Our condolences go out to Marci Faber and her family. She suffered a rare and terrible tragedy described in the recent front page New York Times article “A Pinpoint Beam Strays Invisibly, Harming Instead of Healing.” Her story is a reminder to everyone that radiosurgery is serious business.  We here at Columbia, would like to reassure our patients that we don’t for a minute take it lightly.

It is especially important to get the right type of radiation for the right type of disease and it needs to be done by the right team of doctors and radiation therapy team.

There are two kinds of machines used for radiosurgery; one is the Gamma Knife, and the other is a linear accelerator and there is a BIG difference between the two.

The type of radiosurgery injury described in the Times article was done by a linear accelerator. It is a very sophisticated machine with a lot of moving parts that needs to be highly managed by electronics, computers, and treatment planning systems and should only be used by experts like our own, Dr. Steve Isaacson.

The Gamma Knife, on the other hand, is much simpler. It is one specific machine, made by one company for one purpose and can only be used in a certain way. According to Dr. Michael B. Sisti from the Gamma Knife Center, “There are none of these compatibility or safety issues. There are essentially no moving parts and it has been in use for fifty years (much longer than the linear accelerators).”

Gamma knife is also routinely used in the treatment of trigeminal neuralgia, the condition that caused severe face pain in Marci Farber.  Dr. Sisti says, “This procedure is a slam-dunk, like penicillin, for the Gamma Knife. We have been doing this for 20 years and it’s fortunate we have not encountered this type of complication with Gamma Knife in the treatment of trigeminal neuralgia.”

For most problems we use the Gamma Knife whenever we possibly can; that is about 90% of the time.  To date we have done approximately 2,800 Gamma Knife procedures here.  There are some circumstances, however, where the Gamma Knife is just not going to do the job. For example, says Dr. Sisti, “If the patient has a very large or irregular lesion, or it involves the optic nerve, then we’ve got to go to a linear accelerator, but you have to go to a guy like Dr. Steve Isaacson and his team who are totally immersed in this stuff.”

What’s more important than the type of radiosurgery, is the experience of the team running it. We have been using linear accelerators since 1996 on hundreds of patients with state of the art equipment and experienced radiation physicists, therapists and specialized nurses.

We urge caution in reading the article in the New York Times. The incidences reported, though devastating, are indeed rare and radiation therapy has resolved more pain and saved more lives by far than it has harmed.  Let the article be a reminder to consider all your options and to choose your medical team wisely.

 
Related Blog: Radiation Treatment For Cancer; Don’t Throw The Baby Out With The Bath Water!
Also read the American Society for Radiation Oncology (ASTRO)’s response to the New York Times Article