When diagnosed with a medical condition, it is natural to wonder what comes next, including your treatment options. Taking the time to educate yourself is a great way to become more comfortable with the terminology, procedures and the condition itself.
The following is designed to help you understand the differences between two common treatment options, Gamma Knife radiosurgery and traditional surgery, and when each might be appropriate. Though your treatment plan depends on your individual needs, having a broad understanding can help shed light on why your doctor has made certain recommendations.
Overview of Gamma Knife and Surgery
Traditional surgery is what many people think of when it comes to treating conditions of the head and neck. Surgery is performed in a hospital setting, typically while you are asleep. There is usually a hospital stay involved, along with a recovery period and activity restrictions.
By contrast, Gamma Knife radiosurgery is not a surgery at all but a specialized form of radiation therapy. Using advanced technology, the doctor is able to treat only the area of interest with multiple highly focused beams of radiation. The radiation targets only the affected area, sparing healthy surrounding tissues and producing less unpleasant side effects than traditional radiation therapy.
Generally, there are many cases where both Gamma Knife and surgery are viable treatment options. However, as you read on, you will notice a trend of recommending Gamma Knife when surgery is not an option or the treatment area is small, whereas surgery is common for large tumors that need to be physically resected.
The following is a list of some of the head and neck conditions that can be treated using Gamma Knife radiosurgery, traditional surgery and/or a combination of the two. Keep in mind that these are just general guidelines and not an exhaustive list, and your doctor may consider other factors when recommending Gamma Knife versus surgery.
Acoustic Neuroma/Vestibular Schwannoma
An acoustic neuroma is a benign brain tumor that develops from the vestibulocochlear nerve, the cranial nerve responsible for hearing and balance. These are often small and go undetected. However, if the tumor begins to impinge on nearby tissues and cause symptoms, treatment may be necessary.
Both Gamma Knife radiosurgery and traditional surgery are viable options for acoustic neuroma. However, there are some cases where one may be recommended over the other. For young patients and large tumors, surgery may be required to remove as much of the tumor as possible, sometimes followed by Gamma Knife. For small tumors or patients who are not good surgical candidates, Gamma Knife is typically the first treatment of choice.
Brain metastases occur when cancers spread from another site in the body, such as the breast or lung, and grow into a tumor made up of the origin cells. These tumors will not always cause symptoms but may if they put pressure on surrounding structures.
Because brain metastases can be made up of different cell types, the treatment approach will depend on the originating tissue. Some types of tumors will respond better to one treatment over another, so the first step may be a biopsy to find out what types of cells are present. Potential treatment options include Gamma Knife radiosurgery, traditional surgery, whole brain radiation therapy and chemotherapy.
Craniopharyngioma, Pituitary Tumors and Other Brain Tumors
A craniopharyngioma is a benign tumor that forms before birth from cells of the pituitary gland, while a pituitary tumor is within the gland itself. Because the pituitary gland is made up of different types of cells that release very different hormones, symptoms can vary among patients. Your symptoms may be due to the presence of excess hormones or because your tumor is physically pushing on other structures.
Both Gamma Knife and surgery are potential treatment options for most brain tumors. This includes other benign brain tumors, such as pineal tumors and skull base tumors. If your tumor is particularly large, your doctor may suggest a combination approach of surgery, followed by Gamma Knife to eradicate any remaining cells.
Glioma and Meningioma
Gliomas and meningiomas are brain tumors that are classified based on their grade, or how aggressive they are. Because they are variable in size and aggressiveness, treatment will depend on your individual condition. However, surgery is typically required to remove all of the tumor to prevent it from spreading further. In some cases, such as recurrence, Gamma Knife may be used to destroy the tumor.
Trigeminal neuralgia is a chronic pain condition that affects areas of the face and neck. The cause is often a blood vessel near the brain pushing on the trigeminal nerve, which transmits sensation from the face to the brain. The result is pain without an identifiable cause, which can be debilitating.
Both Gamma Knife and traditional surgery can be used to treat trigeminal neuralgia. Because of its noninvasive nature and reduced risk of nerve damage, Gamma Knife is preferred in many cases.
When there is an anomaly of blood vessels, it is referred to as a vascular malformation. They can occur anywhere in the body but are often found in the brain. Treatment options include both surgery and Gamma Knife. However, because Gamma Knife does not involve any incisions, it is an excellent option with reduced risk, pain and healing time.
Your Condition, Your Treatment
Because you have a better understanding of both Gamma Knife and traditional surgery, you can continue the discussion with your personal physician. Wherever you are in your treatment, be sure to bring up any questions or concerns you may have. Your doctor is the best person to help you understand which treatment will be most beneficial for your condition and why.