Going Under the Knife: A Patient's Experience

On an unusually cool day last summer, Mary V. enjoyed a meal at her Los Angeles hotel, checked in with friends via Facebook, and answered the phone in a clear, upbeat tone. Amazingly, just 24 hours earlier, she had been, in effect, “under the knife”—the Gamma Knife, that is—in a procedure aimed to destroy any lingering cells from a brain tumor that had been removed two weeks earlier.

“The team at The Gamma Knife Center did a wonderful job,” says Mary, while getting ready to fly home to Houston. “I’m up and about. My face is swollen, but I feel great.” She had been awake but sedated during the half-hour procedure, which was performed by John S. Yu, MD, neurosurgical director of the Center. Mary had come all the way to Los Angeles to see Edward M. Wolin, MD, co-director of the Cedars-Sinai Carcinoid and Neuroendocrine Tumor Program, about chemotherapy for her neuroendocrine cancer, a rare form of cancer. While in his office, she suffered a seizure, and it was then discovered that the malignancy had metastasized to her brain.

Dr. Yu surgically removed the tumor in Mary’s left temporal lobe, just in front of her speech center. Given her vocation as a speech therapist, it was crucial to remove the tumor with precision. Yu explains that the normal standard of care after surgery for brain cancer is whole-brain radiation, which carries a significant risk of dementia. Mary was a good candidate for the Gamma Knife, he says, because her cancer carried a low risk of developing additional brain tumors.  What was not rare, however, was how quickly she rebounded from her experience with the Gamma Knife. “Patients tend to tolerate it very well, and often can go back to their regular activities right after the procedure,” says Dr. Yu. “We treat 150 patients each year, and the vast majority of them immediately resume their lives, even the same day.”

Dr. Yu is teaming up with radiation oncologist Amin J. Mirhadi, MD, to study the use of Gamma Knife surgery for the treatment of glioblastoma multiforme, the most prevalent form of brain tumor. “We think treating patients aggressively with surgery and then with Gamma Knife is a novel and effective approach,” says Yu. “Gamma Knife does not kill the residual tumor little by little like other types of radiation—it simply obliterates it.”

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