Friday, April 8, 2011

Brain Surgery as an Outpatient Treatment with Gamma Knife

Through a media briefing, I recently discovered that brain tumors can now be removed without open surgery. Brain cancer treatment can now be an outpatient service. That, totally racked my brain!

From my recent trip to Mindanao, modern medical equipment in facilitating the early diagnosis of tumors in the breast was already a big leap. Having found this advanced imaging equipment outside the big cities opens the opportunities for more rural folk, who mostly do not have access to medical consultations and modern medical facilities. Many Filipinos even travel to the US or Europe for sophisticated medical treatment that are not available locally.
Leksell Gamma Knife

Surprisingly, it is not new to the Philippines. The Philippines Gamma Knife Center was founded in 1998. Since then, they have treated 1774 patients (only a fraction of Filipino patients with brain disorder). 

Among about 200 Leksell Gamma Knife machines, there is only one of its kind in the Philippines. It can be found at The Philippine Gamma Knife Center in San Juan. The center is located inside the Cardinal Santos Medical Center Compound. 
There are only 19 nuerosurgeons trained to operate this sophisticated machine. And they come as far as Bacolod, Cebu, Dagupan and Davao. The team is composed of Neurosurgeons, a Radiation Oncologist, a Medical Physicist, an Anesthesiologist and a Neurosurgical Nurse. For patients seeking treatment for brain tumors, Gamma Knife Surgery gives a 95% success rate.

Dr Theodor Vesagas, MD explained the treatment planning and treatment process. Prior to admission, the Center requires patients to submit a referral or a digital image where the neurosurgeons can study whether a patient’s specific condition can be addressed by the Gamma Knife Radiosurgery.
Dr Vesagas explains the Treatment Planning Stage
Surgery actually takes place in 1 day and patients can return to work the next day without serious complications. That, for me, is priceless. 
Upon admission, patients will be fitted with a frame. It is screwed tight and attached to the skull for accuracy. The measurements on the frame will guide the team during the treatment planning stage. 
lightweight head frame
 When the frame is in place, the patient will have another imaging scan to see the latest condition of the tumor. From these up-to-date images, the team will make the treatment plan in accordance with the treatment planning software especially programmed for the Leksell Gamma Knife. After the plan has been laid out, re-checked and approved by the team, the patient is now ready for Gamma Surgery. 

Patients are awake and can talk to the doctors anytime through a built-in speaker. Most treatments take less than an hour. Treatments that need further adjustments of the collimator (it’s a bowl that connects the frame on your head to the Gamma Knife). The size and the shape of the treatment area determine the size of the collimator for the specific treatment.

There are, however, limitations. The equipment is designed
for precision. It was optimized to treat small lesions and tumors of up to 3cm. Bigger tumors are recommended for other types of radiation treatment like the Cobalt. But unlike the Cobalt Treatment, Gamma Knife Surgery has minimal, 0.5%, radiation to surrounding healthy tissue. So you reduce the risk of cellular damage to tissues near the tumor.

Also, the lightweight head frame may not fit extra large head sizes. 

Complications, so far, have ranged from short-term headaches (caused by the attached frame on the head) and vomiting (due to substances released by the brain when it received the radiation). Nevermind these, I get them during severe PMS situations. I would opt for temporary inconvenience rather than open surgery.

Having read this, I hope you, my dear reader, will extend the service and care by informing patients suffering brain disorders. Let them know so that they have better options and more chances of survival to enjoy life with their loved ones.



High technology is such a very helpful thing on this kind of surgery so that finding the right doctor is probably the most important thing. Although these procedures have become more common, they are no less serious than a regular surgery, and a choice of doctor is just as important.

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Yes Aljur, I definitely agree with you. But for most local patients-who would have limited access to good doctors, recommendations from friends and trusted parties are next to the best option (consultations can be quite expensive). It would be difficult to undergo surgery if one doesn't know or have faith in the team of surgeons.

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