Overcome a tumour with CyberKnife
If someone said before that a tumour in the head can be overcome only by applying a precisely directed beam of rays which allows avoiding major surgery and postoperative complications, it would have seemed like science fiction. However, there are now patients in Latvia who underwent successful radiosurgery procedure performed using the CyberKnife modern equipment.
What do they say?
Mārtiņš (43) at first noticed ringing in the ears. As he says – he consulted all doctors, but they did not find any problems. As Mārtiņš is very fond of music, and he likes listening to it in good quality, he suddenly found that one ear hears worse than the other. “I went back to the ENT specialist who this time advised to undergo magnetic resonance imaging of the head, which revealed the right acoustic neuroma. I got to the neurosurgeon, who said if he operated me, the side effects of this surgery could be similar to the worst manifestations of my illness. Of course, as the tumour grows, nerves are compressed, and it may cause movement disorders, drooping of one side of face, and headache. The doctor advised to undergo the surgery when the tumour grows so large that it will be clear – it can’t get any worse.
The thought that I will grow something incomprehensible in my head and wait what will happen to me seemed frightening, and I started searching if there are other options besides waiting, other tumour treatment methods. I found information on the Internet about CyberKnife applied in Europe. Then I found out it was also available in Russia and Ukraine, and I was about to go there, when I suddenly saw the information on the Internet saying that the procedure will be available here in Latvia after the New year. Although I was informed that the rehabilitation period after this procedure was very successful, I was still rather frightened.
I must admit that the procedure is completely painless, and I had no nausea or impaired balance after it. It has been three weeks, and real changes can only be observed in six months. I hope that everything will be fine, as the tumour was discovered quite fast which is also positive. In any case, I now feel more relaxed because I know that I did everything possible. If I did not do anything, the tumour continued nagging and torturing me, both physically and emotionally. I think this procedure would be a relief for many people, if it is covered by the state or at least if it is included in health insurance. There is no need to stay in bed for a month after this procedure, and there is no need to suffer from complications, which can be quite frightening and unpleasant, and, after all, there is no need to make a hole in the head!
All I had to do to undergo this procedure was to come for an examination and then to come to the procedure. It is that simple.”
Georgs (63) said that he started having dizziness in the morning for no apparent reason. “It underwent examination which revealed that the fault is in the head. The neurologist referred me to magnetic resonance imaging, which showed I had a benign tumour – a meningioma. Then I consulted neurosurgeon Igors Aksiks at Stradiņš Hospital. I was quite sure that I will have to undergo a surgery, but the professor said he could not help me, the tumour was located in such a bad place, near the brain system, that he could not operate. He told me that the Radiosurgery Centre was planned to be opened in Sigulda, he told me to wait and then to go there. But if I did not want to wait, there was the opportunity to receive tumour treatment in Germany. I decided that I would rather be treated at home. I waited for two months and I was actually one of the first patients of Sigulda Hospital who underwent radiosurgery treatment with so-called cyberknife.
The first time I went to Orto clinic in Riga, where I was examined and prepared for the procedure, and one week later I had the procedure. The procedure was completely painless, I did not feel anything during it. The only thing I had to do was to lie calmly for 40 minutes, and I could not move while cyberknife was operated. I had to undergo three procedure. For the first time I took a driver to take me home after the procedure, but it turned out that i was unnecessary – I felt good and was able to drive. After the procedure, I was back to normal life as if nothing had happened.
It has been four months, and I will have to go for a follow-up in early June. Now dizziness has reduced. “
Anita’s mother Sofija (68) underwent treatment with CyberKnife – the most modern robot-assisted radiosurgery equipment in Eastern Europe. Last April, at about the same time of the year, Anita’s mother lost consciousness at night. “She was taken to hospital, and X-ray showed a slight darkening in the head, therefore they had to do magnetic resonance imaging. I took my mother to a consultation in Stradiņš Hospital where we met a wonderful doctor, head of the Clinic of Neurosurgery Edgars Valeinis. Our first reaction was shock when we learned that there was a tumour. The good news was that the tumour was benign – it was a meningioma, but it was not in a very good location – very close to vital areas, so it was impossible to operate.
And we were again in despair, because we didn’t know what to do. But Dr. Valeinis said at once that the Radiosurgery Centre is planned to be opened in Sigulda, that he would send them the parameters of my mother’s tumour, and if they are appropriate, we will be invited there. It was late August, or early September. Time passed by. Of course we were worried how everything will go. I even looked for similar options abroad, but then we got a call from the Sigulda Centre and were invited to the consultation. They began making examinations; all necessary tests were done, and a mask was made. Everything was done professionally – at every stage we are told what would happen next.
In early December my mother was invited to come to the procedure’, tells Sofia’s daughter Anita. “I remember my mother was afraid she would lose her hair. It was one of the first questions she asked Dr. Valeinis, who only laughed good-naturedly – this radiosurgery procedure doesn’t have such side effects! And in fact my mother’s hair didn’t even get less thick. She underwent this procedure, which lasted 40 minutes, for three days in a row. My mother was fully conscious – she just lay quietly. We went home as if nothing had happened. After returning home, we watched our favourite bob-sleigh and supported Melnbārdis’ crew. And I tell everybody – at the end of the year we felt as if we experienced a Christmas miracle. Yes, probably, my mother had less energy at some point, but she did not feel bad or had nausea. She went out, to the store. It has been four months since the procedure, and a year since we learned the diagnosis, and I have not seen my mother so active for a long time. Sometimes I even have to stop her a little (she laughs). But my mother was very lucky that the tumour was in the initial stage – when this procedure is very effective. The stars were on our side, we are happy and grateful to the doctor who did it.
It is very important that during the treatment, when we talked both to doctors and medical personnel, we never felt this frightening emotional thing that it was a tumour. Its treatment in the Radiosurgery Centre is something completely different, not what we used to think about tumour treatment. My father had the same disease, so I can compare the procedure that my mother had with the traditional treatment method. It cannot even be compared. This is great progress when you completely forget about the diagnosis one month later. I would like to wish this opportunity to everyone who needs it. We have professional doctors in Latvia who can do it. This is a unique method, but it must become more affordable”, says Sofia’s daughter Anita.
Comments of Māris Skromanis, head of SRC Sigulda:
Radiosurgery is a method of radiation therapy, when CyberKnife equipment is applied and it allows to deliver a large dose of rays very precisely and directly to the tissues affected by the disease, without affecting or damaging healthy tissues and cells. Precision and efficiency of the method is comparable with surgery. Although there is the word “knife” in the name of the equipment, the procedure does not involve any surgical intervention. Tumour growth is stopped during radiosurgery procedure, moreover, the tissues around the tumour suffer much less than during neurosurgical procedure – the border between the tissues that are irradiated and the tissues that are not only one millimetre!
What should a patient do?
First of all, he (or she) should make an appointment, and we first need to assess whether this method is suitable for the patient. In case of positive reply the patient should undergo computed tomgraphy and magnetic resonance imaging, and he is made a special mask that will be used during the radiosurgery procedure. It takes about two hours, and the patient can leave after it. Then our specialists set to work. Radiation therapist marks the tissue to be irradiated, notes what dose should be received at which point, and marks the areas that must not be irradiated (brain system, nerves, and eyeballs). Then a medical physicist sets to work. His task is to calculate the way of the rays and to prepare a treatment plan. When the radiation plan is ready, it is checked using a human-like imitation, that is, the physicist checks the accuracy of the measurements, and, if there are no errors, approves the plan. Preparation of one patient for the procedures takes 3-4 days.
How many procedures are required?
If a tumour is small, one radiosurgery procedure is enough. It lasts 35 minutes, and then the patient can go home. If the tumour is larger and is located close to the nerves or brain system, the radiation dose is divided into several sessions (up to five). It means the patient must come to the procedure five times. The procedure can be done in the afternoon or after working hours, so that the person can go about his business during the day and arrive for the procedure in the late afternoon. This procedure is completed within a week.
Who the radiosurgery procedure is suitable for?
For those who may have permanent consequences after a neurosurgical procedure, or in cases when a patient’s state does not allow an invasive surgery.
In case of acoustic neuroma patients should be aware that facial nerves responsible for facial sensitivity, functions of the facial muscles, and sense of balance are located in one fascicle with the auditory nerve. As the tumour grows, nerves are compressed, and the person gradually loses hearing, has numbness and impaired balance.
In this case it is important that the tumour is detected as soon as possible, when the first signs appear. The first signs in case of acoustic neuroma include deteriorating hearing, and buzzing in the ears.
In case of meningioma: inexplicable headache, fatigue, and vision may become blurred.
How can an appointment be made?
You can make an appointment by calling +371 20270077 – in Sigulda (Sigulda Hospital) every day during business hours, in Riga our consultations are available in Orto Clinic on Thursday and in Diamed Clinic on Monday from 16.00 to 19.00, or you can also send a request to assess the disease electronically through our web-site: www.cyberknife-sigulda.com