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Gamma Knife

Gamma Knife Treatment

​​​​​​​​​​​Gamma Knife is a type of radiation therapy that delivers thin beams of high-energy ​radiation to the brain. It delivers radiation in a more accurate way compared to the most common way of giving radiation therapy. Gamma Knife is a treatment for brain tumours and other brain conditions. It helps to heal or slow a brain condition.

Gamma Knife doesn’t use a knife and isn’t a type of surgery. You won’t need to be put to sleep during the procedure (have anesthesia). You will have imaging tests, such magnetic resonance imaging (MRI), to get pictures of your brain to help plan treatment. Imaging tests are done before your treatment or on the day of your treatment.

Gamma Knife treatment is only available in Alberta at the University of Alberta Hospital in Edmonton. The Gamma Knife team is made up of neurosurgeons, radiation oncologists, medical physicists, radiologists, nurses, and radiation therapists.

Types of Gamma Knife treatment​​​

There are 2 types of Gamma Knife treatment.

Mask-based treatment uses a mask to hold your head in place during treatment. The mask will be fitted to the shape of your face.

Frame-based treatment uses a head frame to hold your head in place during treatment. The head frame guides the radiation to specific areas of the brain. The head frame is held tightly to your head with 4 pins.

As a patient, you won’t be able to decide which type of Gamma Knife treatment you have. The Gamma Knife team will choose the treatment that is best for you based on your condition.

​​​Frequently asked questions

If you’re having Gamma Knife treatment, you may have the following questions. You can also view a video that shows you what to expect.

What brain conditions does Gamma Knife treat?
​The Gamma Knife treats brain conditions such as tum​ours and abnormal blood vessels. It also helps treat severe facial nerve pain and conditions that affect movement.

Is the treatment painful?
The treatment itself isn’t painful. But if you’re having frame-based treatment, you will need to wear a head frame during the treatment. The head frame and the pins to hold the headframe in plac​e may be uncomfortable so your doctor may offer you medicine to help you relax. You may also find it helps to listen to music during the treatment.​

Will I be awake during the treatment?
You will be awake during the treatment. If you have medicine to help you relax it may make you a bit sleepy.

Can I leave the hospital after the treatment?
Most people can go home the same day as the treatment. If you are from out of town and need to have an angiogram (an x-ray of the blood vessels), you will need to stay overnight in Edmonton (but not in the hospital).

Are there risks or side effects?
The Gamma Knife treatment can make you feel tired, have headaches, or feel sick to your stomach (nauseated). These side effects tend to happen within a few days of the treatment.

What are the advantages of Gamma Knife treatment?
Gamma Knife treatment:

  • helps to treat or slow brain disease
  • is comfortable, safe and targets a very specific area of the brain
  • doesn’t need a general anesthetic
  • lets you go home the same day as the treatment

Preparing for Treatment​​​

Follow all the instructions that your healthcare provider gave you at your consultation. Let the healthcare team know if you have diabetes. You will get special instructions about using your medicines on the day of the surgery.

Make sure you have a ride home. You won’t be able to drive after your treatment because you may be given medicines that make you sleepy.

The day before treatment
On the day before treatment, wash your hair but don’t use any hair products such as gel, mousse or hairspray. Don’t use any scented products such as perfumes, lotions, or after shave.

Special instructions for mask-based and frame-based treatment:

​​​​​Mask-based treatment 
​Frame-based treatment
​Trim any hair from the face so the mask will fit closely to the face.
​Don't eat or drink anything after midnight.

What to bring to your treatment
​Bring the following items to your treatment:

  • photo identification (ID)
  • your Alberta Personal Health Card and your insurance card (if you have one)
  • a light snack for after your treatment
  • medicines you need to take during the day
  • an updated list of medicines you take including vitamins and herbal products
  • a magazine or book
  • your phone (if you want to listen to music during your treatment)
  • indoor shoes or slippers

Don’t bring your valuable items to the hospital. The hospital is not responsible for lost or missing items.

​​​Day of Treatment

On the morning of the treatment take your medicines with a few sips of water. Take off your jewelry and watch. You can bring a friend or family member with you to the hospital.

Check-in at the hospital​​​

Check-in at the University of Alberta Hospital. You’ll then be asked to go to the Gamma Knife waiting area.

​​​Before your treatment

The Gamma Knife staff will ask you to change into a hospital gown and put your belongings in a locker. They will also:

  • explain what will happen during the treatment and answer your questions
  • you may be given​ an intravenous (IV) in your hand or arm if the healthcare team needs to give you fluids, medicine and contrast dye (if you are having an MRI)​
  • check your heart rate, blood pressure and temperature (called your vital signs)

You may need imaging tests, such as MRI, and other tests depending on your care needs. These tests may have been done in the days before your treatment or on the day of your treatment.

​​Mask-based treatment
​Frame-based treatment
​You will be fitted with a mask.
  • ​The fitting is done by putting a warm mask on your face and fitting it to the shape of your face.
  • The mask is attached to a support cushion for your head that you will lie on during the treatment.
  • The mask-fitting will take about 20 minutes.
​A head frame will be put on your head.
  • ​It will be held closely to your head with pins.
  • You will get medicine to numb the skin where the pins are placed into the skin.

Treatment planning​​​

The Gamma Knife team will use the pictures from your imaging tests to decide:

  • the exact location of the treatment area
  • the dose of radiation you need
  • the number of treatments you need

You will be able to rest in a patient room while the team is planning your treatment.

Gamma Knife treatment​​​

You will lie down on the Gamma Knife treatment table. The healthcare team will attach some medical equipment to your body to check your vital signs during the treatment.

A radiation therapist will watch you on camera during your treatment. They will also be able to talk to you during the treatment using a microphone system. You will also get a call bell to put in your hand if you need to get their attention.

During the treatment you will be able to listen to music to help you relax.

​​​After the treatment

You will go to a patient room for 30 to 60 minutes. The healthcare team will check to see how you’re doing and you can have something to eat and drink.

Before you go home, the Gamma Knife staff will give you discharge instructions and let you know the date and time of any follow-up appointments. You will be at the hospital until 4:30 p.m. or later.

It’s important to do the following:

  • Drink plenty of fluids. This will help flush out any contrast dye if you had an MRI.
  • Wait at least 8 hours before you drive. Some medicines you had during the treatment may affect your ability to drive. Make sure you have someone to drive you home and stay with you the first night after treatment.
  • Wait at least 1 to 2 days before doing your regular activities. Your doctor will let you know if you should wait longer.
  • If you have headaches, take acetaminophen (Tylenol) or ibuprofen (Advil), as directed on the bottle. To help avoid headaches, sleep with your head slightly raised for a few nights.
  • If you have diabetes, check your blood sugar level and take your medicines as prescribed.

Specific information for mask-based and frame-based treatment:

Mask-based treatment

  • The mask will be removed right after your treatment.

Frame-based treatment

  • The frame will be removed in the patient room and you will get a small dressing to put on the skin where the pins were.
  • Don’t wash your hair for at least 48 hours after the treatment. When you wash your hair, you may notice a bit of blood in the water if blood was stuck to your hair from the head frame.
  • You may have swelling, bruising, or pain in the area the pins were. Put a cold cloth or icepack on the skin for 10 minutes each hour that you’re awake to help manage these skin reactions.
  • Take off the dressing the day after the treatment and keep bandages on your forehead for 48 hours. If you have bleeding, put pressure on the area with a clean bandage or cloth for about 5 minutes until the bleeding stops.

Current as of: January 29, 2019

Author: Neurosciences, University of Alberta, Alberta Health Services