesthetic – this is different from gamma knife operations, where patients can often return to normal activities within a day or two, though regular check-ups will be needed thereafter.

Of course, the specific details of Gary Woodland’s condition are between him and his doctors, but some factors would determine that invasive surgery instead of gamma knife surgery might be required. Some of these could apply in his case, while others would not.

For example, a gamma knife may not be the best solution for those who are very young or very old, although this would not apply to a patient of Gary Woodland’s age.

Other issues favouring different options could include larger or more complex tumours (gamma knife treatment is best for small and well-defined tumours), bleeding disorders or having a metal implant in the head.

Finding the right treatment for brain tumours is important and there will be times when a gamma knife is not the best option. But when it is, it comes with a lot of advantages in enabling you to resume normal activity sooner than invasive surgery would normally allow. 

Keto Food For Ketogenic And Cholesteral Diet, Healthy Nutritiona

How Can Good Nutrition Help Patients Manage Cancer Treatment

When it comes to treating cancer, surgery, radiotherapy or chemotherapy are most frequently used. 

They are designed to either remove the tumour, kill it or shrink it, so it is no longer at risk of spreading.

However, taking steps to improve the patient’s lifestyle can help them cope with the adverse symptoms of these therapies, as well as make their bodies strong to support their cancer fight. 

Having good nutrition, for instance, is essential, helping to boost the immune system, lower the risk of cancer returning, rebuild tissue, and maintain strength. 

Essentially, cancer patients need to eat extra protein, including meat, fish, eggs, dairy or plant-based proteins. 

One of the biggest side effects of treatment is appetite loss, so it is important for patients to set reminders to eat even if they do not feel like this, as they need to remain strong. 

They might also suffer from a dry or sore mouth or throat, or have trouble swallowing. In this case, swapping to liquid foods, such as gravies, smoothies and soups could help them get their calories in. 

Other side effects can include diarrhoea or constipation, so they need to talk with their nutritionist about how to increase or decrease fibre in their diet.

It is also important to drink plenty of water, particularly on days when appetite is low. 

Other ways to manage food intake while undergoing cancer treatment is to eat smaller meals throughout the day, keep snacks closeby, eat something before bed, have soft or cold foods, consume large meals when feeling well, and only sip liquids during meals to avoid filling up too quickly. 

After the treatment is complete, the symptoms should start to subside, making it easier to eat again. 

It is still important to regain strength and boost mood so patients should continue eating well, making sure there is plenty of fruit and veg in the diet, adding pulses to meals, eating whole grains, choosing low-fat milk options, limiting red meat to three servings a week, and easing off fat, salt, sugar, and alcohol.

,

Stereotactic radiation of prostate cancer in 7 instead of 39 sessions

Radiotherapy uses high-energy beams to kill prostate cancer cells. It is a treatment option for nearly all cancer stages, from early-stage tumours to more advanced and metastatic prostate cancer.

Our radiation oncology team at Amethyst Radiotherapy, represents the largest pan-European network of high-tech radiotherapy centres. Our doctors are committed to providing cutting-edge radiation therapy treatments that effectively target cancer while minimising the risk of side effects. One of these innovative methods is hydrogel spacers.

This technique involves the use of an absorbable gel that temporarily creates a gap between the prostate and rectum, significantly reducing the risk of bowel radiation during treatment. Hydrogel spacers also improve tumor targeting, reducing the total number of treatment sessions from 39 to 7.

This means that you can complete your treatment in 2.5 weeks instead of 8 weeks. The method is used for localised prostate cancer and is performed on an outpatient basis every 2nd working day. A treatment takes about 10 minutes and is painless.

Attached is the example of the first patient we treat using this method. You can see the dose by the very precise color that surrounds the prostate, as well as the white color of the spacer gel that pushes the rectum away from the prostate.

Radiation techniques available at Amethyst Radiotherapy include:

Image guided VMAT radiation therapy

Volumetric modulated arc therapy (VMAT) is one of the most advanced techniques of external radiotherapy. It involves the use of a linear accelerator machine that rotates around the patient while he lies down. The machine precisely delivers radiation doses to the tumor site while limiting the amount of radiation received by the healthy tissues surrounding it.

Stereotactic Body Radiotherapy (SBRT)

Amethyst Radiotherapy is among the few private centres in Europe offering SBRT radiotherapy, and the only one in Austria. SBRT is a cutting-edge radiotherapy technique that can comprise the radiotherapy treatment into a few sessions, by delivering higher radiation doses safely and efficiently. SBRT is an efficient treatment option both for metastasis/lymph nodes as well as for small PET positive relapses for patients that had radiotherapy previously.

Author: Dr. David Kuczer
Literature: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31131-6/fulltext

Moderne Bestrahlung bei Krebs der linken Brust – Präzise, effektiv und gut verträglich

Einleitung

Erfahrungsgemäß hat sich gezeigt, dass alle Patientinnen nach einer die Brust erhaltenden Operation von einer Bestrahlung profitieren.

Sinn der Bestrahlung ist es eine unnötige Amputation der ganzen Brust zu vermeiden und dennoch die gleiche Sicherheit zu bekommen das der Krebs in der Brust nicht wieder zurückkommt. Dadurch konnte die Lebensqualität der betroffenen Patientinnen bei gleichem Therapieerfolg deutlich verbessert werden.

Denn durch die Bestrahlung werden mikroskopisch kleine Tumorherde die sich meist in der Umgebung des sichtbaren Tumors verstecken (aber auch an anderen Stellen in der Brust sein können) abgetötet.

Eine der großen Herausforderungen hierbei ist jedoch der Krebs der linken Brust, da sich hier das Herz in der Nähe des Bestrahlungsgebietes befindet und man auf alle Fälle Schäden am Herzen durch die Bestrahlung vermeiden möchte.

Was bisher geschah…

Eine in den letzten Jahren oft angewandte Methode ist die Bestrahlung in der Phase der tiefen Atmung mit angehaltener Luft. Dadurch hebt sich die Brust und der sehr wichtige Abstand zum Herzen wird größer und dadurch die Schonung besser.

Die Erfahrung hat jedoch gezeigt, dass diese Methode von vielen Patientinnen als anstrengend empfunden wird und die Umsetzung nicht immer gelingt.

Die neue Methode…

Eine neue Methode, die für die Patienten sehr angenehm in der Umsetzung ist, ist die VMAT – Modulierung der Bestrahlungsfelder über eine spezielle Planungssoftware. Bei dieser sehr rechenintensiven Vorbereitungsmethode wird die Verteilung der Strahlendosis sehr genau an Form der Brust angepasst. Dadurch kann die Belastung am Herzen optimal verringert werden.

Zusätzlich wird im Verlauf dieser Vorbereitung auch die Formveränderung der Brust bei der Atmung berücksichtigt. Das ermöglicht eine stabile Behandlung bei normaler Atmung und macht die korrekte Umsetzung der geplanten Therapie sicher und bequem.

So dauert eine Behandlungssitzung selbst lediglich 5 – 10 Minuten während der man entspannt auf dem Behandlungstisch liegt und normal atmet. Die Behandlung ist schmerzfrei und wird gut vertragen.

Eine Behandlungsserie erfolgt über eine kontinuierliche Folge von 15-20 Sitzungen. ( 1 Sitzung pro Tag, 5 Sitzungen pro Woche am Mo-Fr, insgesamt 3-4 Wochen in Folge). Die Aufteilung auf mehrere Sitzungen ist erforderlich um die Behandlung gut verträglich zu machen.

Übliche Nebenwirkung ist ein vorrübergehendes Gefühl leichter Erschöpfung und eine Erwärmung und Anschwellung der Brust am Ende der gesamten Behandlungsserie ähnlich einem Sonnenbrand. All diese Nebenwirkungen sind in der Regel nach einigen Tagen abgeklungen.

Ein Beispiel aus der Praxis

Doch was bedeutet diese moderne Methode konkret für die Schonung des Herzens?

Die gültige Empfehlung für die Schonung des Herzens [1] lautet das das Herz im Durchschnitt weniger als 26 Gy Dosis bekommen sollte um möglichst keinen Schaden zu erleiden (Herz mean < 26 Gy).

Aus Erfahrung spricht man von einem guten Plan, wenn die Dosis am Herzen geringer als 9 Gy ist (Herz mean < 9 Gy) und von einem sehr guten Plan, wenn die Dosis kleiner als 3 Gy ist (Herz mean < 3 Gy).

Nun wie sieht es konkret mit der Belastung des Herzens mit Hilfe der neuen Methode aus?

Ein Bild sagt mehr als 1000 Worte…

Die hier gezeigte Graphik zeigt die Dosisverteilung bei einer Patientin mit Brustkrebs links die mit der modernen Methode behandelt wurde.

Der rote Anteil zeigt die Behandlungsdosis in der Brust, je mehr sich die Farbe wie beim Regenbogen Richtung blau verändert, desto niedriger ist die Dosis (Rot 100%, Blau 10%). Anhand der Graphik erkennt man das sich die Dosis an die Form der Brust schmiegt und nur wenige Zentimeter weiter kaum Strahlung ankommt.

 

 

Quelle Amethyst Radiotherapy Wien

Und wie sieht es nun mit der Strahlenbelastung am Herzen aus? Kann eine Dosis unter 9 Gy oder gar unter 3 Gy erreicht werden?

Die Antwort ist: Ja. Im Falle dieser Patientin beträgt die Dosis lediglich 1,34 Gy (Herz mean = 1,34 Gy)

 

 

 

Quelle Amethyst Radiotherapy Wien

Literatur

  • Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC), “Use of normal tissue complication probability models in the clinic.” (Marks LB, Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S10-9.)

Autor Dr. David Kuczer, Facharzt für Radioonkologie und Strahlentherapie

Globaler Strahlentherapiemarkt wird voraussichtlich boomen

October 26, 2022

Die Zahl der Menschen, die eine Krebsbehandlung mit Strahlentherapie suchen,  ist in den letzten Jahren deutlich gestiegen, da neue Techniken und verbesserte Technologien sie effektiver gemacht haben. Jetzt hat die neueste Forschung gezeigt, dass es mehr Wachstum auf dem Weg geben wird.

Markets and Markets Research hat prognostiziert, dass der globale Wert des Marktes von 6,3 Milliarden US-Dollar in diesem Jahr auf 8,1 Milliarden US-Dollar bis 2027 steigen wird, bei einer durchschnittlichen jährlichen Wachstumsrate (CAGR) von 5,1 Prozent.

Der Bericht hob mehrere verschiedene Faktoren für dieses Wachstum hervor. Erstens gibt es die fortschreitende Technologie, die eine solche Behandlung effektiver machen kann. Zweitens ist auch die steigende Inzidenz von Krebs ein Schlüsselfaktor.

Damit einher geht ein zunehmendes Bewusstsein für die Vorteile, die die Strahlentherapie bringen kann, und zusätzlich zu all dem gibt es mehr Investitionen in das Gesundheitswesen, sowohl im Allgemeinen in Entwicklungsländern als auch durch öffentlich-private Partnerschaften auf der ganzen Welt, um weitere Fortschritte in Forschung und Behandlung zu erzielen.

Im Jahr 2021, so der Bericht, war die externe Strahlentherapie die am häufigsten verwendete Behandlung bei vielen Krebsarten, wobei die Verwendung von bildgeführten Behandlungen häufig bei Hirntumoren eingesetzt wurde, obwohl der am häufigsten auf diese Weise behandelte Krebs Prostatakrebs war, der eine der am häufigsten auftretenden Krebsarten bei Männern ist.

Der Bericht ist nicht der einzige, der diese Woche veröffentlicht wurde und einen starken Anstieg der Strahlentherapie auf der ganzen Welt vorhersagt. Reportlinker.com hat eine neue Studie veröffentlicht,  die ein noch größeres Wachstum bei einer CAGR von 6,1 Prozent zwischen 2022 und 2028 prognostiziert. Damit steigt der globale Marktwert auf 9,3 Milliarden US-Dollar.

Wie im anderen Bericht wurden technologische Fortschritte, ein größeres Bewusstsein und höhere Investitionen in das Gesundheitswesen als Gründe für das Wachstum angeführt. Während Nordamerika voraussichtlich eine Vorreiterrolle übernehmen wird, kann auch Europa, einschließlich Österreich, dank dieser Faktoren mit einer Expansion des Marktes rechnen.

Czech Republic Marks 30 Years Of Gamma Knife Surgery

July 2, 2022

The use of Gamma Knife surgery to treat otherwise incurable brain tumours has been a life-saver for many thousands of patients – and it has been around for longer than many imagine.

For example, over the border in the Czech Republic the technique of using gamma knife surgery has been going on for 30 years, Radio Prague International reports.

The first one used in the country was funded by a nationwide fundraising campaign, focused on the case of a 12-year-old boy called Misa, who had already suffered brain damage through one haemorrhage and was at risk of another without a gamma procedure.

The Gamma Knife used on Misa was subsequently modernised twice and then replaced with a more modern version in 2009, but the benefits of gamma knife radiosurgery have been felt by some 24,000 patients. Misa himself died in 2018, but this meant his life had been extended by nearly 30 years.

For a country with a poor economy that had only just left behind decades of Communism to have raised CZK 160 million Crowns via public subscription was a huge effort. The good news here in neighbouring Austria is that the same procedure is available in Vienna, with the prospect of saving thousands of lives and extending others.

According to one new report about the market for the procedure, central Europe will be one of the places where it is used most in the 2020s.

The study by Future Market Insights titled ’Gamma Knife Market: Global Industry Analysis and Opportunity Assessment 2015-2025’ predicted that between 2021 and 2031 Germany alone would account for a fifth of procedures in Europe.

It also said the worldwide market for the procedure would see compound annual growth of 5.9 per cent, with the global value of the market rising from US$287.3 million to US$507 million.

Ultimately, however, it is not all about money, whether it is the funds raised by the Czechs 30 years ago or the future value of the market. It is about saving the lives of people with brain tumours and other otherwise inoperable conditions and giving them many more years of life.

How Does Radiotherapy Help Relieve Pain?

July 19, 2022

Radiotherapy and radiosurgery and primarily used in a highly targeted way to help remove malignant tumours and other cancerous cells before they can spread and cause considerable harm.

In particular, the precise nature of Gamma Knife radiosurgery allows for the treatment of brain tumours and complex neurological conditions such as trigeminal neuralgia.

However, whilst it is primarily used for the eradication of tumours, radiosurgery techniques can also be used to assist with pain relief for certain types of cancer that are untreatable or have become untreatable.

This is known as palliative radiation therapy and is primarily used for managing the debilitating pain that some people suffering from bone cancer can feel, although it can be used to manage the pain of skin cancer and other forms as well.

To explain how radiotherapy helps with pain relief, we need to understand why cancer cells can cause pain to begin with.

Tumours, lesions and growths associated with cancer can grow, and as they grow they can start to press against nerves, organs and bones. This pressure can feel painful and is compounded by the pain caused by tumours destroying healthy tissue surrounding them.

In the case of bone cancer, this is compounded by bone cells being weakened, increasing the chance of painful breaks.

Radiotherapy kills cancer cells and shrinks tumours, which can help ease the pressure on parts of the body the cancer is affecting, and increase the viability of surgery to remove tumours, even if not every growth can be operated on.

Whilst in some cases radiotherapy takes the form of radiation drugs that are injected into a target area, the main form of radiotherapy is external, which uses a machine such as a gamma knife to aim beams of radiation to target cancer cells.

After the course of treatment, it can take a few weeks, but the majority of people who have had palliative radiotherapy have claimed it has reduced or removed pain caused by the cancerous cells.

World Brain Tumour Day Marked

June 15, 2022

June 8th was World Brain Tumour Day, an event established to raise awareness of brain tumours, dispel misunderstandings, help people spot the signs that indicate they need to seek a scan and highlight the array of treatments that are available.

For this reason, a plethora of articles has been published on the topic to increase understanding and help generate better health outcomes, not least among those who might not otherwise have spotted early signs that something is amiss.

Indian news provider the Economic Times, for example, published a series of tips on what to look out for, with these ranging from milder and less unusual symptoms like headaches to more specific problems like seizures, changes in personality, clumsiness and cognitive impairment.

In the past, developing a brain tumour would normally have been a death sentence. But that is anything but the case now. For one thing, many tumours are benign and non-cancerous; treatments for them will prevent excess pressure building on the brain, which will then ensure they are no longer dangerous.

Cancerous tumours are another matter, of course. They can be the result of specific brain cancer, or another form of cancer spreading across the body including the brain. Either will be deadly unless successfully treated and often once it is very advanced there is often little or nothing that can be done, as is so often the case with cancer. That’s why early diagnosis matters.

As Healthshot notes, the good news is that if a cancerous tumour is detected, the chances of survival are now far greater than they used to be. It stated: “The days of mutilating and incapacitating surgeries are long gone, and modern neurosurgery is really rather safe and successful,” adding that Gamma Knife Surgery is now a key tool in the “modern day” arsenal available to neurosurgeons.

It added: “The post-surgery outcomes have also been revolutionised by radiosurgery. The mortality and morbidity rates have decreased significantly, and we now add life to years rather than just years to life.”

Knowing this can make a crucial difference in more ways than one. The most obvious is that gamma knife treatment offers the hope of a life-changing operation that leaves no scars, no rehabilitation period and potentially a complete recovery.

Secondly, there is the behavioural implication of this. Fir some who might suspect there is a problem, there will be a reluctance to get checked out for fear of what the diagnosis might be. This fear is bound to be greater for any condition that is either incurable or for which the treatment can be arduous and traumatic.

Therefore, knowing that a treatment can be both effective and not come with a lot of side-effects and pain may help some people go forward and get themselves examined if they start to show possible symptoms.

With the medical world both knowing more than ever about brain tumours and the treatments available being more effective and now non-invasive, there is far more hope for patients than there ever was – something that warrants lots of awareness on the other 364 days of the year too.