Bruce Pollock, M.D., Neurosurgery, Mayo Clinic: Stereotactic radiosurgery is an outpatient-based radiation procedure. You're going to walk in, have this done, and walk out again. And that's the way we want people to think about radiosurgery.

There's a variety of devices that are used to perform stereotactic radiosurgery. The Gamma Knife is used only to treat the brain and head and upper neck, whereas the linear accelerators are more versatile and can also be used to treat the head but can treat below the neck and the parts of the body as well.

Ian Parney, M.D., Ph.D., Neurosurgery, Mayo Clinic: In some cases, this is something to manage the metastatic brain tumor burden for patients but isn't something that wouldn't necessarily cure them. Other tumors, this is definitely a cure.

Mayo Clinic experience

Debbie Dixon, Mayo Clinic Patient: I've undergone Gamma Knife two times for two separate meningiomas. Gamma Knife is kind of a misnomer because there's no knives.

Dr. Parney: People often think of it like a laser beam and it's not quite like that. But it is very tightly focused and really down to the millimeter level. It is such a high dose and so tightly focused that we can't have people move their head at all during the procedure.

Dr. Pollock: We need to apply a head frame. This head frame has four points where we inject a local anesthetic.

Ms. Dixon: It reminded me of having a tooth filled. It's that, yeah, it stings. It's like up bee sting. And then there's pressure.

Dr. Pollock: Once the frame is in place, we go upstairs for imaging which could be an MRI, could be a CAT scan or potentially a cerebral angiogram.

Dr. Parney: That allows us to rely on our computers to know where the tumor or the lump or the vascular malformations were going to treat, where that is in space relative to the frame. When we go ahead with the treatment, they just lie there. They get the treatment. Most people won't feel anything at all, just like getting an x-ray or any of the radiation treatments that people have undergone.

Ms. Dixon: Nothing. Nothing. No sound. No, no sensation. And I say are you doing it? When are you going to start? Yeah, we're doing it. I mean, it was it was the most anticlimactic thing ever.

Dr. Parney: Many of our patients actually fall asleep at that time.

Dr. Pollock: We are not beside you, but at the same time, we can see you all the time. You can speak to us. We watch your oxygen. We watch your breathing. There is communication. At any point during a procedure, the procedure can be stopped and we can come in and have you sit up and take a break. When you're finished, you'll come out of this device. We take this frame off your head and a short while later, you're ready to go home.

Dr. Parney: I've had one patient send me a picture of himself golfing in the same day that he had Gamma Knife done. Now that's a little extreme, but I think most patients are really surprised at how smoothly this goes.


Nov. 03, 2023