Gammaknife vs Cyberknife

[kerryk]

Its's now time to take action and I'm totally confused about making a choice between the Cyberknife vs Gammaknife treatments.

It seems that doctors recommend whatever machine their facility have. I've read quite a bit about the pros and cons of both treatments, (maybe too much).
So my question is: is it preferable to have one single dose as in the Gammaknife or a series of treatments with the Cyberknife? I understand the Gammaknife has a smaller footprint and less likely to damage healthy surrounding tissue, however, the larger single dose with the Gammaknife may cause other issues because of larger single dose.

I'm scheduled to have a consultation Dr Kevin Choe at Innova Hospital in Fairfax Va, for a possible Cyberknife treatment and then a consultation with Dr. Jason Sheehan at UVA (Gammaknife) at a later date.

Any advice or experiences with either treatment or doctor would be much appreciated.

Diagnosed 2011 Watch and wait

11/1/2024 17mm x 13mm x 18mm

I'm so thankful for this wonder site!

[mwatto]

I had CK almost 6 years ago (x3 sessions) and very few issues. I support it with a healthy lifestyle. Next MRI in March but so far so good. We do not have Gammaknife in Perth and I was told that CK doesnt impact on healthy tissues - I went to 5D clinic here- but whatever you choose the right team matters.

[Derby]

It seems that doctors recommend whatever machine their facility have.

So my question is: is it preferable to have one single dose as in the Gammaknife or a series of treatments with the Cyberknife?

AFAIK, there is no evidence that one has better outcomes than the other. Both technologies have been around for a long time...any differences would have washed out by now.

Go with the MD and facility (and insurance coverage) that works best for you. Which machine they use is at the bottom of the decision list, honestly.

Best of luck to you.

(I had my tx with a Varian True Beam. I personally preferred the thermoplastic mask over getting metal bits put in my skull.)

[donjehle]

Thanks, kerryk, for posting on the ANA Forums.

I am not a physician and cannot give medical advice, but I think you are right when you said that most doctors recommend whatever machine their facility has.  My recommendation is that you do your own study on what treatment you believe is best and then find a specialist who has a lot of experience treating acoustic neuromas with the treatment you are convinced is best for you.

What I do not recommend is going with a specialist who happens to live close to you, but does not have much experience with acoustic neuromas (vestibular schwanomas).  Personally, I feel that the skill of the specialist is much more important than the type of machine which is used.  And since the tumor is in your brain, you should seek the best care you can.

I wish you the best!
Don

[DanFouratt]

I did CK 15 months ago in the one and done format.  There is a presentation out there 7/27/22 about radiation for ANs.  One slide the Doctor has all four options (three above and one other) and stated something like"I have used three of these and there are subtle differences.  The best one is the one your hospital purchased."  I came across this after my treatment and wish I would have watched it before.  All machines can do the one and done or the serial approach. Good Luck on your journey.

Dan

[mwatto]

Out of interest Dan -which one would you have chosen then after watching? We only have CK where in Perth as it happens. I watched that video today and thought I wonder if I should have taken more time instead of the terrified response I had rushing into treatment two weeks after diagnosis. Certainly I had no real support back then and was in no state to explore my options.

[kerryk]

Update: I just had a consultation with Dr. Choe and Innova, Va.and now I'm totally confused, skeptical/cynical.
His recommendations were 5 Cyberknife sessions of 5gy for a total of 25gys of radiation, or 25 sessions of 1.8 gys for a total of 45 gy. Does this sound right? Is this about the amount of visits he can bill the insurance company for or is this about the best option for me? I didn't have the wherewithal to ask at the time because I was overwhelmed with all the other information he was providing.

Sorry for the negative post.

Kerry

[DanFouratt]

Michelle,  I would have stayed with CK as I preferred that team.  Viewing the seminal would have made my decision journey easier, a little less expensive, and less time consuming as I tried to understand the difference in the machines. After all my reading I really thought there was no difference, it was nice to have it confirmed by a professional. PS I am an engineer so I can dive in to the details.

Kerry, I am not a doctor therefore this is not a professional opinion.  In another presentation it was about 1 and done 12gys or 3 and done 6gys (ttl 18 gys) and the doctor said it really is the same amount of radiation.  I will look for this presentation. I have talked with some on who recently had the same two options. For many reasons they went with the 5 and done. I do not think the radiation we absorb is life changing for us. I believe it is a tradeoff be collateral damage (minimal) and dearth of the tumor. I would get another opinion if you are uncomfortable.

I can be a cynic too but I would not be concerned about billing the insurance company as motivation for treatment. Do you take someone with you to these appointments.  I had my wife on many of them, for this and the open heart surgery.  It is helpful to have some as a second set of ears. A friend of mine said he would go if Palma could not make it.  Never took him up on the offer, as two engineers would have made the appointment way too long.

Good luck on your decision journey.

Dan

[Derby]

Update: I just had a consultation with Dr. Choe and Innova, Va.and now I'm totally confused, skeptical/cynical.
His recommendations were 5 Cyberknife sessions of 5gy for a total of 25gys of radiation, or 25 sessions of 1.8 gys for a total of 45 gy. Does this sound right? Is this about the amount of visits he can bill the insurance company for or is this about the best option for me? I didn't have the wherewithal to ask at the time because I was overwhelmed with all the other information he was providing.

Sorry for the negative post.

Kerry

I've never heard of 25 treatments for an acoustic neuroma. Not saying it's never happened, but I've never heard of more than 5. I had 3 tx of 6 Gy for a total of 18 Gy. I personally would refuse a plan of more than 5 treatments.