Stereotactic Radiosurgery
When doctors are unable to treat a disease with surgery due to the location of the problem or the health of the person who needs the treatment, then they might consider stereotactic radiosurgery (SRS) to address some of these problems.
Stereotactic radiosurgery is a form of radiation treatment that makes the use of focused delivery of radiation in high doses to precise locations in your body. It can be used to treat certain kinds of tumors and other abnormalities in the spine, brain, neck, lungs, or liver.
The technique was developed in the 1950s by Swedish neurosurgeons to treat small tumors located deep in the brain without causing damage to the nearby healthy tissues. Doctors now use this technique to treat any part of the body where tumors are hard to reach or are close to any vital organs.
Purpose
Though stereotactic radiosurgery was initially developed to treat small, deep brain tumors, now it is used for a wider array of problems in the brain as well as other parts of the body. Doctors now use this method for treating areas in the brain or anywhere else that are hard to reach or close to vital organs or they also use it to treat tumors that have moved within the body. Various problems can be addressed with Stereotactic radiosurgery, some of them including:
- Deep brain tumors
- Pituitary tumors
- Cancers of the eye
- Residual tumor cells after surgery
- Neurological problems, such as trigeminal neuralgia
- Arteriovenous malformations, which are tangled blood vessels leaking and disrupting your normal flow
- Parkinson’s disease
- Epilepsy
- Tumors in the liver, lung, spine, prostate, abdomen, head, and neck
Generally, doctors prefer stereotactic for treating older adults or people who are too sick to undergo conventional surgery. Sometimes, after some undergo surgery for removing a cancerous tumor, a doctor can use stereotactic radiosurgery to kill any remaining tumor cells that the surgeon might have missed.
Preparation
You will generally have one or more imaging scans, such as a CT scan or an MRI, before your treatment. Your doctor might inject a contrast agent as it can help them understand the size and location of the tumor or any other structure that they will need to treat. A lot of planning will go into structuring your treatment as well.
Let your doctor know about any medications you are taking or any implants or devices that you have such as:
- A pacemaker
- An artificial heart valve
- Stents
- Implanted pumps
Remember not to eat after midnight on the day of the procedure. Also make sure that you remove items such as eyeglasses, contact lenses, or dentures before the treatment.
Procedure
The procedure can be of various types depending on your condition.
Gamma knife radiosurgery involves aiming nearly 200 beams of highly focused gamma radiation at the target region, such as a tumor. This is used for small- to medium-sized brain or head and neck abnormalities as well as functional brain disorders such as essential tremor.
Linear accelerator machines can involve the use of high energy X-rays to target large tumors by delivering radiation over several treatments. This is sometimes termed as CyberKnife technology.
Proton beam or heavy-charged-particle radiosurgery is used by the doctor for treating smaller tumors throughout the body.
All these methods require a lot of imaging with CT scan, MRI, or maybe other methods, so that your doctor will know where exactly the tumor is, as well as its size.
The professionals in your surgery team can include:
- a radiation oncologist
- a dosimetrist
- a radiologist
- a medical radiation physicist
- a radiation therapist
- a radiation therapy nurse
It is important for you to stay completely still for these methods to work. This will help to ensure that your doctor is able to target the radiation to the affected tissues and that the treatment doesn’t affect as much of your normal tissue. Your doctor might also place strips on you so that you are immobile, or they might place a special facemask or a frame that attaches to your scalp to keep you from moving during the treatment.
You will lie down on a table which will be sliding into a machine. This machine might spin around you to change the angles of the radiation beams. Throughout the procedure, your healthcare team will be able to watch you on a camera. You will be able to speak to them through a microphone if you experience any problems.
Generally, the treatment takes around 30 minutes to one hour. Though your problems should be addressed in a single session, in a few cases, additional treatments can be required.
After the procedure
You should be able to eat and drink after the procedure is complete. You might experience minor bleeding or tenderness at the pin sites. If you experience any headache, nausea, or vomiting after the procedures, you will receive appropriate medications.
It generally takes weeks or sometimes even months for the targeted cells to stop reproducing and die off. Your doctor will continue to check the size of the tumor and the treated area using CT scans and MRI.
Risks
Since stereotactic radiosurgery doesn’t involve surgical incisions, it is generally less risky as compared to traditional surgery.
Some of the early complications or side effects that might occur after the surgery include fatigue, swelling in scalp and hair problems.
In some cases, people might also experience late side effects, such as any kind of neurological problem. This can happen several months after the treatment.