ANA Discussion Forum
Treatment Options => Radiation / Radiosurgery => Topic started by: Greg M on May 03, 2009, 10:59:40 am
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Hello all, I just seen the last of the Neurosurgeons on the GK team. He said that it would take 6 shots to fill my tumor with radiation. The GK machine will pull me in and out of the machine to get different angles to shoot at. I thought it was all one dose? Do people mean you just get it all in one treatment, like one day and not over 3-5 days? He said the 6 different doses will be at different strengths, has anyone heard of this? This Doctor has done over 200 AN treatments with the GK. Thanks for your insight. Greg
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Greg,
I can't say I've ever heard of GK being done in anything but one day , 1 session with the exception of I believe Dr. Noren in the RI / NY area who does some form of fractionation with GK. Your doctor may be referring to some process where they have multiple dose protocols where they would take you out and put you back in for each new treatment plan all in the same day. Problem is even with various dosing in the same day I can't see how that would achieve any real fractionation benefit. If he's really suggesting that you would be treated over 5 days all while wearing the head frame or have it reattached each day, I have never heard of that with GK, and personally, I would run for the hills before I would do that ;D. I know from your previous posts that you are trying to work within some insurance and access issues in terms of CK being an option, but if you are really looking for a fractionated approach to preserve hearing, I would push the CK option harder with the insurance before I would wear the frame for multiple days. Either way, I'd be interested in hearing what the doctor is really proposing in terms of a treatment plan
Best
Mark
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I don't think the GK doc is talking about fractionation, just that with GK, they can't move the beams around, so they move your head instead. To cover a typical tumor, they do from 4 to 9 shots with the GK, all in the space of about 1 hour. Basically they slide you out, adjust your head position a little, and then slide you back in. It is still referred to as a single dose, since it is all one visit to the treatment room.
It's standard operating procedure, nothing to worry about. :)
Steve
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Steve,
That sounds more reasonable and I'd bet your probably right. I knew GK was limited to the fixed beams , but I wasn't familiar with the "in and out" adjustments during the treatment you described. Always good when I can learn something new
Thanks
Mark
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Yeap, this is typical, especially for larger tumors that aren't perfectly "spherical". It has something to do with the number of isocentres that they need to best approach the shape of the tumor. What they usually do is slide you out for 5-10 minutes, and they change the colimator (sp?) helmet, so that they can adjust the beams (or something like that). The more complicated the treatment plan is, the more likely it is to go through this procedure - it is still considered single dose it just prolongs the procedure. This is why the GK procedure itself may range from 20 minutes to more than an hour.
I am sure you are in good hands with your doctor, and he sure sounds experienced.
Marianna
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Hi Greg,
I believe I was slid out of the machine 3 or 4 times. I was also told that they could stop the procedure at any time if I needed to use the restroom, or just needed a break. I think I was in the machine for about 2 1/2 hours, but it didn't seem like it at all. I was a little sedated, and was able to listen to my own music. I made some mix CD's and the techs played them for me. I just laid back and listened to some Pink Floyd, Coldplay, Led Zeppelin, and Elton John. Unlike an MRI the GK is silent. I think that having the breaks made it easier.
Good Luck to you,
Lisa
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Hi Greg,
My AN was small so I wasn't in the GK machine very long.....just 27 minutes. I think I was slld out of the machine 4 times to adjust the colimator. The machine did the adjustments. I also had a CD that helped and was told I could stop the procedure like Lisa said to go to the bathroom or if I needed a break. I didn't need either. It was actually a better experience than having a MRI. It was a good choice for me, and I am doing well at seven months post GK. Did not lose any hearing, and the headframe was no big deal. Best wishes to you.
Nancy
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Hi Greg,
I agree with the others. They have to pull you out of the GK machine in order to do each "dose" but yes, 1 day protocols.
Mark does note about Dr Georj Noren in Providence RI, who has, indeed, been doing some trials on "fractionated" GK (lower "doses" done over a number of days). I thought somewhere else (possibly in Houston, TX... I'd have to check) was also doing the same with "fractionated" GK as well.
Phyl
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Hi Greg,
I did my own research on the gammaknife as this is the only radiation treatment available in Canada for now and if you google gammaknife you will find a website that actually explains the procedure live on video. I cannot recall what the website is right now. I agree with the others that GK is only a one day treatment. It would make send that they would need to pull you in and out during intervals to adjust marjins and what not. The fractioned CK is more of a 3-5 day process. I have not heard of any team of doctors using both GK and CK at the same time but I coul be wrong about this. There is also a website that you can communicate with Radiation Oncologist online. The website is called Cyberknife Robotic Radiosurgery System and they can also answer questions about GK procedures as although they treat CK, they also understand the GK process. I hope you can find these websites. I am not good at attaching the website names to my posts, sorry. I have to learn how to do that one of these days.
Vivian
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Hi Greg,
I did my own research on the gammaknife as this is the only radiation treatment available in Canada for now and if you google gammaknife you will find a website that actually explains the procedure live on video. I cannot recall what the website is right now. I agree with the others that GK is only a one day treatment. It would make send that they would need to pull you in and out during intervals to adjust marjins and what not. The fractioned CK is more of a 3-5 day process. I have not heard of any team of doctors using both GK and CK at the same time but I coul be wrong about this. There is also a website that you can communicate with Radiation Oncologist online. The website is called Cyberknife Robotic Radiosurgery System and they can also answer questions about GK procedures as although they treat CK, they also understand the GK process. I hope you can find these websites. I am not good at attaching the website names to my posts, sorry. I have to learn how to do that one of these days.
Vivian
Hi vivian,
In follow up to your post...
Dr. Clinton Medbery on the CK Patient website performs both, CK and GK, so he truly is terrific in answering radiation protocol questions.... the website is: www.cyberknife.com.
Phyl
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Hi Phyl
I am glad you have pointed out the website. I wasn't sure if it would be found without the actual name of it.
Thanks.
Vivian
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Hi;
Wow; All the realignments and they still wish to keep total number of gys. down to 13 or 14! Seems years ago the GK protocol used about 17 total gys. and morbidities were higher.
I suppose with 5 sessions of hyperfractions of the linear accelerator, the time between allows a rest so a higher number of gys. can be administered.
Seems I recall reading "initial hit" is important in disrupting the bodies DNA, so as to control growth of the AN(s). If that is so, I see a tiny edge for GK in tumor control, but there again, each is so individual.