Refer a Patient - Who is an Appropriate Candidate?

The Gamma Knife is a dedicated radiation device exclusively for treating disease within the head.

While most of our patients are sent to us from radiation oncologists and neurosurgeons, some too, come to us directly. Good candidates for gamma knife radiosurgery include:

Brain Tumors

The Gamma Knife is very effective in the treatment of brain tumors whether the tumor is a primary tumor (glioma, astrocytoma, meningioma) or secondary tumor (brain metastases - tumors that have their origin from cancer from another part of the body).

Metastatic Brain Tumors

If you have seen a medical oncologist and you have disease progression that includes a metastatic brain tumor or tumors, we need to have you see either Dr. Alex MacKay or Dr. John Demakas as soon as possible. (hyperlink the underlined to 'refer a patient' page for each.) We will set you up with the appointments with the neurosurgeon as well as our radiation oncologists within a week and often can treat you within two weeks of your contacting us.

Primary Brain Tumors

If you have a primary brain tumor, we need to have you forward your charts and films to our office (link this to contact page). We will set you up with an appointment with one of our neurosurgeons and radiation oncologists who will let you know what can be done with the gamma knife.

Pituitary Tumors

These tumors are often associated with thyroid, adrenal and reproductive gland problems because the pituitary controls all their functions. Gamma Knife surgery is often effective in treating these difficult-to-access tumors.

Trigeminal Neuralgia / Pain Management

If your pain is not under control with your current treatment for facial pain or pain associated with cancer, the Gamma Knife of Spokane may be able to help you. If your pain has been diagnosed as Trigeminal Neuralgia, contact our office and we'll set you up for evaluation by one of our neurosurgeons (link to 'refer a patient' page). If you suffer from pain associated with bone cancer, we may also be able to help you. Please contact our office (link this to contact page) and Jill, the nurse coordinator, will set you up for an evaluation.

Most of our trigeminal neuralgia patients have been on medication to control their facial pain, which feels like an electrical shock. The source of the pain is not in the face at all but frequently comes from an irritation to the fifth cranial nerve, which conducts facial sensation. While surgical intervention has been very effective for these patients, Gamma Knife offers an alternative that creates a lesion on the nerve itself that blocks the transmission of this pain.

Cancer Pain

By targeting the pituitary with the Gamma Knife, our team can perform a radiosurgical hypophysectomy which, in the case of intractable cancer pain, can stimulate production of the body's own pain-killing chemicals.

Tremors

Deep brain stimulation research has identified an area of the brain (close to the VIM nucleus) through which electrical signals are transmitted that cause the hands of a patient to tremble or move uncontrollably. This target can be reached with a 4mm 'shot' of radiation from the Gamma Knife that will create scar tissue that will prevent the transmission of this unwanted signal. Whether it is an essential tremor, Parkinsonian tremor or one associated with multiple sclerosis, the Gamma Knife has been effective in reducing the tremor or eliminating it altogether.

If you have been diagnosed with either essential tremor or Parkinsonian tremor, there is research and our own experience that indicates you may benefit from gamma knife treatment. Working closely with Dr. David Greeley, a neurologist specializing in movement disorders, our center has seen results similar to the findings of the aforementioned research. For additional information, contact Dr. Greeley directly and ask him about your suitability for gamma knife intervention.

Arteriovenous Malformations (AVMs)

When veins and arteries connect directly rather than through capillaries, the body is susceptible to rupture, causing severe bleeding, headaches or seizures. While the most effective way to eliminate these malformations is by 'surgical clipping', often patients opt for a less invasive method of control. The radiation from the Gamma Knife causes the lining of the blood vessel at the target to thicken over time, creating a blockage that, over time, reduces the chance of rupture.

Acoustic Neuromas (vestibular schwannomas)

Dr. Neil Giddings, neuro-otologist, has surgically removed hundreds of acoustic neuromas (benign tumors that develop on the nerve that effect hearing and balance). Dr. Giddings now uses the Gamma Knife extensively for treating these tumors because of its lower risk of deafness and facial movement.