Gamma Knife Effectively Treats Intractable Cancer Pain, Essential Tremors


The LI Gamma Knife’s interdisciplinary team of neurosurgeons, radiation oncologists, physicists, and nurses have expanded the use of the Gamma Knife to treat intractable cancer pain as well as essential tremors (ET).
Since opening Long Island Gamma Knife® in 2002, nearly 1,000 patients have received Gamma Knife treatment at South Nassau, including patients with trigeminal neuralgia, arteriovenous malformations (AVM's) and a wide variety of tumors.

The LI Gamma Knife has expanded the use of the Gamma Knife to treat intractable cancer pain and essential tremors (ET).

Intractable cancer pain (also referred to as thalamic pain syndrome) is considered to be incurable. Cancer pain may be caused by the cancer itself or it could result from the treatment. Pain lasting more than a few days or longer may be caused by a tumor putting pressure on organs, nerves or bone; poor blood circulation because the cancer has blocked blood vessels; blockage of an organ or tube in the body; metastasis – cancer cells that have spread to other sites in the body; infection or inflammation; side effects from chemotherapy, radiation therapy, or surgery; and stiffness from inactivity.

Treatment regimens including medication (chemical hypophysectomy) and functional neurosurgery (surgical hypophysectomy) have been used to control intractable cancer pain without much short- or long-term success. Gamma Knife Pituitary Radiosurgery (GKPR) or Gamma Knife hypophysectomy has proven to be an effective alternative and it is being used with increasing frequency to bring short- and long-term pain relief to cancer patients without any secondary side effects.

The pituitary gland is called the "master gland" because it controls all other glands, constantly monitoring body functions and sending signals to organs and glands to control their function and to maintain the appropriate environment in the body. GKPR delivers a single high dose of radiation to the pituitary, ablating or creating a lesion in the gland, eradicating the sensation of pain. (Gamma Knife radiosurgery of the pituitary gland is used as a last resort. It is known that even partial destruction of the pituitary gland can improve cancer-induced chronic pain from hormonally dependent metastatic tumors.)
Essential Tremors (ET) affects millions of children and adults. ET most often affect the hands, but may also affect the head and neck, face, jaw, tongue, voice (causing a shaking or quivering sound), and the trunk. Most people with ETs have an episode when the body or a part of the body is held in a certain position (referred to as postural tremor) or when performing a particular action such as writing or eating (action-specific tremor). Approximately 1 in 20 people older than age 40 and 1 in 5 people over 65 have ETs.

Gamma Knife Thalamotomy (GKT) is a safe and precise intervention that results in life-altering improvements in cases of ETs. GKT treats the thalamus, a tiny area of the brain that controls some involuntary movements. After GKT, 90% of patients with ETs have experienced a clinically meaningful improvement in their ET score, with 50-78% of patients reporting either no or slight or very slight intermittent ETs.

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