Multiple tumours targeted at once

Multiple tumours treatment — clinical story

Dr John Fuller, a neurosurgeon at Macquarie University Hospital, and his team were able to treat 26 tumours in a single day using new minimally-invasive Gamma Knife radiosurgery technology.

“Patients with multiple brain metastases are often still offered only whole brain irradiation as a palliative measure, which, in light of current literature, is not necessarily appropriate,” said Dr Fuller. “We look at providing the most effective treatment based on current best practice. This approach means treating patients as individuals based on their specific disease and its extent.”

Adele McDonald is one such patient. She first came to Macquarie University Hospital for Gamma Knife treatment in July 2015. She had been diagnosed with metastatic brain tumours, having had breast cancer several years before. “I live north of Brisbane, and whole brain radiation was the only option available to me there at the time,” said Adele. “I wasn’t completely comfortable with this idea.”

“Around the same time, I read a story featuring Associate Professor Matthew Foote from Princess Alexandra Hospital talking about treating multiple lesions with Gamma Knife." Adele sent results from an MRI scan to Dr John Fuller at Macquarie University Hospital. The team reviewed her case and selected Adele as a suitable candidate for Gamma Knife treatment.

“The MRI scan showed that Adele had at least forty tumours,” said Dr Fuller. “We were able to arrange immediate treatment, and she flew to Sydney within a few days.” The Gamma Knife team was able to treat 26 tumours in one day over eight hours, with Adele’s treatment tailored to the specifics of her situation and condition.

“To treat more than forty lesions would require too long a period of treatment that would not have been well tolerated by her,” explained Dr Fuller. “Therefore, to avoid the potential long-term neurocognitive problems associated with whole brain irradiation to the cerebral hemispheres, all of the lesions located in these regions were treated with Gamma Knife surgery. The multiple lesions in her cerebellum were then planned to be treated with non-focused irradiation to this area alone.”

Indeed, Adele returned to Brisbane to have the remaining tumours in her cerebellum treated with radiation. Since then, she has had eight further brain metastases treated stereotactically in Queensland.

“I can’t say that Gamma Knife treatment is easy as you have to lie absolutely still,” said Adele. “However, I can’t speak highly enough of Dr Fuller and the MQ Health team, who were absolutely incredible. Considering what I had to go through, they treated me like family. “My results have been amazing, and it’s nice to share my story,” said Adele. “Two and a half years ago I was told I had six months to live, and I’m still here with my most recent brain scan showing just one tumour, which is pretty amazing.”