Asking for evaluation - Gamma Knife's vs Cyberknife consequences during years

Symptoms & Treatment Gamma Knife Radiation
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Greetings,

I hope today finds you well!

I am Matina from Greece, 37 years old.

Three MRI brain scans.
First August 2023, second February 2024. Diagnosis of a brain tumor of 1.7 cm (meningioma). A final, third scan July 2024.

It occasionally causes symptoms such as numbness in the left cheek, headaches on the left side of the head, and pain and lacrimation in the left eye.I was told it needs to be addressed because: 1. It’s coincidental 3. Grows 4. I am a 37-year-old woman. No symptoms the last months.

A surgical procedure is not recommended by the majority of Greek neurosurgeons, as the tumor is located in a very dangerous point back deep in the cavernous sinus of the brain where the carotid artery and everything else is responsible for all functions is located.

I think the impact-risks of a craniomy outweigh the benefits of removing a (small ) piece of the tumour. As a very small part could be removed and radiosurgery would be needed again for the rest, anyway.

But that’s my opinion, I’m not a doctor, I’m just a patient going through quite a torturous process that I’ve never chosen.

I cannot afford treatment abroad (only here in Greece) but I really need your opinion to help me decide which method is best (ideal) for my case, benefit - harm relationship (now & next years). Gamma Knife? Cyber-Knife?
What are the short- and long term - consequences of each method during years from your personal experience?

All the doctors had unanimously told me to go to radiosurgery and not let the summer pass. And I left the both summer and the autumn pass and we are already going through the winter…

I would be grateful if I get a response at the earliest so I can take the next steps/actions accordingly.

I wish you a restful and healthy rest of winter! :slight_smile:

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Hey Matina,
My name is Merl, I’m a member of the Modsupport Team here on Ben’s Friends. I have a low grade astrocytoma, the growth itself is deep in the brain and is putting pressure on the aqueduct, the drain tube, causing hydrocephalus and I have a VP shunt to help manage the CSF.

They have opened my skull via craniotomy a couple of times to get to the growth, but it seems it’s growing a bit too close to brain structures I need for it to be completely removed. The surgeon was reluctant to go digging any deeper and as the rate of growth is slow for mine, it’s now recommended to ‘Wait’n’Watch’. To monitor it all.

One of my big issue has been the fluid causing hydrocephalus (aka water on the brain), hence the need for the shunt. I’ve had a few issues with the shunt from blockages to tube and valve breakages which has required a few surgeries to fix. Earlier this year it was recommended I have yet another craniotomy, which I declined. My recovery from the other craniotomies was nasty and I didn’t want to go through all of that again if I could avoid it.

I did not have gamma nor cyber knifing. As for which method is best, from my experience every neuro I’ve spoken to has had a differing opinion, whether that’s ‘their’ specific preference or the treatment option they have available, I’m unsure, but they all swear ‘their’ treatment option is best, so getting a clear picture can be VERY difficult.

As for gamma vs cyber, with gamma the head is secured inside a frame called a ‘halo’. The halo is screwed into the skull and once secured, measurements can be made to pinpoint the exact location of the beam focus. The halo is secured to the device and a single, high dose treatment is then administered. With gamma knife up to 200 points can be administered. With cyber knife no halo is used, but rather a mesh mask is utilised. The advanced computer technology tracks brain movement and pinpoints the optimal location for treatment and a lower dose of radiation is used, up to 1400 points can be administered in a treatment. Because it is lower dose radiation, multiple treatments, up to 5 can be given. This can allow the radiologist to vary the treatment area with each dose, covering a greater surface area of the tumour. As for which is ‘better’ that can be VERY individual both for the patient and the treating Dr. Your overall health needs to be assessed, the size and exact location assessed, any co morbidities considered etc, from there, taking it all into consideration an appropriate treatment plan can be made.

As for a professional 2nd opinion. There are clinics in the U.S., such as Mayo Clinic, that can provide a 2nd opinion. In very basic terms, you can send them images of your scans and (for a fee) they can provide you with their opinion. But as travel/treatment abroad is not an option, even obtaining a 2nd opinion may not be of benefit. For example, they could say, ‘Yes, we can assist’ but that travel to the U.S. is required, which doesn’t help you in Greece. Also, any additional follow up treatment may also require further international travel to the U.S…

So, taking everything into account that you’ve said, I would suggest you’ve almost answered your own question and it’s time to act. The longer you leave it, the more complicated the situation can become.

Like you, I’m just the patient, but that’s my personal opinion.
Best of luck with it all and please do let us know how it all goes.

Merl from the Modsupport Team

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Hello, Dear Merle,

Thank you very much for your message!

I hope you no longer have symptoms and overcome this difficult path you are going through…

You are right on the point about assessing a hospital abroad (it may not be beneficial).
Most neurosurgeons recommended Gamma Knife to Cyber knife (about 80%) for my case.
I hope to find the courage to call my doctor this week to arrange (Gamma) Knife…

I’ll keep you in the loop and I’m always glad to hear from you.

I send my best wishes for quality and long term life.

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