Gamma Knife Perfexion™ at Archbold
: How Noninvasive Brain Surgery Changed Dorothy Gay’s Life

With the ability to deliver a non-invasive but highly accurate therapeutic dose of radiation to the brain with Gamma Knife, Archbold Memorial Hospital has transformed treatment for patients across the region with brain disorders and cancer metastases (cancer that has traveled to the brain from elsewhere in the body) for the last 12 years.

Using the state-of-the-art radiosurgery equipment, Archbold’s Gamma Knife team has successfully treated nearly 900 patients since the hospital acquired the original Gamma Knife technology through the generosity of Archbold Foundation donors in 2003.

This past October, physicians at Archbold Memorial Hospital’s Singletary Oncology Center treated the first patients using the newest Gamma Knife technology—the Gamma Knife Perfexion™.

The Perfexion™ has been referred to as the “gold standard treatment” for non-invasive brain surgery, and it’s the latest and most precise radiosurgery technology to hit the market. Archbold is one of only 275 hospitals worldwide to acquire Gamma Knife, and Archbold is the only hospital in South Georgia and Florida’s Big Bend region with the technology.

“Gamma Knife Perfexion™ is used to treat disorders of the brain including functional disorders, malignant and benign brain tumors and vascular disorders,” said Archbold neurosurgeon Gerald Kadis, MD. “In many ways it’s really transformed the way we treat brain cancer, but for many patients, Perfexion™ also provides amazing treatment options for other conditions, too.”

Albany, Georgia resident Dorothy Gay was the very first patient to be treated with the Perfexion™ at Archbold.

_MG_3771“I’ve suffered from trigeminal neuralgia for over 15 years,” said Gay.
“I kept hoping that as I got older, the symptoms would get better, but my experience was just the opposite.”

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. Most patients initially experience short, mild attacks, but trigeminal neuralgia can progress and cause longer, more-frequent bouts of searing pain.

The condition, which affects women more often than men, is more likely to occur in people who are older than 50, and the symptoms can be extremely painful.

“My symptoms were devastatingly severe,” said Ms. Gay. “For an entire year I experienced eye seizures and excruciating pain in the left side of my face. I couldn’t talk, watch television, do housework or even read. I also developed severe anxiety and depression. My condition was so severe that it robbed our family of our Thanksgiving and Christmas celebrations last year.”

Ms. Gay tried many medications to help with the pain and seizures, but instead of achieving the much needed relief, she had adverse reactions to the medication.

“I was willing to try anything to get the relief I needed,” said Ms. Gay. “My neurologist in Moultrie explained the invasive treatment options available, but he told me he wouldn’t recommend them for me. The invasive procedures were just too drastic for someone my age. So that’s when he recommended Gamma Knife.”

Utilizing advanced diagnostic imaging and three-dimensional treatment planning software, Gamma Knife delivers up to 192 precisely focused beams of gamma radiation to targets (tumors or brain malformations) inside the brain and surrounding structures. The individual beams are weak, and pass through healthy tissue leaving it unharmed. Radiation treatment is only delivered at a single, finely focused point where all 192 beams converge to treat the diseased tissue, while nearby healthy tissue is spared.

“Because Gamma Knife is the least invasive procedure for trigeminal neuralgia, it is a good treatment option for older patients and patients with co-morbidities or other high-risk medical illnesses,” said Dr. Kadis. “In Ms. Gay’s case, it was really the best treatment option.”

The first step in Ms. Gay’s treatment was the attaching of a lightweight stereotactic frame to her head. The patient had an MRI to localize the precise point where the trigeminal nerve arose from the brainstem. Data from the imaging study was transferred into the treatment planning computer. While she rested, the treatment team (a neurosurgeon, radiation oncologist and physicist) used advanced software to determine the treatment plan. Once the individual treatment plan was complete, Ms. Gay was placed on the Gamma Knife couch and precisely positioned. The patient was then moved automatically, head first into the machine, and treatment began.

“Once the treatment started, we monitored the patient on a screen from the room next door. With the former technology, we would have stopped treatment to reposition the patient several times. But with Perfexion, all adjustments are made inside the machine, which streamlined the treatment time tremendously,” said radiation oncologist Steve Johnson, MD. “The flexibility and breadth of options for altering the treatment beams are incredible and proved to be very fast compared to our former Gamma Knife machine. The Perfexion does what we’ve done for years, but it does it better and faster.”

Ms. Gay said the procedure was very quick and involved very little pain and discomfort.

 “I’m so thankful to the Archbold team who took such great care of me while I was a patient. They calmed my fears and ensured I was comfortable,” said Ms. Gay. “And I’m so grateful that the treatment really worked for me. I feel like a huge weight has been lifted. Since my Gamma Knife procedure, I have had relief from facial pain and I haven’t had any eye seizures. I was able to quickly return to doing the things that I enjoy including going to church, reading and I was even able to cook Thanksgiving dinner and Christmas shop for my family this year.”

“The Perfexion™ truly is amazing technology,” said Dr. Kadis. “It’s especially valuable for patients whose neurological disorders require a difficult surgical approach or those who may not be possible to treat at all using conventional neurosurgical techniques.”

In addition, the treatment can be used as an adjunct to the care of a patient who has undergone conventional brain surgery, interventional neuroradiology, conventional radiation therapy or chemotherapy.

“We’re so fortunate to have this technology in our region, and it’s truly unheard of to have a Gamma Knife in a town the size of Thomasville. But when it comes to acquiring the best technology to take care of our patients, Archbold has always been ahead of the curve,” said Dr. Johnson.

Most patients are referred to the Gamma Knife program by their doctors. However, some make self-referrals. The Gamma Knife team reviews each patient’s records to determine if Gamma Knife radiosurgery treatment would be appropriate and advantageous.

“Since we started the Gamma Knife program in 2003, we’ve treated patients from 6 states and 48 counties in Georgia and Florida. We want patients to know that there are treatment options out there for multiple brain metastases and brain malformations in traditionally inaccessible or functionally critical areas of the brain. We really encourage these patients to reach out to us to see if they could be a candidate for Gamma Knife. We’re believers in this technology. The patient outcomes have been tremendous. And we truly want to help as many patients as possible.”

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