Gamma knife for multiple brain mets

Earlier this year I had gamma knife treatment after an MRI showed 24 brain mets ranging in size from 3mm to 3.5cm.

I was told that they have recently found that gamma knife can be very successful when used to treat people who have much larger numbers of mets than they used to think was appropriate for this type of treatment. I would usually have been sent for wbr.

My treatment was split into 2 sessions, both long (6 hours and 4hours) but generally painless (frame fitting hurt a bit). The side effects have been minimal. I had a headache for a few hours after and was tired for a few days but not much else - no hair loss, nausea or memory loss. My treatments were in may and june 2011 so I don’t know how effective it is long term but scans have show that all the mets are shrinking at the moment and I no longer have the nausea/ dizziness that caused my onc to send me for a head MRI in the first place. I have also been told that gamma knife can be repeated as often as necessary if more brain mets appear.

I am not a big researcher so I don’t know if there is any evidence to suggest that this might be any better than WBR but it certainly seems to be another option that some people might want to discuss with their consultant.

I had my gamma knife treatment at the Cromwell hospital in London. My treatment is usually at the Marsden in Fulham road

Everyone is so thrilled/excited with how I have responded to the gamma knife that one of the registrars said it was now possible that my liver mets might be my biggest worry- I said so you mean they’ll be the ones that kill me? And she said ‘probably, yes’. !!! Oh well I did ask :slight_smile:


hi melissa
Great news that the gamma knife was successful! This is useful to know if I have a re-occurance (hopefully not though!) as I am currently going through WBR, I have read up a bit and scared myself, but the oncologist seems to think because I have caught them early and they weren’t symptomatic I have a strong chance of the being treated successfully. I didn’t really have a choice…or was too stunned to take in any alternative info! I was diagnosed last Wednesday, at my 3 monthly CT scan check up, treatment WBR was discussed and I was booked in to start this Tuesday - a very quick start, but I just wanted to get on and sort out these brain mets! I have a few tiny ones, I guess it’s just the way my cancer behaves - I think they have been described as ‘like seedlings’ Myliver is the same just peppered in tiny white dots…no solid tumours. So I can sort of see why WBR has been suggested to me…we are all so different. I have read up and any targeted rads appears to give better results, but I was told that if I had that I would need WBR anyway…to mop up any others that may be undetectable yet.

Please do keep in touch with me please Melissa and let me know your progress! I have had so much support with my bone and liver mets, but unfortunately (well fortunately not many people find themselves in our position) hardly anyone is able to offer me any inspirational stories about living with brain mets for many Years (perhaps we will become those inspirational people!! How much do I hope that is true?)

Take care now xx

hi nicky
good to hear from you
my oncologist did say to me that one big advantage of wbr was that there was a much smaller chhance of recurrence, so that’s good news for you.
He only told me that after i had finished my gamma knife treatment, when he was explaining that i may have to have more gamma knife in the future - excellent!
I know what you mean about things happening really fast - mine was 3 days from diagnosis to treatment. In the end i think i was pleased that they just took over and told me what treatment they thought i should have. I was so stunned and scared (as was my husband) that i couldn’t really make rational decisions, i needed them to do the best thing on my behalf.
it is good to hear from you, good luck with your treatment. i hope it goes well - let me know how it goes next week
ps - about not losing you hair with GK - seemed nice at the time but i’m back on chemo for my liver and my hair is all falling out anyway (in fact i am posting a question about that rightnow!)

In my opinion, Gamma-knife and Cyberknife have two advantages over WBR.
(1)Gamma-knife and Cyberknife are both incredibly accurate and cause minimal damage to healthy tissue - so can be given at a curative dose.
(2)Because Gamma-knife and Cyberknife cause minimal damage to healthy tissue, they can be used on the same area twice.

I have been told that most doctors/stereotactic specialists, consider Gamma-knife to be the gold-standard treatment for the treatment of brain mets. However, as Melissa mentions, Gamma-knife and Cyberkife are not really suitable for multiple tumours or large tumours. Also, although Gamma-knife is considered superior to Cyberknife for the treatment of brain mets, it can only treat head and neck cancers- whereas Cyberknife can treat tumours almost anywhere in the body.
The other disadvantage of Gamma-knife compared to Cybernife is the uncomfortable headframe. Although Cyberknife also uses a headframe it is less cumbersome.

May I ask…? Did the Marsden refer you to the other hospital for your gamma knife treatment, or did you get a second opinion?

They referred me - although they now have cyber knife themselves so might not do that now.

Lemongrove - good to see you on here, interestingly even though the recommendation seems to be to not treat more than 4or 5 mets I had 24 and they treated me.  Apparently they have been finding that they can successfully treat people with far more brain mets than they originally thought with no increase in the risks of brain swelling or fits.  The biggest risk seems to be that if someone has lots of mets there is a good chance that more will appear and you have to go back for more treatment.  It happened to me when a scan showed 3tiny (less than 3mm) new mets, but I believe that some women get recurrence after WBR which they then treat with gamma/cyberknife anyway.
Also you are so right about the gamma knife frame it looks and feels like a medival torture instrument- and they actually screw it into your head! (however they do use anaesthetic so you don’t feel it)

Can I ask if anybody has any information on the size of tumours as opposed to the number of tumours? My wife was diagnosed with brain mets in February 2010 and there were then multiple tumours. We have never enquired about the actual number or the sizes as we understood that SRS was rarely done on multiple tumours and not at all on large tumours.

She had radiotherapy in March but scans in June and October showed that the tumours were still there. She has been on Letrozole and Lapatinib since October and the most recent scan in December 2010 showed that there was no change over the October one.

If the position has changed on multiple small tumours, I wonder if there has been any change in the larger ones or if the extent of radiation required is so large that it is too dangerous.

Hi I asked for cyber knife and was told nooooo its only private and oncon said it will have to be gamma…why !!! why cant we have cyber knife why is it only for the rich… I have been fighting bloody cancer since 2004.

Sorry - probably me, but did your onc tell you that cyberknife was private but gamma knife might be possible on nhs or did he say that both cyberknife and gamma knife were both only available privately?

could possible do gamma waiting to hear from Leeds.

I have sent you a pm
Hope it makes sense. Please get in touch if you want more info

thanks having a read sounds positive the cage scares me a little lol x

Bumping this up for lady who started new thread on Brain mets. Val

To find this thread I went on to Secondary Breast Cancer (left hand column) then the sub-section called “Secondaries. Treatments and other issues” but when I got to the bottom of the page I had to go back a bit to previous pages (Bottom right of this sub-section when threads appear. There are other threads you may be intersted in but if you need any more help, just ask.

Bumping again to keep by the top of list - good luck!