The first patients with benign brain tumors – meningioma and acoustic neuroma – received their appointment and treatment right after the opening of Stereotactic Radiosurgery Center Sigulda (SRC Sigulda).
This is the first time when the noninvasive robotic radiosurgery technology CyberKnife® was used to treat patients in Latvia. Such tumor treatment is particularly suitable for patients with tumors that cannot be removed surgically.
The state-of-the-art Cyberknife® technology is suitable for treating both benign and malignant tumors as primary therapy or in combination with conventional surgery. An individual radiation plan is developed for each patient who is to undergo the treatment.
Duration of the treatment ranges from one to five sessions done within one week. Each session lasts 30 minutes on average. Before starting the treatment, the patient undergoes magnetic resonance imaging and computed tomography. The latest data on the tumor location is entered into the CyberKnife® system to accurately map out the course of the radiation. The effect of treating benign tumors in the head can be fully assessed after 6 to 12 months.
The first patient of SRC Sigulda was 67-year-old retired woman, who had been diagnosed with meningioma, a benign brain tumor, earlier in April. The tumor was relatively small, with a size of about 2 cm. After consultation with the neurosurgeon, it was decided that instead of conventional surgery the woman would be treated with CyberKnife® radiosurgery delivered in three sessions.
The second patient to receive treatment at the center was a 45-year-old businessman, who had been diagnosed with acoustic neuroma and had previously undergone surgery in 2013. After the surgery, however, the tumor resumed growing, and some troublesome symptoms appeared with time, such as numbing sensation in the area of the face, the chin and the tongue. The patient had to choose whether to repeat the surgery or opt for radiosurgery with CyberKnife®. Since the patient had previously faced a prolonged and difficult recovery period after surgery, this time priority was given to a noninvasive method, where radiation was delivered in five sessions. The patient compares his experience with the previous surgery and treatment with CyberKnife®: “After I was diagnosed with acoustic neuroma, I underwent surgery in 2013. I stayed in hospital for ten days, and then a lengthy recovery period began – I had to learn to walk and drive a car again. It took me a very long time before I was in a condition to stand up on my feet again. Currently, I work and at the same time undergo outpatient radiation.”
The third patient of SRC Sigulda was a 62-year-old businessman who had previously received treatment with radiosurgery. He had been diagnosed with meningioma, a benign brain tumor, with a size of about 3 cm, which had not been operated on before. According to the decision of the case consultation committee composed of doctors and other specialists, the patient was given CyberKnife® radiosurgery delivered in three sessions.
Family members of the patients are particularly grateful that this tumor treatment method has now become available. The daughter of the patient Sofija says: “Since April, when we learned about mom’s tumor, we have been very emotional. It is difficult to think rationally and to wrap our mind around what is going on. It is good that technology has advanced so much and everything goes so smoothly. This opportunity is very nice from the patient’s point of view. I would be happy, however, if insuring companies or the state recognized this treatment and covered the costs. The people around are surprised that this is an outpatient treatment. My colleague asked me: “What do you mean? You will go home right after the procedure?” Yes, mom feels good after the procedure – no headache or dizziness.”
During treatment with Cyberknife®, large and concentrated radiation doses are directed at the tumor from more than 1200 angles with the precision of a millimeter.
This ionizing radiation destroys the tumor cells: they are no longer active, and the connective tissue starts growing in their place. The patient does not feel any pain during the tumor radiation. The only thing to get used to is a moving robot that performs radiation by moving on six planes at different distances. In order for the patient to relax during the procedure, the design of the procedure room features the sceneries of Sigulda with background sounds of birds singing and a brook rippling.
This is how the patients describe what they feel during treatment: “The first time is unusual, and the robot’s movements can sometimes be scary, but the face mask helps keep the peace of mind and the background music helps switch off and not think about what is happening.”
Māris Skromanis, Head of SRC Sigulda, says: “Initially, we are offering treatment for patients with primary benign tumors and brain metastases of malignant tumors localized elsewhere in the body. This method is also suitable for pathological vascular formations – arteriovenous malformations. In the near future, radiosurgery at our center will also be used for spinal cord tumors and metastases of tumors localized elsewhere, and later we will introduce the treatment synchronized with the patient’s breathing that will allow us to reach tumors in the lungs, the liver and other parts of the body.
Although the CyberKnife® tumor treatment method is effective and highly accurate, the center today is faced with a problem that most patients who seek help, unfortunately, cannot be helped, because the disease is already at a late stage and has spread widely: the patients have large-sized metastases or a lot of or metastases in various organs, as well as are in a poor general condition. It is therefore very important to seek early diagnosis.
The Nuclear Medicine Center, which is due to open in 2016, will have an essential part to play in timely diagnosis of tumors. The center will provide an opportunity to detect tumors early and accurately with positron emission tomography-computed tomography (PET/CT).
The CyberKnife® method is primarily intended for the treatment of tumors with a diameter of up to 3 cm (or 5 cm in very rare cases), so we can most effectively help fight formations that have been detected early.”
SRC Sigulda was opened in late November 2015 and today it is the only unique CyberKnife® technology center offering treatment of benign and malignant tumors in the Baltic States.