stereotactic radiosurgery in india

Stereotactic Radiosurgery

Radiotherapy in the treatment of cancer exists for the last 100 years. It is primarily useful in eliminating the clusters of unseen cells around the cancer mass and the nearby lymph nodes in addition to killing the cancer cells in the lump. Early in the 1920s, it was realized that side effects would dramatically come down if the dose of radiation is split and given over several sessions. In later years given radiation over 5 to 8 weeks became standard approach.

In the meantime, a Neurosurgeon, initiated the process of giving focused radiation, in a single sitting, to only the region of interest deep within the bain and named it as Radiosurgery. Here there is no removal of any part of the body, yet an invention by the surgeon led to the word "surgery". Still, the name is quite fitting to the procedure, since, radiation acts as a "biological knife" and cuts of the cancer mass. The process of treatment involves accurately locating cancer in the body four dimensions (space as well as time), it's named "stereotactic". When this technique is used in the brain, it is called Stereotactic Radiosurgery (SRS); Stereotactic Body Radiotherapy (SBRT) when used elsewhere in the body. Since the process is cutting off the tumour, it is sometimes referred to as

Stereotactic Ablative Body Radiotherapy (SABR); technically all of the above mean the same.

Stereotactic Radiosurgery of the brain and spine can be done in a single session or nowadays anywhere from one to five. Commonly, to treat cancer in the rest of the body like lung, adrenal, liver, prostate etc. Radiosurgery is delivered in multiple sessions (typically three to five sessions). Its also useful in treating some non-cancerous conditions, when surgery is complicated.

The first machine was Gammaknife to treat brain conditions, and Cyberknife came later with the advantage of targeting cancer anywhere in the body. Subsequently, linear accelerators that could deliver radiotherapy came with the sophisticated added capability of Radiosurgery. Varian True Beam STx with 6 DoF Robotic Positioning system at Aster CMI is such a machine. It has advanced technology to track the cancer mass during the treatment and is elegantly designed to treat tumours in any part of the body.

Cancer Therapy India has a team of stereotactic radiosurgery specialists in Bangalore who are experienced in providing the best stereotactic radiosurgery in Bangalore and treating any kind of cancer condition. If you are looking for a stereotactic radiosurgery in India, then book an appointment with Cancer therapy India now.

FAQ

What is Radiosurgery/ Stereotactic Radiosurgery?

Radiotherapy in the treatment of cancer exists for the last 100 years. It is primarily useful in eliminating the clusters of unseen cells around the cancer mass and the nearby lymph nodes in addition to killing the cancer cells in the lump. Early in the 1920s, it was realized that side effects would dramatically come down if the dose of radiation is split and given over several sessions. In later years given radiation over 5 to 8 weeks became standard approach.

In the meantime, a Neurosurgeon, initiated the process of giving focused radiation, in a single sitting, to only the region of interest deep within the bain and named it as Radiosurgery. Here there is no removal of any part of the body, yet an invention by the surgeon led to the word "surgery". Still, the name is quite fitting to the procedure, since, radiation acts as a "biological knife" and cuts of the cancer mass. The process of treatment involves accurately locating cancer in the body four dimensions (space as well as time), it's named "stereotactic". When this technique is used in the brain, it is called Stereotactic Radiosurgery (SRS); Stereotactic Body Radiotherapy (SBRT) when used elsewhere in the body. Since the process is cutting off the tumour, it is sometimes referred to as

Stereotactic Ablative Body Radiotherapy (SABR); technically all of the above mean the same.

Stereotactic Radiosurgery of the brain and spine can be done in a single session or nowadays anywhere from one to five. Commonly, to treat cancer in the rest of the body like lung, adrenal, liver, prostate etc. Radiosurgery is delivered in multiple sessions (typically three to five sessions). Its also useful in treating some non-cancerous conditions, when surgery is complicated.

The first machine was Gammaknife to treat brain conditions, and Cyberknife came later with the advantage of targeting cancer anywhere in the body. Subsequently, linear accelerators that could deliver radiotherapy came with the sophisticated added capability of Radiosurgery. Varian True Beam STx with 6 DoF Robotic Positioning system at Aster CMI is such a machine. It has advanced technology to track the cancer mass during the treatment and is elegantly designed to treat tumours in any part of the body.

When is Radiosurgery useful?

  • As an alternative to surgery: It should be clearly understood that it is not a substitute for surgery. However, when the surgery is the choice of treatment, but can't be implemented due to the high risk for surgery or when the surgery is complicated Radiosurgery is an excellent option. The advantage of Radiosurgery is that it can be done safely, even in elderly patients.

  • Added to surgery: When some part of the tumour is left behind after safe-surgery, Radiosurgery can be added. Radiosurgery by reducing the size of cancer can make it easier to remove with surgery.

  • Added to radiotherapy: Sometimes added to IMRT/IGRT as 2-3 sittings in the end.

  • When cancer is in the earlier stage, Radiosurgery alone may be sufficient.

  • Other than cancerous conditions: It's also used in situations other than cancer. It is especially useful in particular brain problems when surgery is not possible or to facilitate the surgery.

  • It's also useful to relieve the pain. Since it is focused only on the pain-causing area, It's very well tolerated almost without any side effects.

What are the recent developments in Radiosurgery?

  • Nowadays, even stage IV cancers are treated with the intent of long term control, and some patients may have a cure. Radiosurgery is an important modality to be added to the chemotherapy/immunotherapy in selected situations.

  • Radiosurgery can be used when one or few numbers of metastases (oligo-metastases; a limited number of lumps) are present in any part of the body.

  • It may be useful when one or few lumps remain (can be anywhere in the body) after completion of chemotherapy cycles.

  • Abscopal Effect: In recent times, when Immunotherapy or chemo-immunotherapy is combined with Radiosurgery, an uncommon incident happens. When it happens visible tumours, or invisible tumours elsewhere in the body might regress or disappear. The trials are going on to find out the reason for this and to increase this possibility. It is of intense interest since its implications are enormous.

  • It can be combined with other treatments, such as RFA or Microwave ablation for improved control.

What are the Conditions Treated?

Stereotactic Radiosurgery was discovered about 60 years ago as a noninvasive (without entering the body). Its safety lies in the fact that it is effective without an incision and opening the skull.

The Radiosurgery, as an innovative technique, become a choice to treat a variety of neurological and other conditions, such as:

Brain tumour: Even the benign (non-cancerous conditions) tumours are treated with Radiosurgery. Nowadays, the most valuable use of Radiosurgery is in treating the cancers spread from the rest of body to the brain (brain metastases). Earlier radiation was given to the entire brain (whole-brain radiation - WBRT). Although WBRT was used for decades and is reasonably safe, yet, it is always the fundamental rule to give as low radiation as possible to the normal part of the body. WBRT is even now preferred in some situations, but picking up cancer mass in the brain one by one and "shooting" down is the treatment of choice.

Trigeminal neuralgia: Trigeminal neuralgia is a very persistent painful condition. Intense pain in the forehead going down to the lower jaw is very debilitating. Here surgery is the first choice when medications fail to control the pain. When surgery is not preferred, Stereotactic Radiosurgery is invaluable in treating these pain signals.

Arteriovenous malformation (AVM): It is a collection of an irregular mesh of blood vessels. In the brain, it may press on important brain area or may lead to bleeding inside. Stereotactic Radiosurgery (if not surgery) blocks the blood abnormal blood vessels over some time.

Pituitary tumours: Pituitary is a critical gland and is a "master" controlling most of the hormones in the body. It influences essential bodily functions such as the growth of normal cells, metabolism, response to stress and sexual function. Although pituitary gland tumours are not cancer, yet it can lead to severe problems. Radiosurgery helps in shrinking the size of the tumour and restore the disruption of hormone regulation.

Acoustic neuroma (vestibular schwannoma): It is a non-cancerous cell that grows in the bottom of the brain leading to giddiness, loss of balance, "noise" while sleeping and gradually affects the hearing. Stereotactic Radiosurgery helps in reducing the size and the risk of permanent hearing damage.

Other cancers: It is handy to treat any cancer lump anywhere in the body, be it lung, spine, liver, kidney etc. when required.

 

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