Cancer Research

Behind the research: New equipment means better patient experience

It’s been an exciting week for me. After years of planning, fundraising and more planning, our new Gamma Knife Icon was installed at Sunnybrook’s Odette Cancer Centre.

The Gamma Knife delivers focused radiation to tumours that have spread (metastasized) to a patient’s brain. The frameless Gamma Knife Icon means the patient doesn’t have to have a frame screwed into their head to keep them still while the radiation beams carefully target their brain tumours. We are the first hospital in Canada to get this machine.

I’m passionate about this work. For a long time, patients with brain tumours and metastases were largely considered at the end of life, and using the fanciest equipment known to man was thought to be unjustified.

But as patients live longer, the focus is to make them live better, and using focused radiation can improve the ability for patients to maintain their memory and quality of life. We owe it to our patients to make their end of life as comfortable and as meaningful as we can, and that’s why technology like the Gamma Knife Icon is so important.

It means a much more comfortable journey through treatment for our patients. It means instead of a frame placed on the head with four screws going into the superficial aspect of the skull, we can now do this highly precise radiosurgery with a mask-based system. No screws.

From speaking with my patients, I know the frame is a source of stress and fear leading up to and during their treatments. When it is applied there is pain and when taken off there is pain. Sometimes there’s bleeding. As one of my patients said, “It feels like something from the medieval times.” Overall it is an invasive aspect to this non-invasive therapy. It’s pretty counterintuitive when we have the most advanced brain radiation unit in the world that we still had to have a frame to place.

The Gamma Knife Icon gives us the opportunity for the latest and most precise treatment for a variety of indications. In particular, the Gamma Knife Icon will allow us treat multiple metastases, which we would not otherwise be able to do with a regular linear accelerator. So a whole new world of brain radiation treatments will be realized.

This is a massive new area of research and development for our team. We are already doing technical research to improve image quality, and as soon as it is installed we will start testing our work and applying it to improve treatments. We received a large federal development grant for this research.

My team and our patients used to stay late into the night in order to do treatments before the Gamma Knife Icon, and we were limited as to how many tumours we could treat due to technical difficulties and the time it took. Now, we are able to treat patients with multiple metastases — 5, 10 or even 15 or more — with the Icon, and because it’s frameless we can break up the treatment into a few lesions a day instead of patients laying in the machine for 4 to 6 hours.

As we get our Icon up and running, we continue to conduct trials to see what’s best for these patients. We’ll move more and more treatments over to our Gamma Knife Icon, which we know will improve the experience of our patients.

About the author

Dr. Arjun Sahgal

Dr. Arjun Sahgal is a radiation oncologist and the head of Odette’s Cancer Ablation Therapy program.