Your treatment journey
We support you every step of the way in your Gamma Knife treatment
Once you and your medical team have decided that Gamma Knife radiosurgery is your best treatment option, you will need to complete all the necessary ‘paperwork’ before your treatment. Please read our FAQs to assist you.
With the administrative requirements behind you, your next priority is to prepare for your Gamma Knife surgery.
We are committed to making sure you:
- Prepare properly for your Gamma Knife procedure
- Know what to expect on the day of your treatment.
The night before
- If you live outside of the Johannesburg-Pretoria area, we recommend that you stay in a hotel or guesthouse near Milpark Hospital or with nearby friends.
- You will need someone to drive you to and from the hospital on the day of your procedure.
- Do not eat or drink after 2am on the morning of your Gamma Knife treatment.
- In consultation with your doctor, take your regular medications as prescribed the day or night before and on the morning of your procedure.
- Wash your scalp and your hair thoroughly.
- Make sure you get a good night’s sleep.
The day of your procedure
On the day of your procedure, you should wear:
- Slip-on shoes and
- Comfortable, loose-fitting clothes with short or loose sleeves, preferably one that buttons or zips up
- Female patients should not wear an underwired bra.
You should not wear:
- Jewellery
- Contact lenses
- Makeup
- Nail varnish.
If you wear glasses, they will be removed just before treatment.
Upon your arrival at the Gamma Knife South Africa unit:
- Your treatment team will explain the procedure to you in detail
- You can ask any questions that you may have.
Typically, your treatment can take anything from 30 minutes to three hours. This depends on the size, shape, and location of the lesion and number of radiation doses.
Your Gamma Knife treatment: Five Steps
At Gamma Knife South Africa, you are always in excellent, professional and experienced hands. We will help you relax and tell you everything you need to know throughout your treatment.
Step 1: Applying the headframe
To ensure accurate treatment, a targeting frame is fitted on your head using local anaesthesia so that the placement is as painless as possible. The local anaesthetic is injected into four places on the head where the pins of the headframe are placed. Frame fitting takes 20-30 minutes because we need to wait for the local anaesthetic to take effect.
The frame helps the treatment team:
- Pinpoint the target in your brain
- Prevent any movement during the procedure
- Ensure maximum accuracy of the radiation beams
- Prevent your head from moving during treatment.
Your medical team will place the metal frame on your head and secure it with four pins. Foam will be placed in each of your ears.
Plastic ear bars will be placed on the foam in each ear to balance the frame while it is secured. The discomfort from the ear bars is temporary – they are removed as soon as the frame is stabilised.
Once the headframe is on, the discomfort goes away. The rest of your experience in receiving this world class treatment is pain-free.
The frame will remain in place throughout your procedure.
Step 2: Imaging studies
Detailed imaging tests, including a computerized tomography (CT) and a Magnetic resonance imaging (MRI) scan will then be performed.
Although you may have had these before, they must be repeated with the headframe in place to precisely define the location, size and shape of the treatment area in your brain.
Once imaging scans are complete, you will be taken to a quiet area to rest whilst our expert team creates your individual Gamma Knife treatment plan.
Step 3: Creating your treatment plan
We use the data from your imaging scans to plan your treatment using sophisticated Gamma Knife treatment planning software.
Step 4: Your treatment
- No general anaesthesia is required, but you may be given sedation to help you relax if you are feeling anxious.
- The Gamma Knife machine looks a bit like a CT scanner which you will be familiar with by now.
- You will be helped onto the Gamma Knife machine`s table, also known as the couch. You will be assisted in lying on your back.
- The head frame is then attached to the treatment helmet.
- The couch then smoothly slides into position in the Gamma Knife machine.
- Then our medical team exits the room and shuts the door.
- Your treatment begins.
- You will not see, hear or feel the radiation.
- You will be observed using a CCTV system.
- You can speak to us – there are microphones in the room – at any time or if you need a bathroom break or if you feel uncomfortable.
Step 5: After your treatment
- After your treatment, the table moves out of the machine.
- Your treatment team enters the room.
- We will remove the head frame and assist you in getting up.
- We will place plasters over the incisions at the front of your head and antibiotic ointment on the incisions at the back. We will then place a crepe pressure bandage around your head. This can be removed after two hours.
- Some patients experience swelling or a mild headache where the frame was attached.
After your Gamma Knife treatment
- Some swelling and/or bruising of the skin around the pin sites is common.
- You can experience swelling around the eyes, but this usually resolves within a few days after your procedure. You can apply a cool compress to the swollen area.
- Patients occasionally experience headaches after the stereotactic frame is removed. The headache should lessen within a day or so after treatment.
- Some patients find that they tire easily for a few days after the procedure. While everyone reacts differently, most people are back to normal within a few days.
- Some patients have numbness around the pin sites or on the top of the head. This usually lasts for just a day or two.
Care of the pin sites
Care of the pin sites is very important.
- Skin glue (Dermabond) and steri-strips are placed on the front pin sites after the frame is removed. Make sure to wait 24 hours before showering/bathing. Do not allow the pin sites to get wet.
- Avoid hairspray, mousse, gels, hair colour, permanents or anything which may cause irritation until the pin sites have completely healed.
- You can expect the pin sites to heal in 7-10 days.
Frameless treatment
- A facemask is fitted to your head instead of the head frame.
- The facemask is moulded to conform to your face using thermoplastic material.
- A cone beam CT scan of your brain takes place while you are on the treatment couch to make sure the target in your brain has been precisely located.
- The procedure then takes place as described in Your Gamma Knife treatment: Five Steps
Should you experience any discomfort, please contact us
Gamma Knife patient guide
Courtesy of Elekta and MD Anderson Care Centre
Gamma Knife treatment process
Courtesy of Elekta
