Topic: Gamma Knife Surgery for Brain Mets: What to Expect

Forum: Stage IV/Metastatic Breast Cancer ONLY — Please respect that this forum is for members with stage IV/metastatic breast cancer ONLY. There is a separate forum for caregivers and friends: Caring for Someone with Stage IV or Mets.

Posted on: Nov 23, 2021 08:45AM

Posted on: Nov 23, 2021 08:45AM

moderators wrote:

We asked our awesome member, Illimae, to share her first-hand experience with receiving Gamma Knife surgery for brain metastases in order to help others feel more at ease with this intimidating treatment. We are grateful for Illimae's willingness to share and we hope you find this helpful!

Gamma Knife for Brain Metastasis

Gamma Knife is a type of precision-targeted SRS (Stereotactic Radiosurgery) often used to treat minimal brain tumors, usually less than five but as many as 15-20 in some cases. The procedure begins with the fitting of a metal head frame or a plastic mesh mask. The mask is initially soft and form-fitting, but hardens quickly for a secure fit and is claustrophobic for many. The metal head frame requires numbing medication injected into your head (2 shots in front, 2 in back) where the frame's pins will secure the frame to your skull. This process is the most anxiety-inducing and painful (due to the injections) part, so Xanax, Ativan or something similar is highly recommended, especially if you are needle-phobic. Once numbed, doctors screw the pins in place but you shouldn't feel anything more than pressure at that point. This isn't very pleasant, but you can get through it and it's necessary. The frame will feel like you're wearing a heavy hat, but you'll adjust after a few minutes. From there, a nurse will transport you to the treatment room via bed or wheelchair, you'll then lay on the table and the frame will be bolted down. It is important that you are completely immobilized, so there's no movement during radiation. The actual procedure is similar to an MRI without the noise and lasts about 20-60 minutes, depending on the number of spots being treated. Once complete, the frame will be removed and bandages applied. You may have small wounds at the pin sites, those will heal and should disappear within a few weeks. Gamma Knife is often highly successful, works best over time (3-9 months) and is repeatable to new spots that may pop up later.

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Nov 23, 2021 10:12AM illimae wrote:

Always happy to contribute. Here are pics of the mesh mask and the frame.



Diagnosed at 41 Stage IV De Novo Dx 11/16/2016, IDC, Left, 5cm, Stage IV, metastasized to bone, Grade 3, 3/13 nodes, ER+/PR-, HER2+ Chemotherapy 1/1/2017 Abraxane (albumin-bound or nab-paclitaxel) Targeted Therapy 1/1/2017 Herceptin (trastuzumab) Targeted Therapy 1/1/2017 Perjeta (pertuzumab) Surgery 6/26/2017 Lumpectomy; Lumpectomy (Left); Lymph node removal Radiation Therapy 8/10/2017 Breast, Lymph nodes Dx 10/5/2017, IDC, Left, 5cm, Stage IV, metastasized to brain, Grade 3, 3/13 nodes, ER+, HER2+ Radiation Therapy 10/19/2017 External Local Metastases 10/19/2017 Brain Radiation Therapy 4/18/2018 External Local Metastases 4/18/2018 Brain Radiation Therapy 5/22/2019 External Local Metastases 5/22/2019 Brain Surgery 1/21/2020 Radiation Therapy 2/16/2020 External Local Metastases 2/16/2020 Brain Radiation Therapy 7/20/2020 External Local Metastases 7/20/2020 Radiation therapy: Bone Radiation Therapy 12/4/2020 External Local Metastases 12/4/2020 Brain Targeted Therapy Tukysa (tucatinib) Chemotherapy Xeloda (capecitabine) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Nov 29, 2021 04:17PM Moveforward wrote:

I had my first gamma knife procedure the middle of September. I’d say I had a slight headache for a few weeks that I attributed to the procedure but not sure that is even a side effect.

The anti anxiety drug they gave prior helped metremendously and I actually felt a bit tipsy as the day wore on. In fact I dozed through the procedure!

Targeted Therapy 5/16/2020 Verzenio
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Nov 29, 2021 05:13PM illimae wrote:

moveforward, headaches are fairly common afterwards. I’ve had soreness at the pin sites when using the frame and random twinges due to the radiation or all the nerves in the head. I’m happy it went well for you and I’ve dozed off too, lol.

Diagnosed at 41 Stage IV De Novo Dx 11/16/2016, IDC, Left, 5cm, Stage IV, metastasized to bone, Grade 3, 3/13 nodes, ER+/PR-, HER2+ Chemotherapy 1/1/2017 Abraxane (albumin-bound or nab-paclitaxel) Targeted Therapy 1/1/2017 Herceptin (trastuzumab) Targeted Therapy 1/1/2017 Perjeta (pertuzumab) Surgery 6/26/2017 Lumpectomy; Lumpectomy (Left); Lymph node removal Radiation Therapy 8/10/2017 Breast, Lymph nodes Dx 10/5/2017, IDC, Left, 5cm, Stage IV, metastasized to brain, Grade 3, 3/13 nodes, ER+, HER2+ Radiation Therapy 10/19/2017 External Local Metastases 10/19/2017 Brain Radiation Therapy 4/18/2018 External Local Metastases 4/18/2018 Brain Radiation Therapy 5/22/2019 External Local Metastases 5/22/2019 Brain Surgery 1/21/2020 Radiation Therapy 2/16/2020 External Local Metastases 2/16/2020 Brain Radiation Therapy 7/20/2020 External Local Metastases 7/20/2020 Radiation therapy: Bone Radiation Therapy 12/4/2020 External Local Metastases 12/4/2020 Brain Targeted Therapy Tukysa (tucatinib) Chemotherapy Xeloda (capecitabine) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)

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