Choosing Medical Doctor for Gamma Knife procedure

[jeholloway]

When having surgery for an acoustic neuroma, many patients go to great length to find the most experienced surgeons who do a large number of cases.  Many are willing to travel significant distance to have the procedure done by the surgeon they choose.

When patients will be having the Gamma Knife procedure is it equally important to go to great lengths to find the most experienced physician who has done a certain number of cases. How many AN cases should a neurosurgeon have done to have highest possible skill level/accuracy?

jeholloway

[Pembo]

I chose Dr Lunsford at UPMC because he has been involved with gamma knife and AN's for many many years. In my research he and the team at UVa came up as the best.

[Patti]

good question!

[rupert]

I agree with Pembo.   Seek out the best doctors experienced with AN's. Better outcomes usually come with more experienced teams.  With GK you also have an advantage because it's only a day and a half procedure.  You usually meet with the doctor  the day before and then you're good to go after the treatment the next day.  This allows for treatment anywhere in the Country for just a few hours plane ride and maybe a hotel for the night.

[jeholloway]

Thanks for your responses.  Since the use of Gamma Knife involves a team made up of Neurosurgeon, ENT (preferably a neurotologist) radiation oncologist, and physicist, who is the most important member of the team.  If we assume we want the Neurosurgeon to have done over 100 GK cases, should we reject a team where other members have done fewer than 100?

[rupert]

It's certainly a team approach but,   The neurosurgeon is the lead and they are the ones you consult with about your treatment. They are involved pretty much start to finish.   You can look up the credentials of all involved and usually these people are very well versed in their fields also.  Keep in mind that GK is used to treat many types of tumors other than AN's so these teams can do thousands and thousands of procedures and that equals a lot of experience.  The surgeon also has many areas of expertise besides treating An's.  My doctor, Dr.  Kondziolka had a very fine reputation overall as a surgeon treating other conditions besides AN's but,  his reputation with AN's spoke for itself.  So not only would I look at the number of AN's that they treat,  I would also look to see if they were great surgeons overall.  When you're looking at GK centers,  you're not looking at 100's done you're looking at many thousands done.  I know at UPMC in Pittsburgh they have well over 15,000 Gk procedures under their belt and many thousand of those were AN's.  Did I mention UPMC was a great GK center. 

[Gearbox123]

Hi, I used Dr Kondziolka, he is now at NYU . He is a great Doctor! I used Dr Silverman he is the Radiation Oncologist, very nice guy also, my E.N.T is Dr Jethanamest. I hope you find the team that you are most comfortable with but I met a lot of them in NYC area and all top notch. Best of luck.

[Freelander]

AN is a rare condition so the number of actual procedures is a fraction of the total number of GK procedures that a doctor may perform.  Having been to Dr. K at NYU for a GK consultation and to Dr. Chang at Stanford Health for a CK consultation, both are highly regarded in their field, they estimated they had each done about 1,000 AN treatments.   The larger that number plus the length of time the team (neurologist, radiation oncologist and medical physicist) has worked together, and patient feedback are all good factors to consider.  Above all, we need to be comfortable with our decision about who to use.

[SueLL]

An important thing to consider when choosing your treatment is the follow-up.  I chose to travel for the "best" GK doctor and alienated the local specialists who also recommended GK at their shops.  Then I never had a good neurologist for follow-up. 

[buzneg]

One resource I used was US News rankings of not only Neurology/Neurosurgery Dept. but also their more specific category called:

Advanced technologies
Diagnostic radioisotope services, image-guided radiation therapy, PET/CT scanner, single-photon-emission CT and stereotactic radiosurgery.

Example:
University of Texas MD Anderson Cancer Center - an "Excellent" rating of 5 out of 5


...as well as looking at their general rankings in Neurology/Neurosurgery

Example:

Mayo Clinic
 (507) 405-0312 | Rochester, MN 55902-1906
#1 in Adult Neurology & Neurosurgery Hospitals
Mayo Clinic in Rochester, MN is nationally ranked in 15 adult specialties and 9 pediatric specialties.

I only considered places ranked in the top 50 and had a perfect score in the category that included:
Advanced technologies of -
Diagnostic radioisotope services, image-guided radiation therapy, PET/CT scanner, single-photon-emission CT and stereotactic radiosurgery.

But that was just me coming up with my own system.  Everybody is different.

[Blw]

Lunsford trained with the guy that invented the Gk machine that is used (Leksel) and is without a doubt the best. He has probably done more than 10,000, and publishes his studies regularly. I didn't have mine done by him, I went to UVA with someone who trained with him (didn't want to go to Pittsburgh in January). You want someone who has done a ton of these. It is not hard to find surgeons and radiators who have done 1000+, so those are who you should consider.

[robinb]

I went to Lunsford and I live in CA (and I went in January! I did have complications (minor) but everything was handled perfectly via email and phone. If my doc was local they would have made me come in every tin=me and paid a copay!

Didn't feel the need for face time.


You can read my thread; its in my sig below

-Robin.