Benefits of stereotactic radiosurgery (SRS)
While chemotherapy and surgery are both utilised in cancer treatment in Singapore, they also have side effects that can sometimes be difficult for a patient’s weakened body to handle.
Stereotactic Radiosurgery is a non-surgical type of radiotherapy that delivers high doses of radiation with extreme precision to treat small, localised tumours in the brain.
It aims to destroy the tumour and achieve permanent local control and is usually done within a single outpatient cancer treatment session. As no surgery is involved in Stereotactic Radiosurgery, it has none of the risks generally associated with surgery, such as haemorrhages and infections.
Furthermore, there is minimal interruption of other cancer treatment methods, such as chemotherapy. The results for Stereotactic Radiosurgery for brain metastases appear to be equivalent to the results for surgery in eliminating the tumour. This method is a considerably milder approach to eradicating tumours in a patient’s body, minimising pain and distress in cancer patients across their treatments.
How Does Stereotactic Radiosurgery Work?
Stereotactic Radiosurgery works by concentrating a large number of tiny radiation beams on the part of the body where the tumour is located. These beams have minimal effect on the tissue it goes through. However, the area where all the radiation beams intersect receives a focused dose of radiation. These radiation beams essentially serve as the scalpel for the operation, which removes the need for traditional surgery.
The tumour shrinks and the blood vessels close off over time as a result of the high dosage of radiation delivered to the targeted area, depriving the tumour of its blood supply. Because this cancer treatment method is so precise, it does very little damage to the healthy tissues around it. When compared to other types of traditional surgery for removing cancer cells, radiosurgery has a lower risk of adverse effects in the majority of situations.
There are several modalities of Stereotactic Radiosurgery, such as Framed SRS (e.g Gamma Knife) or Frameless SRS (e.g linac-based cyberknife). Framed SRS usually involves using screws to secure the headframe onto the patient as an invasive procedure, while Frameless SRS uses a thermoplastic mask to secure the head and is non-invasive. You can speak to your oncology doctor to determine which option is more suitable for you.
Risks of stereotactic radiosurgery
Since Stereotactic Radiosurgery does not require surgical operations, it is considered a less invasive cancer treatment option than standard surgery. Anaesthesia, bleeding, and infection are all possible consequences of traditional surgery that can be avoided when opting for stereotactic radiosurgery. Any complications or adverse effects that occur early on are often just transitory.
You may experience tiredness and fatigue during the first few weeks after Stereotactic Radiosurgery. Additionally, headaches, nausea, and vomiting can occur as a result of swelling near the targeted area. Anti-inflammatory drugs may be prescribed by your oncology doctor to prevent or treat symptoms if they arise. Some patients may also experience slight hair loss for a short period.
How to prepare for your stereotactic radiosurgery
Preparation for stereotactic radiosurgery may vary depending on your condition and the body area being treated. However, it generally involves the following steps.
Food and medications
You are advised to eat normally before the treatment. If you are taking medication for other conditions, you should consult your oncology doctor about whether you can take your regular medications the night before or the morning of your stereotactic radiosurgery.
Clothing and personal items
It is advisable to wear comfortable and loose-fitting clothing during your cancer treatment. Avoid wearing the following items during an SRS of the brain.
Precaution regarding allergies and medications
If you have implanted medical devices in your body, such as a pacemaker, an aneurysm clip, or an artificial heart valve, you must inform your oncology doctor. Additionally, if you are allergic to shellfish or iodine, you should let your doctor know since the special dyes used during stereotactic radiosurgery are chemically related.
Recovery and follow-up
After the procedure, patients may be observed for a period of time before they are permitted to go home after the oncology doctor has given the all-clear. Your oncology doctor will typically schedule a follow-up appointment about one month after your stereotactic radiosurgery. Subsequently, a diagnostic test, such as an MRI brain, will be scheduled about three to six months after the procedure to check on the status of the irradiated area.
Volumetric modulated arc therapy [VMAT] involves the use of external radiation therapy beams being directed in a series of arcs or angles to allow for greater access to tumour. VMAT allows more difficult tumours, such as the ones wrapped around other important structures, to be targeted precisely.
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While radiotherapy and stereotactic radiosurgery both refer to the precise delivery of radiation to specific areas, there is a key difference between both cancer treatment methods. Stereotactic radiotherapy delivers radiation at high intensity, all at once, to a small area. Conversely, radiotherapy delivers radiation over many sessions at lower intensities to larger areas.
Stereotactic radiosurgery is an outpatient cancer treatment method. The procedure generally takes between 20 to 40 minutes.
Some patients may experience slight hair loss temporarily after their stereotactic radiosurgery.
Stereotactic radiosurgery of the brain is usually completed in a single session.